ABSTRACT
Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.
ABSTRACT
Background and purpose: With characteristic but non-specific features, subsolid pulmonary nodules (SSPN) is closely associated with early lung cancer. This study aimed to estimate the imaging value of SSPN in stageⅠA lung cancer, and summarized the radiological features of various SSPNs, retrospectively. Methods:The clinical data and imaging data of 405 patients with solitary pulmonary nodules (SPNs) from Apr. 2008 to Apr. 2014 at Fudan University Shanghai Cancer Center were collected. According to ground-glass opacity (GGO) proportion, SPNs were divided into 3 groups:pure ground-glass opacity (pGGO), mixed ground-glass opacity (mGGO) and solid nodule (SN). The malignant ratios were calculated based on the postoperatively pathological results. Besides, SSPNs were classiifed into stageⅠA lung cancer group and benign lesions group aiming at identifying the differentiating computed tomography (CT) features. Results:Of the enrolled 405 SPN patients, there were 367 SSPNs (including 124 pGGOs and 243 mGGOs) whose incidence in stageⅠA lung cancer group was signiifcantly higher than those in benign group [95.9%(257/268) vs 80.3%(110/137), P<0.001]. The total malignant ratio of SSPN was 70.0%(257/367), mGGO had a higher malignant ratio (72.0%) than those of pGGO (66.1%) and SN (28.9%). The malignant SSPNs were frequently detected in upper lobe of middle-aged women with a higher incidence of irregular edge, spiculation, lobulation and pleural retraction than benign group (P<0.05). Conclusion:SSPN is one of the signiifcantly malignant indicators, and mGGO has the highest malignant tendency. Senility, female, irregular edge, spiculation, lobulation, pleural retraction and pulmonary upper lobe distribution are demonstrated the signiifcant discriminators from benign lesions.
ABSTRACT
Background and purpose:Clinical data show that Endostar, a recombinant human endostatin, has the therapeutic beneift for patients with non-small cell lung cancer (NSCLC) while combined with chemotherapy or ra-diotherapy. However, the microenvironment changes induced by Endostar monotherapy in NSCLC is not yet clear. The purpose of this study was to prospectively study tumor vascular effects of Endostar monotherapy in patients with locally advanced or advanced NSCLC by dynamic contrast-enhanced perfusion computed tomography (CT perfusion, CT-p). Methods:Previously untreated patients with histologically or cytologically conifrmed locally advanced or advanced NSCLC were eligible. All patients received daily Endostar (7.5 mg?m2) for 14 days. CT-p scans were acquired at the baseline and post-treatment. CT-p parameters, such as blood lfow (BF), blood volume (BV) and permeability surface PS (area product), were measured in all patients.Results:Of all 7 patients enrolled, four were staged asⅢB and three as stageⅣ (2 with malignant pleural effusion, 1 with brain metastasis). The median BF, BV and PS values of baseline and post-treatment were 27.1/48.9 mL/100 mL/min, 86.8/84.8 mL/100 mL and 45.0/54.0 mL/100 mL/min, respectively. After administration of Endostar for 14 days , BF showed a signiifcant increase compared with that at baseline (P=0.028), whereas no signiifcant changes were found in BV (P=0.398) and PS (P=0.237) values.Conclusion:Our results suggest that Endostar monotherapy induces a signiifcant increase in BF whereas no signiifcant difference in BV and PS.
ABSTRACT
Objective To evaluate the feasibility of sentinel lymph node(SLN) mapping with CT lymphography (CT-LG). Methods Twenty-five patients with confirmed breast cancer and no palpably axillary lymph node underwent CT-LG examination. The first one or more lymph nodes along the lymph duct draining from the injection sites to axilla were defined as SLNs, and then the LG results were compared with sentinel lymph node biopsy (SLNB). The over- and underestimation of LG were evaluated. The quality of LG imaging was classified Grade Ⅰ and Ⅱ according to lymph duct appearance on volume rendering (VR). The body mass index (BMI) ＞ 25 was considered obesity. Fisher exact test was used for the statistics. Results (1)Of 25 patients, 5 had local mastectomy history. BMI ＜ 25 was found in 20 cases, and ≥25 was in 5 cases. (2) All SLNs were showed by CT-LG, and Grade Ⅰ and Ⅱ imaging quality were achieved in 21 cases ( 84. 0% ) and 4 cases ( 16. 0% ), respectively. The obese patient tended to have a poor imaging quality ( P ＜ 0. 05 ). (3) Fifty-six SLNs and 45 lymph ducts in all 25 patients were identified on CT-LG. Compared with the results of SLNB, 7 cases ( 28. 0% ) and 9 cases ( 36. 0% ) were over- and underestimated respectively by CT-LG due to obesity and local mastectomy ( P ＜ 0. 05 ). (4) Fifty-two negative SLNs in 18 patients and 15 positive SLNs in 7 patients were confirmed by pathology through SLNB, while 56 SLNs were delineated on CT-LG with 43 negative and 13 positive. The shape in 32. 6% of the negative SLNs (14/43) and 76. 9% of the positive SLNs (10/13) was round,the difference was significant (P＜0. 05). The filling defect on the center in 9.3% of negative SLNs (4/43) and 23. 1% of positive SLNs (3/13) was demonstrated, and irregular filling defect on the margin was found only in 30.8% of positive SLNs (4/13). 3 SLNs in 2 patients combined with small satellite lymph nodes on CT-LG were also confirmed to have tumor infiltration. Conclusion CT-LG can clearly demonstrate the breast lymphatic pathway and may potentially be used for breast SLN mapping, while the imaging quality can be influenced by the obesity and local mastectomy.
ABSTRACT
Objective To evaluate the feasibility,safety and clinical value of CT-guided localization with a Hook-wire system for nodular pulmonary lesions before video-assisted thoracoscopic resection (VATS). Methods The records of all patients undergoing VATS resection for solitary pulmonary nodules preoperatively localized by CT-guided a Hook-wire system were assessed with respect to failure to localize the lesion by the Hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of nodular pulmonary lesions. Results Sixty-eight patients with seventy four nodules underwent VATS resections. Preoperative CT-guided Hook-wire localization succeeded in all patients ( 100. 0% ). Conversion thoracotomy was necessary in 2 patients. The average operative time was ( 15 ±6)min. Asymptomatic complication rate was 70.6% (48/68), asymptomatic pneumothorax rate, asymptomatic hemorrhage rate and simultaneous pneumothorax and bleeding rate were 45.6% (31/68),25.0% ( 17/68 ) and 4. 4% ( 3/68 ), respectively. The mean hospitalization was ( 15 ± 6 ) days.Histological assessment revealed primary lung cancer (NSCLC) in 30, metastasis in 18, and nonmalignant disease in 26 nodules. Conclusions Video-assisted thoracoscopic resection of nodular pulmonary lesions previously localized by a CT-guided Hook-wire system is related to a low conversion thoracotomy rate, short operation time, and high safety. It for differential diagnosis and treatment.
ABSTRACT
The pharmacological activity of Mycena dendrobii Fan et Guo, a new species of endophytic fungus was studied. It was revealed that the mycelia methanol extracts and the fermentation liquid ethanol extracts of Mycena dendrobii showed anglgesic effect to mice, which have the correlations to that of the traditional Chinese medicine ‘shihu’. The fermentation liquid ethanol extracts of Mycena dendrobii showed excitation effect to central nervous system of mice. Then the effective parts of anglgesic effect was determined.