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Yu YH, Yen TY, Hung SK, Chen SH, Wang KY. A 3D-printed phantom for stereotactic body radiation therapy simulation. Biomed Phys Eng Express 2024; 10:025034. [PMID: 38350115 DOI: 10.1088/2057-1976/ad28cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/13/2024] [Indexed: 02/15/2024]
Abstract
In modern radiation therapy for lung cancer, examining the uncertainty between tumor motion and beam delivery is vitally important. To lower the radiation dose delivery to the patient's normal tissue, narrowing the irradiation field margin to hit the tumor accurately is critical. Thus we proposed a phantom that simulates the thorax and lung tumor's motions by employing a 3D printing technique. The lung tumor is controlled by a linear miniature Delta robot arm, with a maximum displacement of 20 mm in each direction. When we simulated the thoracic breathing movements at 12 mm in A-P (Anterior-Posterior), the control errors were within 10%. The average tracking errors of the prosthetic tumor were within 1.1 mm. Therefore, the 3D-printed phantom with a robot arm can provide a reliable simulation for training and dosimetry measurement before lung radiotherapy, especially SBRT.
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Affiliation(s)
- Ying-Hao Yu
- Department of Electrical Engineering and AIM-HI, National Chung Cheng University, Taiwan
| | - Tsung-Yu Yen
- Department of Radiation Oncology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shih-Kai Hung
- Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shi-He Chen
- Department of Electrical Engineering and AIM-HI, National Chung Cheng University, Taiwan
| | - Kuei-Ying Wang
- Department of Nursing, Chang-Jung Christian University, Taiwan
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2
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Perrone C, Bozzano F, Dal Bello MG, Del Zotto G, Antonini F, Munari E, Maggi E, Moretta F, Farshchi AH, Pariscenti G, Tagliamento M, Genova C, Moretta L, De Maria A. CD34 +DNAM-1 brightCXCR4 + haemopoietic precursors circulate after chemotherapy, seed lung tissue and generate functional innate-like T cells and NK cells. Front Immunol 2024; 15:1332781. [PMID: 38390333 PMCID: PMC10881815 DOI: 10.3389/fimmu.2024.1332781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/17/2024] [Indexed: 02/24/2024] Open
Abstract
Background There is little information on the trajectory and developmental fate of Lin-CD34+DNAM-1bright CXCR4+ progenitors exiting bone marrow during systemic inflammation. Objective To study Lin-CD34+DNAM-1bright CXCR4+ cell circulation in cancer patients, to characterize their entry into involved lung tissue and to characterize their progenies. Methods Flow cytometric analysis of PBMC from 18 patients with lung cancer on samples collected immediately before the first and the second treatment was performed to study Lin-CD34+DNAM-1bright CXCR4+ precursors. Precursors were purified (>99%) and cultured in vitro from all patients. Paired PBMC and tissue samples from patients undergoing tumor resection were analyzed by flow cytometry to assess tissue entry and compare phenotype and developmental potential of Lin-CD34+DNAM-1bright CXCR4+ cells in both compartments. Results Significant circulation of Lin-CD34+DNAM-1bright CXCR4+ precursors was observed 20d after the first treatment. Precursors express CXC3CR1, CXCR3, CXCR1 consistent with travel towards inflamed tissues. Flowcytometric analysis of lung tissue samples showed precursor presence in all patients in tumor and neighboring uninvolved areas. Successful purification and in vitro culture from both blood and lung tissue generates a minor proportion of maturing NK cells (<10%) and a predominant proportion (>85%) of α/β T-progenies with innate-like phenotype expressing NKG2D,NKp30,DNAM-1. Innate-like maturing T-cells in vitro are cytotoxic, can be triggered via NKR/TCR co-stimulation and display broad spectrum Th1,Th2 and Th1/Th17 cytokine production. Conclusion In advanced stage lung cancer CD34+DNAM-1brightCXCR4+ inflammatory precursors increase upon treatment, enter involved tissues, generate functional progenies and may thus represent an additional player contributing to immune balance in the highly SDF-1/CXCR4-biased pro-metastatic tumor microenvironment.
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Affiliation(s)
- Carola Perrone
- Experimental Immunology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Federica Bozzano
- Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Genny Del Zotto
- Integrated Department of Services and Laboratories, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Francesca Antonini
- Integrated Department of Services and Laboratories, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Enrico Munari
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Enrico Maggi
- Tumor Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Moretta
- Department of Laboratory Medicine, Istituto di Ricovero e Cura a Carattere Scientifico Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Gianluca Pariscenti
- Thoracic Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marco Tagliamento
- Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genova, Italy
| | - Carlo Genova
- Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genova, Italy
| | - Lorenzo Moretta
- Tumor Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea De Maria
- Department of Health Sciences, University of Genova, Genova, Italy
- Infections of Immunocompromised Hosts Unit, Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Kimiaei A, Safaei S, Çağan P, Kutlu CA. Emergency Surgical Intervention in Microwave Ablation-Induced Massive Lung Necrosis. Cureus 2024; 16:e54542. [PMID: 38516481 PMCID: PMC10956637 DOI: 10.7759/cureus.54542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Microwave ablation (MWA) has become an increasingly used procedure for the management of lung nodules in recent years. Here, we report a 33-year-old female presenting with massive pulmonary necrosis and tension pneumothorax after MWA for metastatic colon cancer. She required surgical intervention, including thoracotomy, debridement, and wedge resection, for the management of these complications.
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Affiliation(s)
- Ali Kimiaei
- Thoracic Surgery, Bahçeşehir University, Istanbul, TUR
| | | | - Pinar Çağan
- Thoracic Surgery, Bahçeşehir University, Istanbul, TUR
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Gupta P, Chugh S, Gupta N, Gupta K, Sodhi KS, Kakkar N, Srinivasan R, Rohilla M, Kundu R, Trehan A, Bansal D, Peters NJ. Cytomorphologic and immunocytochemical characterization of pediatric pleuropulmonary blastoma with a comprehensive review of the literature. Diagn Cytopathol 2024; 52:103-115. [PMID: 37964698 DOI: 10.1002/dc.25254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Pleuropulmonary blastoma (PPB) is a rare, aggressive, primary intrathoracic malignancy typically seen in infancy and early childhood. Accurate distinction from congenital cystic lung lesions is crucial due to significant prognostic and therapeutic differences. Cytologic features have rarely been described. Establishing a cytodiagnosis is challenging owing to its rarity, lack of awareness, and multiple morphologic mimics. MATERIALS AND METHODS This was a retrospective study conducted over 8 years. The histopathology and cytopathology databases were searched for all pediatric PPB cases. The corresponding cytologic samples were reviewed to identify characteristic features that can help distinguish PPB from its mimics. RESULTS There was a total of six cases of pediatric PPB reported during the study period. Of these, four (66.7%) presented as intrathoracic, and two (33.3%) as pleural-based masses. Cytology smears showed discretely scattered and perivascular arrangements of round-oval tumor cells with background eosinophilic stromal material. The tumor cells were mildly pleomorphic (n = 3) with round nuclei, fine chromatin, inconspicuous nucleoli, and scanty cytoplasm; however, three cases showed marked anaplasia, and one each showed necrosis and rhabdoid differentiation. On immunocytochemistry (4/6), these were positive for vimentin and desmin and negative for WT1, chromogranin, SALL4, cytokeratin, CD45, and CD99. FISH (1/6) did not show N-Myc amplification. CONCLUSIONS Knowledge of the characteristic cytomorphological and immunocytochemical features of PPB is vital to establish a prompt and accurate cytodiagnosis with appropriate clinicoradiologic correlation.
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Affiliation(s)
- Parikshaa Gupta
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjoli Chugh
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kushaljit Singh Sodhi
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Kakkar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Reetu Kundu
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amita Trehan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Bansal
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Ley S. Impact of pulmonary fibrosis on tumor measurements. J Thorac Dis 2024; 16:6-7. [PMID: 38410575 PMCID: PMC10894367 DOI: 10.21037/jtd-2023-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/05/2023] [Indexed: 02/28/2024]
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Manabe Y, Shiinoki T, Fujimoto K, Ueda K, Karita M, Ono T, Kajima M, Tanaka H. Intra- and inter-fractional variations of tumors with fiducial markers measured using respiratory-correlated computed tomography images for respiratory gated lung stereotactic body radiation therapy. J Appl Clin Med Phys 2024:e14280. [PMID: 38252745 DOI: 10.1002/acm2.14280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 10/22/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE This study evaluated the intra- and inter-fractional variation of tumors with fiducial markers (FMs), relative to the tumor-FM distance, to establish how close an FM should be inserted for respiratory-gated stereotactic body radiation therapy (RG-SBRT). METHODS Forty-five lung tumors treated with RG-SBRT were enrolled. End-expiratory computed tomography (CT) (CTplan ) and four-dimensional-CT (4D-CT) scans were obtained for planning. End-expiratory CT (CTfr ) scanning was performed before each fraction. The FMs were divided into two groups based on the median tumor-FM distance in the CTplan (Dp ). For the intra-fractional variation, the correlations between the corresponding tumor and FM intra-fractional motions, defined as the centroid coordinates of those in each 0-90% phase, with the 50% phase of 4D-CT as the origin, were calculated in the left-right, anterior-posterior, and superior-inferior directions. Furthermore, the maximum difference in the tumor-FM distance in each phase of 4D-CT scan, based on those in the 50% phase of 4D-CT scan (Dmax ), was obtained. Inter-fractional variation was defined as the maximum distance between the tumors in CTplan and CTfr , when the CT scans were fused based on each FM or vertebra. RESULTS The median Dp was 26.1 mm. While FM intra-fractional motions were significantly and strongly correlated with the tumor intra-fractional motions in only anterior-posterior and superior-inferior directions for the Dp > 26 mm group, they were significantly and strongly correlated in all directions for the Dp ≤ 26 mm group. In all directions, Dmax values of the Dp ≤ 26 mm group were lower than those of the Dp > 26 mm group. The inter-fractional variations based on the Dp ≤ 26 mm were smaller than those on the Dp > 26 mm and on the vertebra in all directions. CONCLUSIONS Regarding intra- and inter-fractional variation, FMs for Dp ≤ 26 mm can increase the accuracy for RG-SBRT.
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Affiliation(s)
- Yuki Manabe
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Kazushi Ueda
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Masako Karita
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Taiki Ono
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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Wang Z, Wu W, Wu S, Zhou Z, Zhang H. An Automatic Needle Puncture Path-Planning Method for Thermal Ablation of Lung Tumors. Diagnostics (Basel) 2024; 14:215. [PMID: 38275462 PMCID: PMC10814031 DOI: 10.3390/diagnostics14020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Computed tomography (CT)-guided thermal ablation is an emerging treatment method for lung tumors. Ablation needle path planning in preoperative diagnosis is of critical importance. In this work, we proposed an automatic needle path-planning method for thermal lung tumor ablation. First, based on the improved cube mapping algorithm, binary classification was performed on the surface of the bounding box of the patient's CT image to obtain a feasible puncture area that satisfied all hard constraints. Then, for different clinical soft constraint conditions, corresponding grayscale constraint maps were generated, respectively, and the multi-objective optimization problem was solved by combining Pareto optimization and weighted product algorithms. Finally, several optimal puncture paths were planned within the feasible puncture area obtained for the clinicians to choose. The proposed method was evaluated with 18 tumors of varying sizes (482.79 mm3 to 9313.81 mm3) and the automatically planned paths were compared and evaluated with manually planned puncture paths by two clinicians. The results showed that over 82% of the paths (74 of 90) were considered reasonable, with clinician A finding the automated planning path superior in 7 of 18 cases, and clinician B in 9 cases. Additionally, the time efficiency of the algorithm (35 s) was much higher than that of manual planning. The proposed method is expected to aid clinicians in preoperative path planning for thermal ablation of lung tumors. By providing a valuable reference for the puncture path during preoperative diagnosis, it may reduce the clinicians' workload and enhance the objectivity and rationality of the planning process, which in turn improves the effectiveness of treatment.
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Affiliation(s)
- Zhengshuai Wang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing 100054, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100021, China
| | - Honghai Zhang
- Beijing Youan Hospital, Capital Medical University, Beijing 100054, China
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La Rosa A, Mittauer KE, Bassiri N, Rzepczynski AE, Chuong MD, Yarlagadda S, Kutuk T, McAllister NC, Hall MD, Gutierrez AN, Tolakanahalli R, Mehta MP, Kotecha R. Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors. Tomography 2024; 10:169-180. [PMID: 38250959 PMCID: PMC10820032 DOI: 10.3390/tomography10010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Radiotherapy for ultracentral lung tumors represents a treatment challenge, considering the high rates of high-grade treatment-related toxicities with stereotactic body radiation therapy (SBRT) or hypofractionated schedules. Accelerated hypofractionated magnetic resonance-guided adaptive radiation therapy (MRgART) emerged as a potential game-changer for tumors in these challenging locations, in close proximity to central organs at risk, such as the trachea, proximal bronchial tree, and esophagus. In this series, 13 consecutive patients, predominantly male (n = 9), with a median age of 71 (range (R): 46-85), underwent 195 MRgART fractions (all 60 Gy in 15 fractions) to metastatic (n = 12) or primary ultra-central lung tumors (n = 1). The median gross tumor volumes (GTVs) and planning target volumes (PTVs) were 20.72 cc (R: 0.54-121.65 cc) and 61.53 cc (R: 3.87-211.81 cc), respectively. The median beam-on time per fraction was 14 min. Adapted treatment plans were generated for all fractions, and indications included GTV/PTV undercoverage, OARs exceeding tolerance doses, or both indications in 46%, 18%, and 36% of fractions, respectively. Eight patients received concurrent systemic therapies, including immunotherapy (four), chemotherapy (two), and targeted therapy (two). The crude in-field loco-regional control rate was 92.3%. No CTCAE grade 3+ toxicities were observed. Our results offer promising insights, suggesting that MRgART has the potential to mitigate toxicities, enhance treatment precision, and improve overall patient care in the context of ultracentral lung tumors.
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Affiliation(s)
- Alonso La Rosa
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
| | - Kathryn E. Mittauer
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Nema Bassiri
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Amy E. Rzepczynski
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
| | - Michael D. Chuong
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Sreenija Yarlagadda
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
| | - Tugce Kutuk
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
| | - Nicole C. McAllister
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
| | - Matthew D. Hall
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Alonso N. Gutierrez
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Ranjini Tolakanahalli
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Minesh P. Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Rupesh Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA; (K.E.M.); (N.B.); (A.E.R.); (M.D.C.); (S.Y.); (T.K.); (N.C.M.); (M.D.H.); (A.N.G.); (R.T.); (M.P.M.)
- Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
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Oláh CZ, Oláh B, Demeter B, Papp A. [An enormous epidural abscess secondary to cranial metastasis of a lung tumor]. Orv Hetil 2024; 165:69-73. [PMID: 38219235 DOI: 10.1556/650.2024.32943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/30/2023] [Indexed: 01/16/2024]
Abstract
Epiduralis abscessus a leggyakrabban otitis media, sinusitis és mastoiditis
következtében alakul ki. Ezekben az esetekben a kórokozók a legtöbbször a vénás
és artériás rendszeren keresztül jutnak az epiduralis térbe, míg nyílt törések
vagy idegsebészeti műtétek során direkt módon is kerülhetnek baktériumok a
koponyacsont és a dura közé. Esetismertetésünk irodalmi ritkaságnak tekinthető,
mivel az enormis nagyságú epiduralis tályog kialakulásában szerepet játszott a
tüdődaganat áttéte miatt kialakult craniumdestrukció, mely megnyitotta a nem
steril sinusokat és a mastoid rendszert az epiduralis tér irányába. A gyors
állapotromlásban szerepet játszott a beteg szegényes együttműködése és krónikus
alkoholizálása. Orv Hetil. 2024; 165(2): 69–73.
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Affiliation(s)
- Csaba Zsolt Oláh
- 1 Tokaj-Hegyalja Egyetem, Lorántffy Intézet Sárospatak Magyarország
- 2 B.-A.-Z. Vármegyei Központi Kórház és Egyetemi Oktatókórház, Idegsebészeti Osztály Miskolc, Szentpéteri kapu 72-76., 3526 Magyarország
| | - Benedek Oláh
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar Budapest Magyarország
| | - Béla Demeter
- 2 B.-A.-Z. Vármegyei Központi Kórház és Egyetemi Oktatókórház, Idegsebészeti Osztály Miskolc, Szentpéteri kapu 72-76., 3526 Magyarország
| | - Attila Papp
- 2 B.-A.-Z. Vármegyei Központi Kórház és Egyetemi Oktatókórház, Idegsebészeti Osztály Miskolc, Szentpéteri kapu 72-76., 3526 Magyarország
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10
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Su JM, Huang WL, Huang HC, Tseng YL, Li MJ. A scenario-based web app to facilitate patient education in lung tumor patients undergoing video-assisted thoracoscopic surgery: Development and usability testing. Digit Health 2024; 10:20552076241239244. [PMID: 38495861 PMCID: PMC10944589 DOI: 10.1177/20552076241239244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
Background Patient education (PE) is essential for improving patients' knowledge, anxiety, and satisfaction, and supporting their postoperative recovery. However, the advantages of video-assisted thoracoscopic surgery (VATS)-smaller incisions and faster recovery-can result in shorter hospital stays, making PE more challenging to implement effectively. Multimedia PE can potentially enhance PE, but its effectiveness for patients undergoing VATS is unclear. Objective This study developed a scenario-based PE web app for lung tumor patients undergoing VATS (SPE-VATS) to facilitate the PE process and evaluated its usability through a clinical trial. Methods The SPE-VATS provided the experimental group (EG: 32 participants) with interactive scenario, query guidance, diagnostic analysis, experience sharing, and active reminder, while the control group (CG: 32 participants) used pamphlets and videos. The usability of SPE-VATS in terms of postoperative anxiety reduction and patient satisfaction with the app was evaluated using self-reported questionnaires based on the state-trait anxiety inventory, technology acceptance model, system usability scale, and task load index. Results There was no statistically significant difference in postoperative anxiety reduction between the EG and CG, possibly because 90% of the participants underwent a low-risk surgical type, and VATS is known to be advantageous in alleviating surgical anxiety. However, females and higher educated EG participants showed a non-significant but favorable reduction than their CG counterparts. Moreover, the EG was highly satisfied with the app (rated 4.2 to 4.4 out of 5.0), with no significant gender and education level difference. They particularly valued the interactive scenario, experience sharing, and diagnostic analysis features of SPE-VATS. Conclusions The SPE-VATS demonstrated its usability and high patient satisfaction, particularly for female and higher educated patients. Low-risk patient predominance and VATS's advantages may explain non-significant postoperative anxiety reduction, warranting further studies on high-risk patients to evaluate the impact of SPE-VATS on clinical practice.
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Affiliation(s)
- Jun-Ming Su
- Department of Information and Learning Technology, National University of Tainan, Tainan, Taiwan
| | - Wei-Li Huang
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Huang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yau-Lin Tseng
- Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Jhen Li
- Institute of Learning Sciences, National Tsing Hua University, Hsinchu, Taiwan
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11
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Bellegarde SB, Gibson V, Andaz S, Purrazella R, Robinson E, Noel P, Punter L, Tofuah D, Gapizov A, Ekhator C. Rare Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) Finding in a 9/11 World Trade Center Survivor: A Case Report. Cureus 2024; 16:e51862. [PMID: 38327919 PMCID: PMC10848887 DOI: 10.7759/cureus.51862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/09/2024] Open
Abstract
Bronchial carcinoid tumors represent a relatively uncommon category within lung neoplasms, originating from neuroendocrine cells. The exact cause of these pulmonary tumors remains not fully understood. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is characterized by widespread hyperplasia of these neuroendocrine cells, essential for regulating air and blood flow in response to stimuli such as hypoxia, dyspnea, and chronic obstructive pulmonary disease (COPD). The prognosis for bronchial carcinoid tumors hinges on factors such as grade and stage, with lung resection being the preferred treatment. A chest computed tomography (CT) scan unveiled diffuse bilateral pulmonary nodules with ground-glass opacities, leading to a right video-assisted thoracoscopic surgery (VATS) wedge resection. Immunohistochemical examination confirmed neuroendocrine differentiation, describing a lung wedge measuring 9 × 4 × 1.5 cm with spongy parenchyma and scattered white nodules.
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Affiliation(s)
- Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
| | - Vanessa Gibson
- Thoracic Surgery, Mount Sinai South Nassau, Oceanside, USA
| | | | | | | | - Pharlin Noel
- Surgery, Mount Sinai South Nassau, Oceanside, USA
| | - Lauren Punter
- Pathology, American University of Antigua, St. John's, ATG
| | | | - Abubakar Gapizov
- General Surgery, American University of Antigua, St. John's, ATG
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
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12
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Zhu L, Huang J, Jin C, Zhou A, Chen Y, Zhang B, Venuta F, Pua BB, Shen Y. Retrospective cohort study on the correlation analysis among peri-procedural factors, complications, and local tumor progression of lung tumors treated with CT-guided microwave ablation. J Thorac Dis 2023; 15:6915-6927. [PMID: 38249890 PMCID: PMC10797391 DOI: 10.21037/jtd-23-1799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024]
Abstract
Background Despite adherence to guidelines, recurrence of lesions remains possible in lung tumor microwave ablation (MWA) even when termination is enabled by 5-10 mm ground glass changes. Limited evidence exists regarding the correlation between timely management of perioperative complications (including pneumothorax, pleural effusion, hemorrhage, cavity formation, and infection) and local tumor progression. This retrospective study aimed to investigate the relationship among peri-procedural factors, complications, and local tumor progression in 164 cases of lung tumors treated with computed tomography-guided MWA (CT-MWA), and improve the local prognosis and reduce the complication rate of CT-guided lung tumor ablation. Methods We reviewed 164 consecutive patients who underwent CT-MWA at Fudan University Shanghai Cancer Center's Minimally Invasive Therapy Center for lung cancer from September 2019 to May 2020. Correlative analysis was performed between peri-procedural factors, complications and outcomes (local tumor progression rates). Patients who have had prior surgery or previous MWA were excluded. Ablation was the first treatment of choice, and all patients who have had other treatments were excluded. Patients were followed every 3 months with CT. Outcomes of ablation including complications and local tumor progression were evaluated. Peri-procedural factors included demographical factors, tumor features, ablation parameters, management of intra-procedural pneumothorax, and CT features. Complications included pneumothorax, post-procedural refractory infection, and pleural effusion. Results The study included 98 males and 68 females, with an average age of 56.1 years. Local tumor progression rate was negatively correlated with intra-procedural management of pneumothorax (R=-0.550, P=0.0003) and Hounsfield unit (HU) difference between HU before and after procedure (R=-0.855, P=0.006), and positively correlated with the average HU value of immediate post-procedural CT at the measurement points (R=0.857, P=0.00002). The correlation analysis results also showed a positive correlation between infection after procedure and pneumothorax (R=0.340, P=0.0001). Conclusions A greater difference between HU before and after the procedure or a decrease in CT values immediately after ablation may predict a higher rate of local complete ablation. Prompt management of intraoperative pneumothorax may lower local tumor progression rates and decrease incidence of post-procedural infection.
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Affiliation(s)
- Liming Zhu
- Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Jiaxi Huang
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
| | - Chunhui Jin
- Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Acheng Zhou
- Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Ying Chen
- Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Baonan Zhang
- Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, China
| | - Federico Venuta
- Università di Roma “Sapienza”, Cattedra di Chirurgia Toracica, Policlinico Umberto I, Rome, Italy
| | - Bradley B. Pua
- Division of Interventional Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - Yehua Shen
- Minimally Invasive Therapy Center, Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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13
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Lucà S, Montella M, Monti R, Accardo M, Savarese G, Sirica R, Fiorelli A, Morgillo F, Franco R. Pulmonary leiomyosarcoma arising in pulmonary hamartoma: an exceptional occurrence in a rare tumor. Pathologica 2023; 115:325-332. [PMID: 38180140 PMCID: PMC10767797 DOI: 10.32074/1591-951x-941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 01/06/2024] Open
Abstract
A solitary peripheral lung nodule was found in the left lung of a 52-year-old man. It was located in the lower lobe and measured 18.5 cm of major axis on chest computed tomography. A tru-cut core biopsy was obtained and a proliferation of bland, monomorphic, spindle cells in interlacing fascicles was observed. Accordingly, a surgical resection of the neoplasm was subsequently carried out. Macroscopically, the tumor appeared as a well-circumscribed nodule with a firm and whitish cut surface. Histologically, the neoplasm was predominantly composed of bland and monomorphic spindle cells, with a predominantly fascicular growth pattern, in which many tubular and cleft-like spaces of entrapped normal respiratory epithelium were involved. Myxoid change, stromal hyalinization and scattered bizarre mononucleated and multinucleated cells were also observed. Based on clinico-morphological, immunophenotypical and molecular features, we made a diagnosis of malignant transformation of pulmonary adenoleiomyomatous hamartoma into pulmonary leiomyosarcoma. As far as we know, this is the first described case of this exceptionally rare occurrence in an already rare neoplasm.
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Affiliation(s)
- Stefano Lucà
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | - Riccardo Monti
- Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | | | - Roberto Sirica
- AMES-Centro Polidiagnostico Strumentale, SRL, Naples, Italy
| | - Alfonso Fiorelli
- Division of Thoracic Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Floriana Morgillo
- Department of Precision Medicine, Medical Oncology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Campania, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
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14
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Yao H, Jiang X, Zeng Y, Wang X, Tang X. Classic biphasic pulmonary blastoma: A case report and review of the literature from 2000 to 2022. Clin Respir J 2023; 17:1103-1116. [PMID: 37772674 PMCID: PMC10632085 DOI: 10.1111/crj.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/23/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
Classic biphasic pulmonary blastoma (CBPB), a distinct type of lung cancer, is a dual-phasic tumor characterized by the co-existence of low-grade fetal adenocarcinoma and primitive mesenchymal stroma. Accounting for less than 0.1% of surgically removed lung cancers, CBPB commonly presents in individuals during their fourth to fifth decades of life, with smoking as a significant risk factor. The optimal management strategy entails surgical resection, supplemented by chemotherapy to improve prognosis. The frontline chemotherapeutic agents typically include platinum agents and etoposide, with preoperative neoadjuvant chemotherapy potentially enabling operability for initially inoperable cases. In recent years, targeted therapies, such as antiangiogenic agents, have emerged as promising new treatment strategies for CBPB. For patients exhibiting brain metastases or deemed inoperable, radiation therapy proves to be a crucial therapeutic component. CBPB prognosis is adversely affected by factors such as early metastasis, tumor size exceeding 5 cm, and tumor recurrence. In this regard, serological markers have been identified as valuable prognostic indicators. To exemplify, we recount the case of a 44-year-old female patient with CBPB, wherein serum lactate dehydrogenase levels showed significant diagnostic value. This report further incorporates a comprehensive review of CBPB literature from the past 22 years.
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Affiliation(s)
- Hui Yao
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xin Jiang
- Department of PathologyChongqing General HospitalChongqingChina
| | - Ying Zeng
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xue Wang
- Department of PathologyChongqing General HospitalChongqingChina
| | - Xuefeng Tang
- Department of PathologyChongqing General HospitalChongqingChina
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15
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Shameem M, Jian Bagherpoor A, Nakhi A, Dosa P, Georg G, Kassie F. Mitochondria-targeted metformin (mitomet) inhibits lung cancer in cellular models and in mice by enhancing the generation of reactive oxygen species. Mol Carcinog 2023; 62:1619-1629. [PMID: 37401866 PMCID: PMC10961008 DOI: 10.1002/mc.23603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/04/2023] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States. Although some epidemiological studies have shown an inverse relationship between the use of metformin, a widely used antidiabetic drug, and the incidence of lung cancer, the real benefits of the drug are unclear as the efficacy is low and the outcomes are quite heterogeneous. To develop a more potent form of metformin, we synthesized mitochondria-targeted metformin (mitomet) and tested its efficacy in in vitro and in vivo models of lung cancer. Mitomet was cytotoxic to transformed bronchial cells and several non-small cell lung cancer (NSCLC) cell lines but relatively safe to normal bronchial cells, and these effects were mediated mainly via induction of mitochondrial reactive oxygen species. Studies using isogenic A549 cells showed that mitomet was selectively toxic to those cells deficient in the tumor suppressor gene LKB1, which is widely mutated in NSCLC. Mitomet also significantly reduced the multiplicity and size of lung tumors induced by a tobacco smoke carcinogen in mice. Overall, our findings showed that mitomet, which was about 1000 and 100 times more potent than metformin, in killing NSCLC cells and reducing the multiplicity and size of lung tumors in mice, respectively, is a promising candidate for the chemoprevention and treatment of lung cancer, in particular against LKB1-deficient lung cancers which are known to be highly aggressive.
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Affiliation(s)
- Mohammad Shameem
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Ali Nakhi
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Medicinal Chemistry, Institute for Therapeutics Discovery and Development, College of Pharmacy, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Peter Dosa
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Medicinal Chemistry, Institute for Therapeutics Discovery and Development, College of Pharmacy, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Gunda Georg
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Medicinal Chemistry, Institute for Therapeutics Discovery and Development, College of Pharmacy, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Fekadu Kassie
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
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16
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Chen Y, Liu T, Xu Z, Dong M. Association of Epstein-Barr virus (EBV) with lung cancer: meta-analysis. Front Oncol 2023; 13:1177521. [PMID: 37860200 PMCID: PMC10582925 DOI: 10.3389/fonc.2023.1177521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
Objective Epstein-Barr virus (EBV) is a virus that is ubiquitous in humans. To investigate the association between EBV infection and lung cancer risk to reveal whether it is involved in the development and development of lung cancer. Although there has been discussion of EBV and lung cancer in the past. Through this study, we hope to deepen our understanding of the causes of lung cancer and provide new clues and targets for the prevention, early diagnosis and treatment of lung cancer. This study is also beneficial to the development of medical science and public health. First of all, the research results are expected to be incorporated into lung cancer prevention and treatment strategies and policies, so as to provide better treatment decisions for lung cancer patients and improve the survival rate and quality of life of patients. At the same time, communicating the research results to the public can help raise awareness of lung cancer risk factors. By encouraging healthy lifestyles and screening measures, the public can reduce their risk of lung cancer. In addition, this study also provides an important foundation for subsequent academic research and scientific exploration. It provides valuable information and inspiration for in-depth understanding of lung cancer and other related fields. Overall, this study makes an important contribution to both medical science and public health. Method By September 26, 2022, an online database was used to conduct a literature search in English. Random effects models were employed to estimate the prevalence of EBV with 95% confidence intervals (CIs). Additionally, the pooled odds ratio (OR) and 95%CI were calculated from case-control studies to determine the association between EBV and lung cancer. Results In this study of 886 patients with lung cancer, the overall prevalence of EBV infection was found to be 44.36% (95%CI: 4.08-16.9). Fourteen studies were included in the analysis, all of which used a case-control design and involved comparisons of tumors with adjacent or non-adjacent normal and non-cancerous controls. There was a significant difference in the prevalence of EBV infection in lung cancer tissues between China and other regions, with an odds ratio (OR) of 9.36 (95% confidence interval: 4.00-21.94, P<0.001, I²=73.5%). This suggests that the association between EBV infection and lung cancer cases is stronger in China than in other regions. Additionally, the prevalence of EBV infection varied across different pathological types of lung cancer, with rates of 81.08% for pulmonary lymphoepithelioma-like carcinoma (LELC),this a rare subtype of non-small cell lung cancer (NSCLC).34.78% for non-small cell lung cancer, and 21.17% for small cell lung cancer. The statistical analysis indicated that EBV infection was most significantly associated with cancer risk in LELC, while non-small cell lung cancer was more strongly associated with EBV than small cell lung cancer. Conclusion The study found that EBV infection increases the risk of lung cancer by more than four times, and this risk is associated with the pathological type, lymphatic infiltration, and degree of differentiation of the lung cancer, particularly in the rare subtype of pulmonary lymphoepithelioma in non-small cell lung cancer(NSCLC). Additionally, there are racial and regional differences in the correlation between EBV-infected lung cancer, with the Asian population showing greater susceptibility. The study used normal or abnormal tissue adjacent to the tumor as a control, which is considered a more accurate method for determining the relationship between EBV infection and lung cancer.
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Affiliation(s)
| | | | | | - Ming Dong
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China
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17
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Zhou Y, Yang N, Ruan S, Wu S, Yu D, Jin J. Lung cancer patient with Tropheryma whipplei and Nocardia co-infection. Ultrastruct Pathol 2023; 47:451-459. [PMID: 37533314 DOI: 10.1080/01913123.2023.2241888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
A 34-year-old male presented with lung shadow and was asymptomatic during medical examination. The patient had a prior history of thyroid tumors. Imaging manifestation showed a nodule in the medial segment of the right middle lobe, with partial obstruction of the distal bronchus within the lesion. Ground-glass and inflammatory nodules were observed in the anterior segment of the right upper lobe, as well as chronic inflammatory changes in the lower lobe of the right lung. Lung histopathological examination suggested invasive adenocarcinoma. A morphological examination of the bronchoalveolar lavage fluid revealed the presence of Tropheryma whipplei (TW) and Nocardia. Although TW infection has been reported in cancer patients, co-infection with Nocardia is a unique occurrence in this case. Opportunistic pathogens are common in immunocompromised patients but in this case, the patient was a young adult with normal immunity and an early-stage tumor with TW and Nocardia co-infection. We demonstrated the presence of rare microorganisms through imaging findings, combined with different staining methods of bronchoalveolar lavage fluid and lung tissue sections and evaluation of morphological characteristics. The aim of the present study was to provide early diagnosis and treatment of patients by improving microbial morphological detection.
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Affiliation(s)
- Yuli Zhou
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Nan Yang
- Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Senlin Ruan
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Shenghai Wu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Daojun Yu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Juan Jin
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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18
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Du K, Liu Y, Wu K, Sun Z, Han X, Jiao D. Percutaneous microwave ablation for lung tumors: a retrospective case-control study of conventional CT and C-arm CT guidance. Quant Imaging Med Surg 2023; 13:5737-5747. [PMID: 37711800 PMCID: PMC10498196 DOI: 10.21037/qims-22-985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 07/12/2023] [Indexed: 09/16/2023]
Abstract
Background Although conventional computed tomography (cCT) is the mainstream guidance equipment for lung microwave ablation (MWA), C-arm CT can provide 3-dimensional (3D) CT-like images reconstructed from 2-dimensional (2D) digital subtraction angiography (DSA) information within 8 seconds, highlighting its utility as a new guidance tool. This retrospective case-control study was performed to evaluate the clinical performance of percutaneous MWA for lung tumors using cCT and C-arm CT guidance. Methods From April 2015 to April 2020, 101 consecutive patients with solitary lung tumors who underwent percutaneous MWA at our single center (Zhengzhou, China) were divided into 2 groups: the cCT group (n=56), with unarmed puncture, and the C-arm CT group (n=45), with iGuide navigation-assisted puncture. The primary endpoints were technical success, technical efficacy, puncture scoring (PS), and complete ablation (CA) rate. The secondary endpoints were complications, median progression-free survival (mPFS), and median overall survival (mOS). Results The technical success rates were 100% in both the C-arm CT group and cCT group. The technical efficacies were 93.3% and 91.1% in the C-arm CT group and cCT group, respectively, with no statistical difference (P=0.67). The PS (2.9 vs. 2.5, P=0.02), total procedure time (TPT; 39.3 vs. 50.0 min, P<0.001), puncture time (PT; 12.6 vs. 15.7 min, P=0.001), and irradiation effective dose (ED; 15.2 vs. 20.9 mSV, P<0.001) showed significances between patients in the C-arm CT and those in the cCT group. The ablation time (AT; 9.1 vs. 9.6 min, P=0.36), CA rate (93.3% vs. 92.9%, P=0.93), local tumor progression (LTP) rate (11.1% vs. 8.9%, P=0.98), complications, mPFS (9.5 vs. 10.1 months, P=0.52), and mOS (37.9 vs. 38.8 months, P=0.67) showed no statistically significant difference between the 2 groups. Conclusions C-arm CT guidance is as feasible and effective as cCT for lung tumor MWA, which can increase PS and decrease TPT.
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Affiliation(s)
- Kepu Du
- Department of Imaging Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiming Liu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kunpeng Wu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhanguo Sun
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dechao Jiao
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Cavaliere C, Baldi D, Brancato V, Aiello M, Salvatore M. A customized anthropomorphic 3D-printed phantom to reproducibility assessment in computed tomography: an oncological case study. Front Oncol 2023; 13:1123796. [PMID: 37700836 PMCID: PMC10493384 DOI: 10.3389/fonc.2023.1123796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Studies on computed tomography (CT) reproducibility at different acquisition parameters have to take into account radiation dose administered and related ethical issues. 3D-printed phantoms provide the possibility to investigate these features deeply and to foster CT research, also taking advantage by outperforming new generation scanners. The aim of this study is to propose a new anthropomorphic 3D-printed phantom for chest lesions, tailored on a real patient CT scan, to investigate the variability of volume and Hounsfield Unit (HU) measurements at different CT acquisition parameters. Methods The chest CT of a 75-year-old patient with a paramediastinal lung lesion was segmented based on an eight-compartment approach related to HU ranges (air lung, lung interstitium, fat, muscle, vascular, skin, bone, and lesion). From each mask produced, the 3D.stl model was exported and linked to a different printing infill value, based on a preliminary test and HU ratios derived from the patient scan. Fused deposition modeling (FDM) technology printing was chosen with filament materials in polylactic acid (PLA). Phantom was acquired at 50 mAs and three different tube voltages of 80, 100, and 120 kVp on two different scanners, namely, Siemens Somatom Force (Siemens Healthineers, Erlangen, Germany; same setting of real patient for 80 kVp acquisition) and GE 750 HD CT (GE Healthcare, Chicago, IL). The same segmentation workflow was then applied on each phantom acquisition after coregistration pipeline, and Dice Similarity Coefficient (DSC) and HU averages were extracted and compared for each compartment. Results DSC comparison among real patient versus phantom scans at different kVp, and on both CT scanners, demonstrated a good overlap of different compartments and lesion vascularization with a higher similarity for lung and lesion masks for each setting (about 0.9 and 0.8, respectively). Although mean HU was not comparable with real data, due to the PLA material, the proportion of intensity values for each compartment remains respected. Discussion The proposed approach demonstrated the reliability of 3D-printed technology for personalized approaches in CT research, opening to the application of the same workflow to other oncological fields.
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Nunn K, Yanxiang Guo J. Transient systemic autophagy ablation irreversibly inhibits lung tumor cell metabolism and promotes T-cell mediated tumor killing. Autophagy 2023; 19:1879-1881. [PMID: 36314942 PMCID: PMC10262792 DOI: 10.1080/15548627.2022.2141534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/02/2022] Open
Abstract
Macroautophagy/autophagy is a highly conserved catabolic process pivotal to cellular homeostasis and support of tumorigenesis. Being a potential therapeutic target for cancer, we have worked to understand the implications of autophagy inhibition both systemically, and tumor-specifically. We utilized inducible expression of Atg5 shRNA to temporally control autophagy levels in a reversible manner to study the effects of tumor-intrinsic and systemic autophagic loss and restoration on established KrasG12D/+;trp53-/- (KP) lung tumor growth. We reported that transient systemic ATG5 loss significantly reduces KP lung tumor growth. Through in vivo isotope tracing and metabolic flux analyses, we noted that systemic ATG5 knockdown significantly reduces the uptake of glucose and lactate in lung tumors, leading to impaired TCA cycle metabolism and biosynthesis. Additionally, we observed an increased tumor T cell infiltration in the absence of systemic ATG5, which is essential for T cell-mediated tumor killing. Moreover, the impaired tumor metabolism and increased T cell infiltration are sustained when autophagy is restored in a short term. Finally, we found that intermittent systemic ATG5 knockdown, a mock therapy situation, significantly prolongs the lifespan of mice bearing KP lung tumors. Our findings lay the proof of concept for inhibition of autophagy as a valid approach to cancer therapy.
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Affiliation(s)
- Kyle Nunn
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jessie Yanxiang Guo
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Chemical Biology, Rutgers Ernest Mario School of Pharmacy, Piscataway, NJ, USA
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21
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Iwai H, Yanagawa N, Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Yoshimura R, Kanno H, Sugai M, Shikanai S, Sugai T, Saito H. Surgical treatment for lung metastasis of inflammatory myofibroblastic tumor of the lung: A case report. Thorac Cancer 2023. [PMID: 37146628 DOI: 10.1111/1759-7714.14914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare disease that is considered an intermediate neoplasm, with the risk of recurrence and metastasis. Surgical treatment is the standard therapy for IMT, although there are only a few reports of surgery for lung metastasis of pulmonary IMT. We opine that surgical treatment might be effective not only for localized tumors, but also for cases of lung metastasis of IMT.
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Affiliation(s)
- Hidenobu Iwai
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Naoki Yanagawa
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Hiroyuki Deguchi
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Makoto Tomoyasu
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Wataru Shigeeda
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Yuka Kaneko
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Ryuichi Yoshimura
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Hironaga Kanno
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
| | - Mayu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Shunsuke Shikanai
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Hajime Saito
- Department of Thoracic Surgery, Iwate Medical University, Iwate, Japan
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22
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Abstract
Bronchial schwannomas are rare tumors that arise from Schwann cells and account for a very small percentage of primary lung tumors. This case report describes a rare incidental finding of a bronchial schwannoma discovered in the left lower lobe secondary carina via bronchoscopy in a 71-year-old female who presented with minimal symptoms.
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Affiliation(s)
- Kyle A Burton
- Internal Medicine, Michigan State University College of Human Medicine, Marquette, USA
| | - Matthew Karulf
- Pulmonology, Upper Peninsula Health System, Marquette, USA
| | - Brian Pahn
- Pathology, Upper Peninsula Health System, Marquette, USA
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23
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Sato K, Takigawa N, Kubo T, Katayama H, Kishino D, Okada T, Hisamoto A, Mimoto J, Ochi N, Yoshino T, Ueoka H, Tanimoto M, Maeda Y, Kiura K. Effect of a Cyclooxygenase-2 Inhibitor in Combination with (-)-Epigallocatechin Gallate or Polyphenon E on Cisplatin-Induced Lung Tumorigenesis in A/J Mice. Acta Med Okayama 2023; 77:65-70. [PMID: 36849147 DOI: 10.18926/amo/64363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
We investigated the effects of celecoxib combined with (-)-epigallocatechin-3-gallate (EGCG) or polyphenon E in a cisplatin-induced lung tumorigenesis model. Four-week-old female A/J mice were divided into seven groups: (i) Control, (ii) 150 mg/kg celecoxib (150Cel), (iii) 1,500 mg/kg celecoxib (1500Cel), (iv) EGCG+150 mg/kg celecoxib (EGCG+150Cel), (v) EGCG+1,500 mg/kg celecoxib (EGCG+1500Cel), (vi) polyphenon E+150 mg/kg celecoxib (PolyE+150Cel), and (vii) polyphenon E+1,500 mg/kg celecoxib (PolyE+1500Cel). All mice were administered cisplatin (1.62 mg/kg of body weight, i.p.) 1×/week for 10 weeks and sacrificed at week 30; the numbers of tumors on the lung surface were then determined. The tumor incidence and multiplicity (no. of tumors/mouse, mean±SD) were respectively 95% and 2.15±1.50 in Control, 95% and 2.10±1.29 in 150Cel, 86% and 1.67±1.20 in 1500Cel, 71% and 1.38±1.24 in EGCG+150Cel, 67% and 1.29±1.38 in EGCG+1500Cel, 80% and 1.95±1.36 in PolyE+150Cel, and 65% and 1.05±0.10 in PolyE+1500Cel. The combination of high-dose celecoxib with EGCG or polyphenon E significantly reduced multiplicity in cisplatin-induced lung tumors.
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Affiliation(s)
- Ken Sato
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Medical School
| | - Toshio Kubo
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Daizo Kishino
- Department of Medicine, Yamaguchi-Ube Medical Center
| | - Toshiaki Okada
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Akiko Hisamoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Junko Mimoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nobuaki Ochi
- Department of General Internal Medicine 4, Kawasaki Medical School
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Ueoka
- Department of Medicine, Yamaguchi-Ube Medical Center
| | - Mitsune Tanimoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yoshionobu Maeda
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Katsuyuki Kiura
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Feng Y, Han X, Zhang Z, Qiao H, Tang H. ABI3BP is a prognosis biomarker related with clinicopathological features and immunity infiltration of lung tumor. Front Genet 2023; 13:1085785. [PMID: 36744181 PMCID: PMC9894588 DOI: 10.3389/fgene.2022.1085785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Background: The primary factor of cancer mortality is lung tumor. ABI3BP gene encodes an extracellular matrix bind protein associated to multiplication and derivation. However, the prognosis score of ABI3BP for lung tumor and its relation with immunity cellular infiltration for lung tumor have not been reported. Methods: Public repository systems (Timer, GEPIA, TCGA, HPA) were utilized to explore expression of ABI3BP for lung tumor, and explored the relation of ABI3BP and clinicopathological parameters. TCGA information set was utilized for cox analysis for data with one or more variables of ABI3BP for lung tumor. STRING was utilized to explore ABI3BP regulatory networks. GO/KEGG enrichment analysis as well as enrichment analysis of gene sets were carried out for ABI3BP co-expression via R package. And finally we explored the relation of expression of ABI3BP and lung tumor immunity invasion, exploring the influence of ABI3BP level of expression on immunotreatment and whether immunity invasion would affect the prognosis of patients with lung tumor. Results: ABI3BP is downregulated in LUAD and LUSC, and associated to lung tumor phase and prognosis. Univariate and multivariate cox regression showed that ABI3BP was an independent prognostic factor in patients with lung tumors. The extracellular matrix protein-coding gene and the ABI3BP-related gene were intersected to obtain 10 hub genes. On the basis of GO/KEGG enrichment analysis, hub genes are closely associated to immunity-associated pathways including T cell receptor signaling pathway, immune response-activating cell surface receptor signaling pathway. Finally, the expression of ABI3BP is closely related to immune cell infiltration and immune cell marker set, and the expression of ABI3BP can help predict the therapeutic effect of immune checkpoint inhibitors and improve the prognosis of patients. Conclusion: ABI3BP could be a new target for lung tumor that could be utilized as a diagnostic and therapeutic tool.
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Affiliation(s)
- Yan Feng
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xiaolei Han
- Department of Health Office, Qingdao Municipal Hospital, Qingdao, China
| | - Zhe Zhang
- Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Han Qiao
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Huaping Tang
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China,*Correspondence: Huaping Tang,
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25
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Lei Y, Wang T, Jeong JJ, Janopaul-Naylor J, Kesarwala AH, Roper J, Tian S, Bradley JD, Liu T, Higgins K, Yang X. Automated lung tumor delineation on positron emission tomography/computed tomography via a hybrid regional network. Med Phys 2023; 50:274-283. [PMID: 36203393 PMCID: PMC9868056 DOI: 10.1002/mp.16001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Multimodality positron emission tomography/computed tomography (PET/CT) imaging combines the anatomical information of CT with the functional information of PET. In the diagnosis and treatment of many cancers, such as non-small cell lung cancer (NSCLC), PET/CT imaging allows more accurate delineation of tumor or involved lymph nodes for radiation planning. PURPOSE In this paper, we propose a hybrid regional network method of automatically segmenting lung tumors from PET/CT images. METHODS The hybrid regional network architecture synthesizes the functional and anatomical information from the two image modalities, whereas the mask regional convolutional neural network (R-CNN) and scoring fine-tune the regional location and quality of the output segmentation. This model consists of five major subnetworks, that is, a dual feature representation network (DFRN), a regional proposal network (RPN), a specific tumor-wise R-CNN, a mask-Net, and a score head. Given a PET/CT image as inputs, the DFRN extracts feature maps from the PET and CT images. Then, the RPN and R-CNN work together to localize lung tumors and reduce the image size and feature map size by removing irrelevant regions. The mask-Net is used to segment tumor within a volume-of-interest (VOI) with a score head evaluating the segmentation performed by the mask-Net. Finally, the segmented tumor within the VOI was mapped back to the volumetric coordinate system based on the location information derived via the RPN and R-CNN. We trained, validated, and tested the proposed neural network using 100 PET/CT images of patients with NSCLC. A fivefold cross-validation study was performed. The segmentation was evaluated with two indicators: (1) multiple metrics, including the Dice similarity coefficient, Jacard, 95th percentile Hausdorff distance, mean surface distance (MSD), residual mean square distance, and center-of-mass distance; (2) Bland-Altman analysis and volumetric Pearson correlation analysis. RESULTS In fivefold cross-validation, this method achieved Dice and MSD of 0.84 ± 0.15 and 1.38 ± 2.2 mm, respectively. A new PET/CT can be segmented in 1 s by this model. External validation on The Cancer Imaging Archive dataset (63 PET/CT images) indicates that the proposed model has superior performance compared to other methods. CONCLUSION The proposed method shows great promise to automatically delineate NSCLC tumors on PET/CT images, thereby allowing for a more streamlined clinical workflow that is faster and reduces physician effort.
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Affiliation(s)
- Yang Lei
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Tonghe Wang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Jiwoong J Jeong
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - James Janopaul-Naylor
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Aparna H Kesarwala
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Justin Roper
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Sibo Tian
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Jeffrey D Bradley
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Kristin Higgins
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia, USA
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26
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Zhang X, Lu Y, Huang K, Pan Q, Jia Y, Cui B, Yin P, Li J, Ju J, Fan X, Tian R. The synergized diagnostic value of VTQ with chemokine CXCL13 in lung tumors. Front Oncol 2023; 13:1115485. [PMID: 37025603 PMCID: PMC10070862 DOI: 10.3389/fonc.2023.1115485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
Virtual Touch Tissue Quantification (VTQ) offers several advantages in the diagnosis of various lung diseases. Chemokine expression levels, such as CXCL13, play a vital role in the occurrence and development of tumors and aid in the diagnosis process. The purpose of this study was to evaluate the combined value of VTQ and changes in CXCL13 expression levels for the diagnosis of lung tumors. A total of 60 patients with thoracic nodules and pleural effusion were included, with 30 of them having malignant pleural effusion (based on pathology) and the remaining 30 having benign thoracic nodules and pleural effusion. The relative expression level of CXCL13 was measured in the collected pleural effusions using Enzyme-Linked Immunosorbent Assay (ELISA). The relationship between CXCL13 expression levels and various clinical features was analyzed. A Receiver Operating Characteristic (ROC) curve analysis was conducted on the VTQ results and relative expression levels of CXCL13, and the areas under the curve, critical values, sensitivity, and specificity were calculated. Multivariate analysis incorporating multiple indicators was performed to determine the accuracy of lung tumor diagnosis. The results showed that the expression levels of CXCL13 and VTQ were significantly higher in the lung cancer group compared to the control group (P < 0.05). In the Non-Small Cell Lung Cancer (NSCLC) group, CXCL13 expression levels increased with later TNM staging and poorer tumor differentiation. The expression level of CXCL13 in adenocarcinoma was higher than that in squamous cell carcinoma. The ROC curve analysis revealed that CXCL13 had an area under the curve (AUC) of 0.74 (0.61, 0.86) with an optimal cut-off value of 777.82 pg/ml for diagnosing lung tumors. The ROC curve analysis of VTQ showed an AUC of 0.67 (0.53, 0.82) with a sensitivity of 60.0% and a specificity of 83.3%, and an optimal diagnostic cut-off of 3.33 m/s. The combination of CXCL13 and VTQ for diagnosing thoracic tumors had an AUC of 0.842 (0.74, 0.94), which was significantly higher than either factor alone. The results of the study demonstrate the strong potential of combining VTQ results with chemokine CXCL13 expression levels for lung tumor diagnosis. Additionally, the findings suggest that elevated relative expression of CXCL13 in cases of malignant pleural effusion caused by non-small cell lung cancer may indicate a poor prognosis. This provides promising potential for using CXCL13 as a screening tool and prognostic indicator for patients with advanced lung cancer complicated by malignant pleural effusion.
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Affiliation(s)
- Xu Zhang
- Department of Ultrasound, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Yejian Lu
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
| | - Kenan Huang
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
| | - Qingfang Pan
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
| | - Youchao Jia
- Department of Oncology, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Baoshuan Cui
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
| | - Peipei Yin
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
| | - Jianhui Li
- Department of Ultrasound, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Junping Ju
- Department of Radiology, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Xiangyu Fan
- Department of Pathology, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Rui Tian
- Department of Oncology, Hospital of the People’s Liberation Army: 82nd Group Army, Baoding, China
- *Correspondence: Rui Tian,
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Duetschler A, Prendi J, Safai S, Weber DC, Lomax AJ, Zhang Y. Limitations of phase-sorting based pencil beam scanned 4D proton dose calculations under irregular motion. Phys Med Biol 2022; 68. [PMID: 36571234 DOI: 10.1088/1361-6560/aca9b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/07/2022] [Indexed: 12/12/2022]
Abstract
Objective.4D dose calculation (4DDC) for pencil beam scanned (PBS) proton therapy is typically based on phase-sorting of individual pencil beams onto phases of a single breathing cycle 4DCT. Understanding the dosimetric limitations and uncertainties of this approach is essential, especially for the realistic treatment scenario with irregular free breathing motion.Approach.For three liver and three lung cancer patient CTs, the deformable multi-cycle motion from 4DMRIs was used to generate six synthetic 4DCT(MRI)s, providing irregular motion (11/15 cycles for liver/lung; tumor amplitudes ∼4-18 mm). 4DDCs for two-field plans were performed, with the temporal resolution of the pencil beam delivery (4-200 ms) or with 8 phases per breathing cycle (500-1000 ms). For the phase-sorting approach, the tumor center motion was used to determine the phase assignment of each spot. The dose was calculated either using the full free breathing motion or individually repeating each single cycle. Additionally, the use of an irregular surrogate signal prior to 4DDC on a repeated cycle was simulated. The CTV volume with absolute dose differences >5% (Vdosediff>5%) and differences in CTVV95%andD5%-D95%compared to the free breathing scenario were evaluated.Main results.Compared to 4DDC considering the full free breathing motion with finer spot-wise temporal resolution, 4DDC based on a repeated single 4DCT resulted inVdosediff>5%of on average 34%, which resulted in an overestimation ofV95%up to 24%. However, surrogate based phase-sorting prior to 4DDC on a single cycle 4DCT, reduced the averageVdosediff>5%to 16% (overestimationV95%up to 19%). The 4DDC results were greatly influenced by the choice of reference cycle (Vdosediff>5%up to 55%) and differences due to temporal resolution were much smaller (Vdosediff>5%up to 10%).Significance.It is important to properly consider motion irregularity in 4D dosimetric evaluations of PBS proton treatments, as 4DDC based on a single 4DCT can lead to an underestimation of motion effects.
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Affiliation(s)
- A Duetschler
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland.,Department of Physics, ETH Zürich, 8092 Zürich, CH, Switzerland
| | - J Prendi
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland.,Department of Physics, University of Basel, 4056 Basel, CH, Switzerland
| | - S Safai
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland
| | - D C Weber
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland.,Department of Radiation Oncology, University Hospital of Zürich, 8091 Zürich, CH, Switzerland.,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, CH, Switzerland
| | - A J Lomax
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland.,Department of Physics, ETH Zürich, 8092 Zürich, CH, Switzerland
| | - Ye Zhang
- Center for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, CH, Switzerland
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Zhang X, Song X, Li G, Duan L, Wang G, Dai G, Song Y, Li J, Bai S. Machine Learning Radiomics Model for External and Internal Respiratory Motion Correlation Prediction in Lung Tumor. Technol Cancer Res Treat 2022; 21:15330338221143224. [PMID: 36476136 PMCID: PMC9742719 DOI: 10.1177/15330338221143224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: The complexity and specificity of lung tumor motion render it necessary to determine the external and internal correlation individually before applying indirect tumor tracking. However, the correlation cannot be determined from patient respiratory and tumor clinical characteristics before treatment. The purpose of this study is to present a machine learning model for an external/internal correlation prediction that is based on computed tomography (CT) radiomic features. Methods: 4-dimensional computed tomography (4DCT) images of 67 patients were collected retrospectively, and the external/internal correlation of lung tumor was calculated based on Spearman's rank correlation coefficient. Radiomic features were extracted from average intensity projection and the light gradient boosting machine (LightGBM)-based cross-validation (the recursive elimination method) was used for feature selection. The LightGBM framework forecasting models with classification thresholds 0.7, 0.8, and 0.9 are established using stratified 5-fold cross-validation. Model performance was assessed using receiver operating characteristics, sensitivity, and specificity. Results: There were 16, 18, and 13 features selected for models 0.7, 0.8, and 0.9, respectively. Texture features are of great importance in external/internal correlation prediction compared to other features in all models. The sensitivities of the predictions in models 0.7, 0.8, and 0.9 were 0.800 ± 0.126, 0.829 ± 0.140, and 0.864 ± 0.086, respectively. The specificities were 0.771 ± 0.114, 0.936 ± 0.0581, and 0.839 ± 0.101, whereas the area under the curve (AUC) was 0.837, 0.946, and 0.877, respectively. Conclusions: Our findings indicate that radiomics is an effective tool for respiratory motion correlation prediction, which can extract tumor motion characteristics. We proposed a machine learning framework for correlation prediction in the motion management strategy for lung tumor patients.
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Affiliation(s)
- Xiangyu Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyu Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Department of Radiation Oncology, Cancer Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guangjun Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lian Duan
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Guangyu Wang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Sen Bai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Sen Bai, MS, Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Guangjun Li, MS, Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
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29
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Khayati K, Bhatt V, Lan T, Alogaili F, wang W, Lopez E, Hu ZS, Gokhale S, Cassidy L, Narita M, Xie P, White E, Guo JY. Transient Systemic Autophagy Inhibition Is Selectively and Irreversibly Deleterious to Lung Cancer. Cancer Res 2022; 82:4429-4443. [PMID: 36156071 PMCID: PMC9722642 DOI: 10.1158/0008-5472.can-22-1039] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/17/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023]
Abstract
Autophagy is a conserved catabolic process that maintains cellular homeostasis. Autophagy supports lung tumorigenesis and is a potential therapeutic target in lung cancer. A better understanding of the importance of tumor cell-autonomous versus systemic autophagy in lung cancer could facilitate clinical translation of autophagy inhibition. Here, we exploited inducible expression of Atg5 shRNA to temporally control Atg5 levels and to generate reversible tumor-specific and systemic autophagy loss mouse models of KrasG12D/+;p53-/- (KP) non-small cell lung cancer (NSCLC). Transient suppression of systemic but not tumor Atg5 expression significantly reduced established KP lung tumor growth without damaging normal tissues. In vivo13C isotope tracing and metabolic flux analyses demonstrated that systemic Atg5 knockdown specifically led to reduced glucose and lactate uptake. As a result, carbon flux from glucose and lactate to major metabolic pathways, including the tricarboxylic acid cycle, glycolysis, and serine biosynthesis, was significantly reduced in KP NSCLC following systemic autophagy loss. Furthermore, systemic Atg5 knockdown increased tumor T-cell infiltration, leading to T-cell-mediated tumor killing. Importantly, intermittent transient systemic Atg5 knockdown, which resembles what would occur during autophagy inhibition for cancer therapy, significantly prolonged lifespan of KP lung tumor-bearing mice, resulting in recovery of normal tissues but not tumors. Thus, systemic autophagy supports the growth of established lung tumors by promoting immune evasion and sustaining cancer cell metabolism for energy production and biosynthesis, and the inability of tumors to recover from loss of autophagy provides further proof of concept that inhibition of autophagy is a valid approach to cancer therapy. SIGNIFICANCE Transient loss of systemic autophagy causes irreversible damage to tumors by suppressing cancer cell metabolism and promoting antitumor immunity, supporting autophagy inhibition as a rational strategy for treating lung cancer. See related commentary by Gan, p. 4322.
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Affiliation(s)
- Khoosheh Khayati
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Vrushank Bhatt
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Taijin Lan
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Fawzi Alogaili
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Wenping wang
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Enrique Lopez
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Zhixian Sherrie Hu
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
| | - Samantha Gokhale
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854, USA
| | - Liam Cassidy
- University of Cambridge, Cancer Research UK Cambridge Institute, Robinson Way, Cambridge, CB2 0RE, UK
| | - Masashi Narita
- University of Cambridge, Cancer Research UK Cambridge Institute, Robinson Way, Cambridge, CB2 0RE, UK
| | - Ping Xie
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854, USA
| | - Eileen White
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
- Department of Molecular Biology and Biochemistry, Rutgers University, Piscataway, New Jersey 08854, USA
- Ludwig Princeton Branch, Ludwig Institute for Cancer Research, Princeton University, Princeton, New Jersey 08540, USA
| | - Jessie Yanxiang Guo
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey 08901, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA
- Department of Chemical Biology, Rutgers Ernest Mario School of Pharmacy, Piscataway, New Jersey 08854, USA
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30
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Kitamura K, Takayama K, Yamazaki R, Ueda Y, Nishiki S. A new method for assessing lung tumor motion in radiotherapy using dynamic chest radiography. J Appl Clin Med Phys 2022; 23:e13736. [PMID: 35930373 PMCID: PMC9588259 DOI: 10.1002/acm2.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/17/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
Dynamic chest radiography (DCR) is a recent advanced modality to acquire dynamic and functional images. We developed a new method using DCR and the free analysis software, Kinovea, to assess lung tumor motion. This study aimed to demonstrate the usefulness of our method. Phantom and clinical studies were performed. In the phantom study, dynamic images of a moving lead sphere were acquired using DCR, and the motion of the phantom was tracked using Kinovea in a DCR video. The amplitude of phantom motion was measured and compared with a predetermined baseline amplitude. In a clinical study, DCR and respiratory‐gated four‐dimensional computed tomography (4D‐CT) were performed on 15 patients who underwent stereotactic body radiation therapy for lung tumors. The amplitudes of tumor motion in DCR and 4D‐CT were measured in the superior‐inferior (SI), left‐right (LR), and anterior‐posterior (AP) directions, and the square root of the sum of squares (SRSS) of the amplitude was calculated in all directions. Spearman's rank correlation and the Wilcoxon signed‐rank test were performed to determine the correlations of the amplitudes of tumor motion obtained using DCR and 4D‐CT. In the phantom study, the absolute mean error between the measured and predetermined amplitudes was 0.60 mm (range: 0.061.53 mm). In the clinical study, the amplitudes of tumor motion obtained using DCR correlated significantly with those of 4D‐CT in the SI and LR directions, as did the SRSS values. The median amplitudes for DCR were significantly higher than those for 4D‐CT in all (SI, LR, and AP) directions, as were the SRSS values. Our proposed method based on DCR and Kinovea is useful for assessing lung tumor motion, visually and quantitatively. Therefore, DCR has potential as a new modality for evaluating lung tumor motion in radiotherapy.
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Affiliation(s)
| | - Kenji Takayama
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - Ryo Yamazaki
- Department of Radiology, Tenri Hospital, Tenri, Japan
| | - Yukihiro Ueda
- Department of Radiology, Tenri Hospital, Tenri, Japan
| | - Shigeo Nishiki
- Japanese Society of Radiological Technology, Shimogyo-ku, Japan
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31
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Xiang Y, Luettich K, Martin F, Battey JND, Trivedi K, Neau L, Wong ET, Guedj E, Dulize R, Peric D, Bornand D, Ouadi S, Sierro N, Büttner A, Ivanov NV, Vanscheeuwijck P, Hoeng J, Peitsch MC. Discriminating Spontaneous From Cigarette Smoke and THS 2.2 Aerosol Exposure-Related Proliferative Lung Lesions in A/J Mice by Using Gene Expression and Mutation Spectrum Data. Front Toxicol 2022; 3:634035. [PMID: 35295134 PMCID: PMC8915865 DOI: 10.3389/ftox.2021.634035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/19/2021] [Indexed: 11/25/2022] Open
Abstract
Mice, especially A/J mice, have been widely employed to elucidate the underlying mechanisms of lung tumor formation and progression and to derive human-relevant modes of action. Cigarette smoke (CS) exposure induces tumors in the lungs; but, non-exposed A/J mice will also develop lung tumors spontaneously with age, which raises the question of discriminating CS-related lung tumors from spontaneous ones. However, the challenge is that spontaneous tumors are histologically indistinguishable from the tumors occurring in CS-exposed mice. We conducted an 18-month inhalation study in A/J mice to assess the impact of lifetime exposure to Tobacco Heating System (THS) 2.2 aerosol relative to exposure to 3R4F cigarette smoke (CS) on toxicity and carcinogenicity endpoints. To tackle the above challenge, a 13-gene gene signature was developed based on an independent A/J mouse CS exposure study, following by a one-class classifier development based on the current study. Identifying gene signature in one data set and building classifier in another data set addresses the feature/gene selection bias which is a well-known problem in literature. Applied to data from this study, this gene signature classifier distinguished tumors in CS-exposed animals from spontaneous tumors. Lung tumors from THS 2.2 aerosol-exposed mice were significantly different from those of CS-exposed mice but not from spontaneous tumors. The signature was also applied to human lung adenocarcinoma gene expression data (from The Cancer Genome Atlas) and discriminated cancers in never-smokers from those in ever-smokers, suggesting translatability of our signature genes from mice to humans. A possible application of this gene signature is to discriminate lung cancer patients who may benefit from specific treatments (i.e., EGFR tyrosine kinase inhibitors). Mutational spectra from a subset of samples were also utilized for tumor classification, yielding similar results. “Landscaping” the molecular features of A/J mouse lung tumors highlighted, for the first time, a number of events that are also known to play a role in human lung tumorigenesis, such as Lrp1b mutation and Ros1 overexpression. This study shows that omics and computational tools provide useful means of tumor classification where histopathological evaluation alone may be unsatisfactory to distinguish between age- and exposure-related lung tumors.
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Affiliation(s)
- Yang Xiang
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Karsta Luettich
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Florian Martin
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - James N D Battey
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Keyur Trivedi
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Laurent Neau
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Ee Tsin Wong
- Philip Morris International R&D, Philip Morris International Research Laboratories Pte. Ltd., Singapore, Singapore
| | - Emmanuel Guedj
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Remi Dulize
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Dariusz Peric
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - David Bornand
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Sonia Ouadi
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Nicolas Sierro
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Nikolai V Ivanov
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
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32
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Yamada T, Lake BG, Cohen SM. Evaluation of the human hazard of the liver and lung tumors in mice treated with permethrin based on mode of action. Crit Rev Toxicol 2022; 52:1-31. [PMID: 35275035 DOI: 10.1080/10408444.2022.2035316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The non-genotoxic synthetic pyrethroid insecticide permethrin produced hepatocellular adenomas and bronchiolo-alveolar adenomas in female CD-1 mice, but not in male CD-1 mice or in female or male Wistar rats. Studies were performed to evaluate possible modes of action (MOAs) for permethrin-induced female CD-1 mouse liver and lung tumor formation. The MOA for liver tumor formation by permethrin involves activation of the peroxisome proliferator-activated receptor alpha (PPARα), increased hepatocellular proliferation, development of altered hepatic foci, and ultimately liver tumors. This MOA is similar to that established for other PPARα activators and is considered to be qualitatively not plausible for humans. The MOA for lung tumor formation by permethrin involves interaction with Club cells, followed by a mitogenic effect resulting in Club cell proliferation, with prolonged administration producing Club cell hyperplasia and subsequently formation of bronchiolo-alveolar adenomas. Although the possibility that permethrin exposure may potentially result in enhancement of Club cell proliferation in humans cannot be completely excluded, there is sufficient information on differences in basic lung anatomy, physiology, metabolism, and biologic behavior of tumors in the general literature to conclude that humans are quantitatively less sensitive to agents that increase Club cell proliferation and lead to tumor formation in mice. The evidence strongly indicates that Club cell mitogens are not likely to lead to increased susceptibility to lung tumor development in humans. Overall, based on MOA evaluation it is concluded that permethrin does not pose a tumorigenic hazard for humans, this conclusion being supported by negative data from permethrin epidemiological studies.
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Affiliation(s)
- Tomoya Yamada
- Environmental Health Science Laboratory, Sumitomo Chemical Company, Ltd., Osaka, Japan
| | - Brian G Lake
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Samuel M Cohen
- Department of Pathology and Microbiology, Havlik-Wall Professor of Oncology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, USA
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33
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Matsuzawa R, Morise M, Tanaka I, Hayai S, Tamiya Y, Koyama J, Hase T, Wakahara K, Kim D, Shimoyama Y, Hashimoto N. Amelanotic Malignant Melanoma with a BRAF V600E Mutation Mimicking Primary Lung Cancer. Intern Med 2022; 61:703-708. [PMID: 34433708 PMCID: PMC8943366 DOI: 10.2169/internalmedicine.6657-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Amelanotic melanoma is a rare type of melanoma that shows little or no melanin pigmentation. When tumor lesions are not detected in cutaneous sites, the presence of melanin is the hallmark sign of malignant melanoma. We herein report a case of amelanotic melanoma with a BRAF V600E mutation mimicking primary lung cancer that was finally diagnosed on an autopsy. The current case suggests important caveats for the differential diagnosis of patients with BRAF V600E mutation-positive poorly differentiated lung tumors. In terms of the pathological diagnosis, routine immunohistochemical staining may be useful, especially in patients with a poorly differentiated lung tumor without TTF-1 expression.
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Affiliation(s)
- Reiko Matsuzawa
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Ichidai Tanaka
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Shunsaku Hayai
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Yutaro Tamiya
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Junji Koyama
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Tetsunari Hase
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Keiko Wakahara
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Deoksu Kim
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Japan
| | - Yoshie Shimoyama
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Japan
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
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34
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Kassie F, Jian Bagherpoor A, Kovacs K, Seelig D. Combinatory lung tumor inhibition by myo-inositol and iloprost/rapamycin: association with immunomodulation. Carcinogenesis 2022; 43:547-556. [PMID: 35147705 DOI: 10.1093/carcin/bgac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 11/12/2022] Open
Abstract
Although both preclinical and clinical studies have suggested that myo-inositol (MI) may be a safe and effective lung cancer chemopreventive agent, its efficacy is moderate. To test whether the chemopreventive agents iloprost (IL) or rapamycin enhance the lung tumor inhibitory effects of MI, A/J mice were treated with the tobacco smoke carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and, beginning one week after the end of NNK treatment, given MI, IL, rapamycin, MI+IL or MI+rapamycin for 17 weeks. Analyses of the number and size of tumors on the surface of the lung have indicated that MI, IL, rapamycin, MI+IL and MI+rapamycin reduced the multiplicity of NNK-induced lung tumors by 41%, 34%, 46%, 79% and 67%, respectively, and larger tumors (lung tumors with a diameter of 1-2 mm or > 2 mm) were absent in the MI+IL and MI+rapamycin groups. These results clearly indicated that MI+IL and MI+rapamycin are more effective than MI alone in inhibiting the formation and growth of lung tumors. Assessment of the immunomodulatory effects of the drugs showed that whereas MI+rapamycin and MI+IL increased the infiltration of lung tumors by CD4 + and CD8 + T cells, MI+rapamycin reduced the expression of the immune checkpoint protein programmed-death ligand-1 (PD-L1). Moreover, all treatments, except IL, increased apoptosis, whereas cell proliferation was markedly suppressed in all treated groups. In summary, these results suggest that IL and rapamycin could enhance the efficacy of MI in lung cancer chemoprevention trials.
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Affiliation(s)
- Fekadu Kassie
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.,College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
| | | | - Katalin Kovacs
- College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
| | - Davis Seelig
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.,College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
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35
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Abstract
Pulmonary adenofibroma is a rare biphasic tumor that contains epithelial and stromal components. We report a case of pulmonary adenofibroma in which the tumor was resected by thoracoscopic surgery and the diagnosis was established by histopathology. A 59-year-old woman with a past medical history of pyelonephritis visited our hospital for evaluation of an abnormal opacity on a plain chest x-ray during a comprehensive medical examination. A follow-up chest x-ray showed enlargement of the lesion, and the patient was referred to our department for further management. Chest computed tomography revealed a well-circumscribed nodule measuring 1.4 cm in diameter in the upper lobe of the left lung. The chest imaging findings suggested a benign tumor, but because of evidence of lesion enlargement and elevated serum carcinoembryonic antigen levels, we performed wide wedge resection of the left upper lobe by video-assisted thoracoscopic surgery, for diagnosis and treatment. The resected specimen was submitted for rapid pathological diagnosis during the operation, and a benign tumor, possibly sclerosing pneumocytoma, was suspected. Therefore, we completed the operation with wide wedge resection. The final histopathological diagnosis was pulmonary adenofibroma. The patient had an uneventful postoperative course, and at this writing, 6 months postoperatively, there has been no evidence of tumor recurrence. We have reported this case of pulmonary adenofibroma because the tumor is rare, has not yet been well-characterized, and has an unclear prognosis. Collection of data from a larger number of patients is necessary.
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Affiliation(s)
- Takumi Sonokawa
- Department of Thoracic Surgery, Nippon Medical School Hospital
| | - Yutaka Enomoto
- Department of Thoracic Surgery, Nippon Medical School Hospital
| | - Shinobu Kunugi
- Department of Analytic Human Pathology, Nippon Medical School
| | | | - Jitsuo Usuda
- Department of Thoracic Surgery, Nippon Medical School Hospital
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36
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Gendre DAJ, Ameti E, Karenovics W, Perriraz-Mayer N, Triponez F, Serre-Beinier V. Optimization of tumor spheroid model in mesothelioma and lung cancers and anti-cancer drug testing in H2052/484 spheroids. Oncotarget 2021; 12:2375-87. [PMID: 34853659 DOI: 10.18632/oncotarget.28134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
Advanced lung cancers and mesothelioma remain incurable diseases. Despite some promising new therapy strategies, predicting whether an individual patient will be sensitive to a given therapy is challenging. The purpose of this study is to establish and evaluate the efficiency of a three-dimensional spheroid model of human thoracic cancer in predicting the efficacy of drugs. Human mesothelioma and lung tumor spheroids were established from cell lines and primary cells derived from the patient. The growth kinetics and cell viability of microtumors were assessed using spheroid size and intracellular ATP level. The sensitivity of the mesothelioma spheroids to the cisplatin or cisplatin/pemetrexed combination was determined. We determined that studying the kinetics of the spheroid growth for 15 days after seeding 1000 cells/well in a 96-well plate was optimal. Monitoring the growth kinetic and intracellular ATP of spheroids allowed the identification of early changes in spheroid viability. Finally, we validated this model by measuring a dose-dependent reduction in the cell viability of mesothelioma H2052/484 spheroids treated with both first-line treatments, cisplatin and the cisplatin/pemetrexed combination. In conclusion, we have developed a three-dimensional spheroid model of thoracic tumor cells useful for tailoring the medical treatment to the specific characteristics of each patient.
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37
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Lei X, Zheng Y, Zhang G, Zheng H. Case Report: Primary Bilateral Minimally Invasive Adenocarcinoma of the Lungs in an 11-Year-Old Child: A Rare Case. Front Surg 2021; 8:741744. [PMID: 34765637 PMCID: PMC8575692 DOI: 10.3389/fsurg.2021.741744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
There are many types of benign and malignant tissue, but primary lung tumor is very rare in children and often remains undiagnosed until after distant metastasis has occurred. Few cases of early lung adenocarcinoma in children have been reported. However, this case concerns an 11-year-old child with primary bilateral minimally invasive adenocarcinoma. As far as we know, this is the youngest reported case of its type.
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Affiliation(s)
- Xing Lei
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Yongfei Zheng
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Guohua Zhang
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Hailan Zheng
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
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38
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Shukla I, Stead TS, Aleksandrovskiy I, Rodriguez V, Ganti L. Symptomatic Pulmonary Hamartoma. Cureus 2021; 13:e18230. [PMID: 34692355 PMCID: PMC8526074 DOI: 10.7759/cureus.18230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/05/2022] Open
Abstract
Pulmonary hamartoma is the most common benign tumor of the lungs. It is most often asymptomatic and is discovered incidentally. The condition is two to three times more common in men and is usually seen in the sixth to seventh decade of life. The authors present the case of a 44-year-old female in whom the condition was symptomatic, causing cough, shortness of breath, and fatigue. This case is unusual in that it occurred in a woman in her 40s and was symptomatic. The authors discuss the presentation, clinical features, and management of pulmonary hamartoma.
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Affiliation(s)
- Isha Shukla
- Emergency Medicine, Trinity Preparatory School, Winter Park, USA
| | - Thor S Stead
- Medicine, The Warren Alpert Medical School of Brown University, Providence, USA
| | | | - Vashun Rodriguez
- Department of Emergency Medicine, Lakeland Regional Health, Lakeland, USA
| | - Latha Ganti
- Emergency Medicine, Envision Physician Services, Plantation, USA.,Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.,Emergency Medicine, Ocala Regional Medical Center, Ocala, USA.,Emergency Medicine, HCA Healthcare Graduate Medical Education Consortium Emergency Medicine Residency Program of Greater Orlando, Orlando, USA
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39
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Niyitanga G, Zouita I, Basraoui D, Jalal H. Pneumoblastoma: A Rare Tumor in Children Revealed by Pyopneumothorax. Cureus 2021; 13:e17539. [PMID: 34646596 PMCID: PMC8478691 DOI: 10.7759/cureus.17539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 11/05/2022] Open
Abstract
Pneumoblastoma is a rare but severely aggressive primary lung tumor. Exceptional at the pediatric age, pneumoblastoma lacks clinical and radiological specificity. It is rarely mentioned as a first-line differential, as radiological images are often confused with those of congenital lung malformation. This history is reminiscent of the diagnostic difficulty with which the clinician is confronted with the finding of an intrathoracic cystic image of the child. Primary childhood lung tumors, especially pneumoblastoma, are difficult to diagnose both clinically and by imaging. It is necessary to think about it in the face of any lingering respiratory infection and any atypical radiological presentation. We report this case in order to illustrate the usual radiographic, ultrasound, and scenographic aspects of this rare malignant tumor in children and to highlight the diagnostic problems posed by this exceptional pathology.
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Affiliation(s)
- Germaine Niyitanga
- Department of Radiology, University Hospital Mohammed VI, Marrakesh, MAR
| | - Ibtissam Zouita
- Department of Radiology, University Hospital Mohammed VI, Marrakesh, MAR
| | - Dounia Basraoui
- Department of Radiology, University Hospital Mohammed VI, Marrakesh, MAR
| | - Hicham Jalal
- Department of Radiology, University Hospital Mohammed VI, Marrakesh, MAR
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40
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Li F, Qu Y, Zhang T, Cui Z, Sun X, Zhang T, Li J. Evaluation of lung tumor motion in a large sample: Target-related and clinical factors influencing tumor motion based on four-dimensional CT. Cancer Med 2021; 10:7126-7135. [PMID: 34519169 PMCID: PMC8525155 DOI: 10.1002/cam4.4255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/05/2021] [Accepted: 08/18/2021] [Indexed: 12/25/2022] Open
Abstract
Background and purpose We aimed to analyze the influence of target‐related and clinical factors on lung tumor motion based on four‐dimensional CT (4DCT), and clarify the motion based on subgroups in lung stereotactic body radiation therapy. Materials and methods 4DCT image data of 267 tumors from 246 patients were analyzed. The coordinates in the left–right (LR), anterior–posterior (AP), and cranial–caudal (CC) directions of the center of mass (COM) of the gross tumor volumes in 10 phases of 4DCT were measured. The peak‐to‐peak COM displacement in the LR, AP, CC, and 3D directions was calculated. The influence of target‐related and clinical factors on tumor motion was evaluated using multivariate analysis. Results The tumor segment location correlated with the tumor motion in each direction. Tumor size was predictive of tumor motion in the 3D (p = 0.023) and AP directions (p = 0.049). The tumor motion for metastatic tumors was smaller than that for primary tumors in the LR (p = 0.019) and AP directions (p = 0.008). The CC motion for pulmonary surgery recipients (3.8 ± 4.5 mm) was less than that for patients who had not undergone surgery (5.6 ± 5.4 mm), and no significant clinical factor was observed. BSA and BMI were positively correlated with the motion in the CC (p = 0.02) and LR directions (p = 0.002). Conclusion The tumor segment location was a good predictor of tumor motion. A larger tumor tends to have a smaller motion. Patients with metastatic tumors or those who have undergone pulmonary surgery exhibited smaller and more unpredictable tumor motions, which required individual assessments. Thus, clinical factors can potentially predict tumor motion.
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Affiliation(s)
- Fengxiang Li
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yanlin Qu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tingting Zhang
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zhen Cui
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xin Sun
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianbin Li
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Donís SP, García AG, Vila PG, Carrión AB, Jornet PL, Peñaranda JMS, Sayáns MP. Gingival exophytic lesions as first oral manifestation of primary lung adenocarcinomas: Systematic review. Natl J Maxillofac Surg 2021; 12:297-302. [PMID: 35153422 PMCID: PMC8820301 DOI: 10.4103/njms.njms_120_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 05/04/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022] Open
Abstract
Metastases from malignant tumors in the oral cavity are rare and comprise approximately 1% of all oral neoplasms, being more frequent in the jaws than in the soft tissues. The presentation of a gingival metastasis as the first manifestation of a primary tumor in the oral cavity is extremely rare. The objective of this review is to update the diagnosis and management of oral metastasis being the first clinical manifestation of the tumor and review all the cases published to date, providing a new original clinical case with very specific histopathological characteristics. We systematically reviewed the literature in order to find all the cases of primary lung tumors that appeared with a gingival metastasis as the first manifestation. The search process involved a total of 1916 articles. After reading the latter, 15 (one of them with two different cases) met the inclusion criteria. Of the 15 articles, 6 were rated as medium quality (40%) and 9 as high quality (60%). We present a lung adenocarcinoma that first manifested as a metastasis in the gum, simulating a benign lesion. The unusually high growth rate of this lesion should conduct to have other diagnostic possibilities, and histopathological confirmation is essential.
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Affiliation(s)
- Sergio Piñeiro Donís
- Department of Oral Surgery and Implantology, MedOralRes Group, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Spain
| | - Abel García García
- Department of Oral Surgery and Implantology, MedOralRes Group, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Pilar Gándara Vila
- Department of Oral Surgery and Implantology, MedOralRes Group, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Andrés Blanco Carrión
- Department of Oral Surgery and Implantology, MedOralRes Group, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Spain
| | - Pía López Jornet
- Murcian Institute for Biomedical Research (IMIB), University of Murcia, Spain.,Clinical University Hospital Morales Meseguer, University of Murcia, Spain
| | - José M Suárez Peñaranda
- Pathological Anatomy Service of the Santiago de Compostela University Clinical Hospital, Spain
| | - Mario Pérez Sayáns
- Department of Oral Surgery and Implantology, MedOralRes Group, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Spain.,ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Spain
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Yoshimura R, Nishiya M, Yanagawa N, Deguchi H, Tomoyasu M, Kudo S, Shigeeda W, Kaneko Y, Kanno H, Sugai M, Shikanai S, Sugai T, Saito H. Low-grade fibromyxoid sarcoma arising from the lung: A case report. Thorac Cancer 2021; 12:2517-2520. [PMID: 34374195 PMCID: PMC8447909 DOI: 10.1111/1759-7714.14107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/30/2022] Open
Abstract
Low‐grade fibromyxoid sarcoma (LGFMS) is a rare sarcoma subtype that most commonly arises in young adults. This tumor typically presents in the deep soft tissues of the proximal extremities or trunk as a painless mass. Although the most common site of LGFMS metastasis is the lung, it is rarely the primary site. Here, we report a case of primary pulmonary LGFMS. A 22‐year‐old asymptomatic man was referred to our hospital for investigation of a lung mass that had been discovered incidentally. Computed tomography (CT) showed a well‐defined mass 4.0 cm in diameter in the upper lobe of the right lung. Malignancy was suggested by focal uptake of 18F‐fluorodeoxyglucose positron‐emission tomography (18‐FDG‐PET). Following surgery, postoperative histological analysis of the resected specimen demonstrated LGFMS based on histological and immunohistological findings. In particular, mucin 4 showed diffuse positivity in the spindle‐shaped tumor cells. In conclusion, LGFMS can arise in the lungs, and physicians should consider this entity as a differential diagnosis for solitary lung mass in young adults.
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Affiliation(s)
- Ryuichi Yoshimura
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Masao Nishiya
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Naoki Yanagawa
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Hiroyuki Deguchi
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Makoto Tomoyasu
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Satoshi Kudo
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Wataru Shigeeda
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Yuka Kaneko
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Hironaga Kanno
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
| | - Mayu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Shunsuke Shikanai
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Hajime Saito
- Department of Thoracic Surgery, Iwate Medical University School of Medicine, Iwate, Japan
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Patrizi S, Pederiva F, d'Adamo AP. Whole-Genome Methylation Study of Congenital Lung Malformations in Children. Front Oncol 2021; 11:689833. [PMID: 34262872 PMCID: PMC8273538 DOI: 10.3389/fonc.2021.689833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives The treatment of asymptomatic patients with congenital pulmonary malformations (CPMs) remains controversial, partially because the relationship between congenital lung malformations and malignancy is still undefined. Change in methylation pattern is a crucial event in human cancer, including lung cancer. We therefore studied all differentially methylated regions (DMRs) in a series of CPMs in an attempt to find methylation anomalies in genes already described in association with malignancy. Methods The DNA extracted from resected congenital lung malformations and control lung tissue was screened using Illumina MethylationEPIC arrays. Comparisons between the group of malformed samples or the malformed samples of same histology or each malformed sample and the controls and between a pleuropulmonary blastoma (PPB) and controls were performed. Moreover, each malformed sample was pairwise compared with its respective control. All differentially methylated regions (DMRs) with an adjusted p-value <0,05 were studied. Results Every comparison highlighted a number of DMRs closed to genes involved either in cell proliferation or in embryonic development or included in the Cancer Gene Census. Their abnormal methylation had been already described in lung tumors. Conclusions Methylation anomalies already described in lung tumors and also shared by the PPB were found in congenital lung malformations, regardless the histology. The presence of methylation abnormalities is suggestive of a correlation between congenital lung malformations and some step of malignant transformation.
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Affiliation(s)
- Sara Patrizi
- Medical, Surgical and Health Sciences Department, University of Trieste, Trieste, Italy
| | - Federica Pederiva
- Pediatric Surgery, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Adamo Pio d'Adamo
- Medical, Surgical and Health Sciences Department, University of Trieste, Trieste, Italy.,Laboratory of Medical Genetics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
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Nowosielska EM, Cheda A, Pociegiel M, Cheda L, Szymański P, Wiedlocha A. Effects of a Unique Combination of the Whole-Body Low Dose Radiotherapy with Inactivation of Two Immune Checkpoints and/or a Heat Shock Protein on the Transplantable Lung Cancer in Mice. Int J Mol Sci 2021; 22:6309. [PMID: 34208396 PMCID: PMC8231142 DOI: 10.3390/ijms22126309] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) continues to be the leading cause of cancer death worldwide. Recently, targeting molecules whose functions are associated with tumorigenesis has become a game changing adjunct to standard anti-cancer therapy. As evidenced by the results of preclinical and clinical investigations, whole-body irradiations (WBI) with X-rays at less than 0.1-0.2 Gy per fraction can induce remissions of various neoplasms without inciting adverse side effects of conventional chemo- and radiotherapy. In the present study, a murine model of human NSCLC was employed to evaluate for the first time the anti-neoplastic efficacy of WBI combined with inactivation of CTLA-4, PD-1, and/or HSP90. The results indicate that WBI alone and in conjunction with the inhibition of the function of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) and the programmed death-1 (PD-1) receptor immune checkpoints (ICs) and/or heat shock protein 90 (HSP90) markedly reduced tumorigenesis in mice implanted by three different routes with the syngeneic Lewis lung cancer cells and suppressed clonogenic potential of Lewis lung carcinoma (LLC1) cells in vitro. These results were associated with the relevant changes in the profile of pro- and anti-neoplastic immune cells recruited to the growing tumors and the circulating anti- and pro-inflammatory cytokines. In contrast, inhibition of the tested molecular targets used either separately or in combination with each other did not exert notable anti-neoplastic effects. Moreover, no significant synergistic effects were detected when the inhibitors were applied concurrently with WBI. The obtained results supplemented with further mechanistic explanations provided by future investigations will help design the effective strategies of treatment of lung and other cancers based on inactivation of the immune checkpoint and/or heat shock molecules combined with low-dose radiotherapy.
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Affiliation(s)
- Ewa M. Nowosielska
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland; (A.C.); (P.S.); (A.W.)
| | - Aneta Cheda
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland; (A.C.); (P.S.); (A.W.)
| | - Mateusz Pociegiel
- National Centre for Nuclear Research Radioisotope Centre POLATOM, 7A Soltana St., 05-400 Otwock, Poland;
| | - Lukasz Cheda
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, 101 Żwirki i Wigury St., 02-089 Warsaw, Poland;
| | - Paweł Szymański
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland; (A.C.); (P.S.); (A.W.)
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, 1 Muszyńskiego St., 90-151 Lodz, Poland
| | - Antoni Wiedlocha
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland; (A.C.); (P.S.); (A.W.)
- Department of Molecular Cell Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway
- Centre for Cancer Reprograming, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Montebello, 0379 Oslo, Norway
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Shen X, Chen T, Yang B, Liu N, Qian X, Xia B, Feng D, Chen S. Magnetic resonance imaging-guided microwave ablation for lung tumor: a case report. Quant Imaging Med Surg 2021; 11:2780-2784. [PMID: 34079742 DOI: 10.21037/qims-20-667] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Thoracoscopic surgery is considered to be the best treatment option for pulmonary lesions. However, for patients with clinical stage IIIA, surgery is not always feasible, due to a lack of sufficient lung function. Microwave ablation (MWA) is an appropriate, minimally invasive treatment option for these patients. In this case study, we present our initial experience with MWA guided by magnetic resonance imaging (MRI), in a patient with a lesion located in the right lower lobe. The patient was successfully ablated and achieved a long progression-free period.
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Affiliation(s)
- Xiaokang Shen
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China.,The Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Tianming Chen
- Department of General Surgery, Nanjing Medical University Third Affiliated Hospital, Nanjing, China
| | - Bo Yang
- Department of Medical Imaging, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Nianlong Liu
- Department of Medical Imaging, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaowei Qian
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Bin Xia
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Dongjie Feng
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Shilin Chen
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China.,The Fourth Clinical College of Nanjing Medical University, Nanjing, China
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Rao CV, Xu C, Farooqui M, Zhang Y, Asch AS, Yamada HY. Survival-Critical Genes Associated with Copy Number Alterations in Lung Adenocarcinoma. Cancers (Basel) 2021; 13:cancers13112586. [PMID: 34070461 PMCID: PMC8197496 DOI: 10.3390/cancers13112586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 12/19/2022] Open
Abstract
Chromosome Instability (CIN) in tumors affects carcinogenesis, drug resistance, and recurrence/prognosis. Thus, it has a high impact on outcomes in clinic. However, how CIN occurs in human tumors remains elusive. Although cells with CIN (i.e., pre/early cancer cells) are proposed to be removed by apoptosis and/or a surveillance mechanism, this surveillance mechanism is poorly understood. Here we employed a novel data-mining strategy (Gene Expression to Copy Number Alterations [CNA]; "GE-CNA") to comprehensively identify 1578 genes that associate with CIN, indicated by genomic CNA as its surrogate marker, in human lung adenocarcinoma. We found that (a) amplification/insertion CNA is facilitated by over-expressions of DNA replication stressor and suppressed by a broad range of immune cells (T-, B-, NK-cells, leukocytes), and (b) deletion CNA is facilitated by over-expressions of mitotic regulator genes and suppressed predominantly by leukocytes guided by leukocyte extravasation signaling. Among the 39 CNA- and survival-associated genes, the purine metabolism (PPAT, PAICS), immune-regulating CD4-LCK-MEC2C and CCL14-CCR1 axes, and ALOX5 emerged as survival-critical pathways. These findings revealed a broad role of the immune system in suppressing CIN/CNA and cancer development in lung, and identified components representing potential targets for future chemotherapy, chemoprevention, and immunomodulation approaches for lung adenocarcinoma.
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Affiliation(s)
- Chinthalapally V. Rao
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
- VA Medical Center, Oklahoma City, OK 73104, USA
- Correspondence: (C.V.R.); (H.Y.Y.)
| | - Chao Xu
- Hudson College of Public Health, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
| | - Mudassir Farooqui
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA;
| | - Yuting Zhang
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
| | - Adam S. Asch
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
| | - Hiroshi Y. Yamada
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, USA;
- Correspondence: (C.V.R.); (H.Y.Y.)
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Trabucco SMR, Brascia D, Cazzato G, De Iaco G, Colagrande A, Signore F, Ingravallo G, Resta L, Marulli G. Pulmonary Sclerosing Pneumocytoma: A Pre and Intraoperative Diagnostic Challenge. Report of Two Cases and Review of the Literature. Medicina (Kaunas) 2021; 57:medicina57060524. [PMID: 34071040 PMCID: PMC8224668 DOI: 10.3390/medicina57060524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 02/05/2023]
Abstract
Pulmonary sclerosing pneumocytoma is a rare benign pulmonary tumor of primitive epithelial origin. Because of the unspecific radiological features mimicking malignancies and its histological heterogeneity, the differential diagnosis with adenocarcinoma and carcinoid tumors is still challenging. We report our experience of two cases of sclerosing pneumocytoma, as well as a review of the literature. Immunohistochemical findings showed intense staining of the cuboidal epithelial cells for cytokeratin-pool and TTF-1, with focal positivity for progesterone receptors. Round and spindle cells expressed positivity for vimentin, TTF-1 and focally for the progesterone receptor. Cytologic diagnosis of pulmonary pneumocytoma requires the identification of its dual cell population, made up of abundant stromal cells and fewer surface cells. Since the pre- and intraoperative diagnosis should guide surgical decision making, obtaining a sufficient specimen size to find representative material in the cell block is of paramount importance.
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Affiliation(s)
- Senia Maria Rosaria Trabucco
- Pathology Unit, Department of Organ Transplantation and Emergency (DETO), University Hospital of Bari, 70124 Bari, Italy; (S.M.R.T.); (A.C.); (G.I.); (L.R.)
| | - Debora Brascia
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70124 Bari, Italy; (D.B.); (G.D.I.); (F.S.)
| | - Gerardo Cazzato
- Pathology Unit, Department of Organ Transplantation and Emergency (DETO), University Hospital of Bari, 70124 Bari, Italy; (S.M.R.T.); (A.C.); (G.I.); (L.R.)
- Correspondence: (G.C.); (G.M.); Tel.: +34-0-5203641 (G.C.)
| | - Giulia De Iaco
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70124 Bari, Italy; (D.B.); (G.D.I.); (F.S.)
| | - Anna Colagrande
- Pathology Unit, Department of Organ Transplantation and Emergency (DETO), University Hospital of Bari, 70124 Bari, Italy; (S.M.R.T.); (A.C.); (G.I.); (L.R.)
| | - Francesca Signore
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70124 Bari, Italy; (D.B.); (G.D.I.); (F.S.)
| | - Giuseppe Ingravallo
- Pathology Unit, Department of Organ Transplantation and Emergency (DETO), University Hospital of Bari, 70124 Bari, Italy; (S.M.R.T.); (A.C.); (G.I.); (L.R.)
| | - Leonardo Resta
- Pathology Unit, Department of Organ Transplantation and Emergency (DETO), University Hospital of Bari, 70124 Bari, Italy; (S.M.R.T.); (A.C.); (G.I.); (L.R.)
| | - Giuseppe Marulli
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70124 Bari, Italy; (D.B.); (G.D.I.); (F.S.)
- Correspondence: (G.C.); (G.M.); Tel.: +34-0-5203641 (G.C.)
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Abstract
Objective To study the safety and feasibility of implementation of precise radiotherapy with inducement of an apnea-like condition. Methods Two patients with lung tumors underwent precise radiotherapy under an apnea-like condition. The apnea-like condition was induced 11 times between the two patients for tumor localization and treatment. The changes in the blood oxygen saturation, blood pressure, heart rate, and end-tidal carbon dioxide during the apnea-like periods were observed, and the incidence of adverse reactions was recorded. Results The average apnea-like time was 6.2 minutes (range, 3–9 minutes), and the average radiotherapy time was 4.6 minutes (range, 1–7 minutes). The lowest blood oxygen saturation level was 97%, with a change of <1%. The heart rate and average arterial blood pressure increased during the apnea-like periods. Contact sores appeared on the patients’ posterior pharyngeal wall after the first apnea-like period; no other adverse events occurred. Conclusion Precise radiotherapy under an apnea-like condition is safe and feasible for patients with lung tumors.
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Affiliation(s)
- Shilong Zhang
- Department of Anesthesiology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Bin Zhao
- Department of Anesthesiology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Dongji Chen
- Department of Radiotherapy, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Ying Qi
- Department of Radiotherapy, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Youguo Ma
- Department of Radiotherapy, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Juan Ma
- Department of Anesthesiology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Wenjuan Xie
- Department of Anesthesiology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Haiyan Guo
- Department of Anesthesiology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
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Kang DK, Kang MK, Heo W, Hwang YH, Kim JY. Large pulmonary sclerosing pneumocytoma in a young female: A rare lung tumor. Thorac Cancer 2021; 12:1909-1911. [PMID: 33951309 PMCID: PMC8201539 DOI: 10.1111/1759-7714.13970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022] Open
Abstract
We report a case of a 28‐year‐old female who presented with a solid mass lesion in the right middle lobe (RML). A chest computed tomography (CT) scan showed a 3.5 cm sized round and solid mass between the medial and lateral segment of the RML. The patient underwent a percutaneous lung biopsy with CT scan guidance and pathological examination showed pulmonary sclerosing pneumocytoma. RML lobectomy was performed for definitive treatment. Here, we describe this rare lung disease which presented as a large homogeneous lesion. Pulmonary sclerosing pneumocytoma should be considered in the differential diagnosis of solitary lung tumor, even if the patient is young.
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Affiliation(s)
- Do Kyun Kang
- Department of Thoracic and Cardiovascular Surgery, Inje University College of Medicine, Busan, South Korea
| | - Min Kyun Kang
- Department of Thoracic and Cardiovascular Surgery, Inje University College of Medicine, Busan, South Korea
| | - Woon Heo
- Department of Thoracic and Cardiovascular Surgery, Inje University College of Medicine, Busan, South Korea
| | - Youn-Ho Hwang
- Department of Thoracic and Cardiovascular Surgery, Inje University College of Medicine, Busan, South Korea
| | - Ji Yeon Kim
- Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Székely R, Suhai FI, Karlinger K, Baksa G, Szabaczki B, Bárány L, Pölöskei G, Rácz G, Wagner Ö, Merkely B, Ruttkay T. Human Cadaveric Artificial Lung Tumor-Mimic Training Model. Pathol Oncol Res 2021; 27:630459. [PMID: 34257596 PMCID: PMC8262143 DOI: 10.3389/pore.2021.630459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/01/2021] [Indexed: 12/11/2022]
Abstract
Introduction: An important phase in surgical training is gaining experience in real human anatomical situations. When a cadaver is available it may complement the various artificial practice models. However, it is often necessary to supplement the characteristics of the cadavers with a simulation of a tumor. Our objective was to develop an easy-to-create, realistic artificial tumor-mimic model for peripheral lung tumor resection practice. Methods: In our work we injected barium sulphate enriched silicone suspension into 10 isolated, non-fixed lungs of human cadavers, through the puncture of the visceral pleura. Four lesions–apical, hilar and two peripheral–were created in each of ten specimens. After fixation CT scans were obtained and analyzed. The implanted tumor-mimics were examined after anatomical preparation and slicing. Also performed CT-guided percutaneous puncture was also performed to create the lesions in situ in two lungs of human cadavers. Results: Analyzing the CT data of 10 isolated lungs, out of 40 lesions, 34 were nodular (85.0%) and in the nodular group five were spiculated (12.5%). Satellite lesions were formed in two cases (5.0%). Relevant outflow into vessels or airway occurred in five lesions (12.5%). Reaching the surface of the lung occured in 11 lesions (27.5%). The tumor-mimics were elastic and adhered well to the surrounding tissue. The two lesions, implanted via percutaneous puncture, both were nodular and one also showed lobulated features. Conclusion: Our artificial tumor-mimics were easy to create, varied in shape and size, and with percutaneous implantation the lesions provide a model for teaching every step of a surgical procedure.
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Affiliation(s)
- Réka Székely
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | | | - Kinga Karlinger
- Medical Imaging Center, Semmelweis University, Budapest, Hungary
| | - Gábor Baksa
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Bence Szabaczki
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - László Bárány
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Gergely Pölöskei
- Medical Imaging Center, Semmelweis University, Budapest, Hungary
| | - Gergely Rácz
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Ödön Wagner
- Department of Inorganic and Analytical Chemistry, Budapest University of Technology and Economics, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tamás Ruttkay
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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