Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
ObjectiveTo compare the current status of clinical studies regarding lung cancer between China and the United States in 2019, and to indicate the weakness, trend and future development direction of clinical studies drug treatment in China.MethodsThe data of lung cancer clinical studies from January 1st to November 30th, 2019 in China and the United States were retrieved and analyzed through Informa pharmaprojects database.ResultsThe United States was superior on the number of projects (128 vs. 156) and research institutions (743 vs. 2 250). Compared with the United State, there were more phase Ⅲ confirmatory researches (19.5% vs. 10.3%), bioequivalent drug researches (3.1% vs. 0%), and researches initiated by academic institutions (39.8% vs. 28.1%) in China. The United States exhibited advantages in phaseⅠ andⅠ/Ⅱstudies (25.8% vs. 60.3%), immunodrugs (49.2% vs. 60.3%), primary tested drug ratio (61.7% vs. 93.6%), targets abundance (32.9% vs. 69.6%), and chimeric antigen receptor-T (CAR-T, 0.7% vs. 7.1%).ConclusionCompared with the United States, China should pay more attention to innovative drug investigations in early phase of clinical studies, especially novel immune agents, vaccines, and CAR-T.
ObjectiveTo evaluate the feasibility and clinical value of robot-assisted lobectomy through anterior approach.MethodsWe retrospectively analyzed the clinical data of 180 patients who underwent robot-assisted lobectomy through anterior approach in our hospital between April 2017 and February 2018. There were 97 males and 83 females, aged 59.5 (32.0-83.0) years. The clinical effects were analyzed.ResultsOne patient was transferred to thoracotomy due to tumor invasion of adjacent blood vessels and injury to the blood vessels, and there was no perioperative death. There were 8.5 (1.0-35.0) dissected lymph nodes for each patient. The median operation time was 120 (50-360) min, including robot Docking time 5 (1-23) min and robot operation time 65 (7-270) min. The median blood loss was 50 (5-1 500) mL, 132 (73.3%) patients had malignant tumors and median drainage time was 5 (2-30) d. The mean postoperative pain score was 3.4±0.7 points and the postoperative hospital time was 8 (2-32) d. At the median follow-up of 24 months, 11 patients developed recurrence and metastasis, and 3 died.ConclusionRobot-assisted lobectomy through anterior approach is a safe and convenient operation method, which is worthy of clinical application.
Objective To evaluate the value of incremental dynamic enhanced computer tomography (CT) in diagnosis of solitary pulmonary nodules (SPN). Methods The data of 42 cases with SPN who had undergone pulmonary lobectomy were collected retrospectively to find the relationship between character of preoperative dynamic enhanced CT image and postoperative pathologic result. Results All bronchogenic carcinoma showed significant enhancement after intravenous 100 ml iodinated contrast material. The average degree of enhancement of bronchogenic carcinoma during the time 85s and 135s after infusion was significantly different from that of tuberculoma and other benign lesions(Plt;0.05). Conclusion Dynamic enhanced CT is valuable in identifying the malignant nodules from benign nodules. Emphasis should be paid to the lymph nodes in the relative field with dynamic enhanced CT, which is beneficial to the diagnosis of SPN and it is an important predictor of the result of surgical treatment.
Objective To improve accuracy of clinical diagnosis through analyzing the CT characteristics and clinical manifestations of patients with benign lung diseases whose CT manifestations initially led to a suspicion of lung cancer. Methods This study collected 2 239 patients of benign lung disease verified by postoperative pathology in the Department of Thoracic Surgery, Beijing Chao-yang Hospital from June 2006 to December 2016. Lesions of 173 patients (101 males and 72 females with a mean age of 56.0 years) were considered very likely to be malignant on preoperative contrast CT scan, which were sorted to 20 types of lung diseases, and the 20 types of diseases contained 907 patients diagnosed or misdiagnosed. Statistical analyses were performed using the CT and clinical characteristics of the 173 patients. Results Among the 907 patients with benign lung disease, the benign pathologies that were most commonly misdiagnosed by preoperative enhanced CT were pulmonary leiomyoma (100.0%), pulmonary actinomycosis (75.0%), pulmonary cryptococcosis (71.4%), sclerosing hemangioma (50.0%) and organizing pneumonia (44.2%). Among the 173 patients with benign diseases, the most common diseases were tuberculosis (29.5%), organizing pneumonia (28.9%), pulmonary hamartoma (6.4%) and pulmonary abscess (6.4%). In the 173 patients, 17.3% had fever, 56.6% coughing, 8.7% yellow sputum, 28.9% hemoptysis, 16.2% chest pain, 18.5% elevated leukocyte counts and 4.6% elevated carcinoembryonic antigen levels. Most of the CT manifestations consisted of nodular or mass shadows, 70.5% of which had foci≤3 cm and manifestations were similar to those of lung cancer, such as a spiculated margin (49.1%), lobulation (33.5%), pleural indentation (27.2%) and significant enhancement (39.3%). Furthermore, some patients had uncommon tumor signs, such as calcification (12.7%), central liquefactive necrosis (18.5%), satellite foci (9.8%) and multiple pulmonary nodules (42.2%). Moreover, 24.3% of the patients had enlarged lymph nodes of the mediastinum or hilum. Conclusion As the CT manifestations of some benign lung conditions are similar to those of lung cancer, careful differential diagnosis is necessary to identify the basic characteristics of the disease when the imaging results are ambiguous, and the diagnosis of a lung disease need incorporate the patients' clinical characteristics and a comprehensive analysis.
Increasing evidence suggests that there is a close relationship between pulmonary ground-glass opacity (GGO) and early-stage lung cancer, especially bronchial alveolar carcinoma in the early stage. With the use of high-resolution computed tomography (HRCT) and positron emission tomography/computed tomography (PET/CT), more and more GGO patients have been identified. Correct diagnosis and surgical indications should be determined according to the image characteristics including proportion and size of GGO in a pulmonary nodule as well as intraoperative quick pathological examination to avoid unnecessary surgical resection. Therefore, early detection and correct diagnosis of GGO are very important to improve patient prognosis.
Objective An animal model of lung cancer was established to study whether wasabi could inhibit the expression of hnRNP A2/B1 in lung.Methods Thirty-six Wistar rats were randomly divided as model group and wasabi group.0.1 mL of arcinogenic iodized oil [50 mg 3-methylcholanthrene (MCA) in 1 mL carcinogenic iodized oil] were instilled intratracheally to induce lung cancer.A week before instillation of MCA，the wasabi group was orally administered wasabi extract solution until the animals were killed while the model group was given isometric saline at the same time.Six rats in each group were randomly killed on 30th day，60th day and 90th day.Immunohistochemisty and RT-PCR were used to measure the protein and mRNA expression of hnRNP A2/B1，respectively.Results Wasabi lowered the protein expression of hnRNP A2/B1 with a total inhibitory rate of 48.5%.At the 30th，60th and 90th day，the inhibitory rate was 51.0%，51.0% and 45.1% respectively.Meanwhile，wasabi lowered the mRNA expression of hnRNP A2/B1 with a total inhibitory rate of 60.5%.At the 60th and 90th day，the inhibitory rate was 79.5% and 58.0%，respectively.Conclusion Wasabi solution can down-regulate the expression of hnRNP A2/B1 which may be a molecular mechanisms by which wasabi inhibits lung cancer.
Recently, sponsored by the Science Popularization Department of the China Anti Cancer Association, jointly organized by the Rehabilitation Branch of the China Anti Cancer Association and the Mijian Digital Cancer Patient Course Management Platform, and co-organized by the Science Popularization Special Committee of the China Anti Cancer Association, The "2022 White Paper on the Quality of Life of Chinese Lung Cancer Patients" has been officially released (herein after referred to as the "White Paper"), which mainly elaborates on the basic situation of Chinese lung cancer patients and the medical, social, and economic impacts caused by the disease. This article interprets the White Paper in order to help the public understand the real situation of lung cancer patients and provide important empirical evidence and valuable insights for the diagnosis, treatment, and rehabilitation of lung cancer in China.
The article titled "The global burden of lung cancer: Current status and future trends" which is recently published in Nature Reviews Cinical Oncology has provided a detailed analysis of the current global status of lung cancer. This article focuses on the global burden of lung cancer, risk factors, related prevention, control measures and treatment progress. Based on the current situation of lung cancer in the world, this paper analyzes the current situation of lung cancer in China, and briefly interprets the key points of prevention as well as control measures in the article.
Objective To explore the effect of motivational interviewing (MI) on anxiety and depression in patients with lung cancer undergoing initial chemotherapy. Methods From May 2015 to April 2016, patients with lung cancer who underwent initial chemotherapy after operation were collected and randomly divided into the control group and the MI group. The patients in the control group received traditional health education, psychological care, and post-discharge follow up; while the patients in the MI group were given routine nursing cares and three motivational interviews and one telephone follow up. At the admission and one month after chemotherapy, all patients were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Distress Thermometer (DT). Results At the admission, the SAS, SDS, and DT scores of patients in the two groups had no significant differences (P>0.05). After one month of chemotherapy, the SAS, SDS, and DT scores in the MI group were much better compared to the admission (P<0.05). The differences in the SAS, SDS, and DT scores between the two groups were significant (P<0.05). Conclusion MI can significantly alleviate anxiety and depression of patients with lung cancer undergoing initial chemotherapy.