Value of endobronchial ultrasound-transbronchial needle aspiration biopsy for diagnosis of PET-CT positive mediastinal lymph nodes / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) biopsy for diagnosis of PET-CT positive mediastinal lymph nodes.</p><p><b>METHODS</b>One hundred and twenty-six patients with lung cancer undergoing both PET-CT scanning and EBUS-TBNA biopsy in the First Affiliated Hospital of Guanzhou Medical College from July 2008 to August 2010 were included in this study. There were 89 male and 37 female patients with a mean age of 56.3 years (range 34 to 81 years). (18)FDG-PET was considered positive in mediastinal nodes if the PET-CT reported hypermetabolic activity consistent with malignant disease (standardized uptake value > 2.5). All of the patients were clinically followed up.</p><p><b>RESULTS</b>Among the 126 patients, 185 stations of lymph nodes were punctured. The mean diameter of the nodes was 13.6 mm and the range was 6 - 23 mm. There were no procedural complications. The diagnostic accuracy, sensitivity, and specificity of EBUS-TBNA were 95.7%, 95.7%, and 100%, respectively.</p><p><b>CONCLUSIONS</b>EBUS-TBNA is a minimally invasive, highly effective and accurate, practical and safe procedure for diagnosis of PET-CT positive mediastinal lymph nodes.</p>

Injection of activated carbon nanoparticles for guiding lymphadenectomy during minimal invasive surgery in lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in lung cancer.</p><p><b>METHODS</b>Fourty-two lung cancer patients were divided into two groups: the control group (22 cases) and experiment group (20 cases) who received activated carbon nanoparticles injection around the tumor either by endoscopic injection or intraoperative subserosal injection. The number of dissected lymph node, black-stained lymph node, positive lymph node and the side effect of the procedure were analyzed, respectively.</p><p><b>RESULTS</b>No severe complication was observed in the experiment group. The operative time was not prolonged significantly in the experiment group either. However, the number of average lymph nodes dissected in the experiment group (25.5) was significantly more than that in the control group (14.6) (P <0.01).</p><p><b>CONCLUSION</b>Local injection of activated carbon nanoparticles around the tumor during surgical exploration is effective, safe and easy to do for guiding lymphadenectomy in lung cancer patient.</p>

Single lung transplantation for emphysema: analysis of 6 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To review the experience with the management of single lung transplantation for emphysema.</p><p><b>METHODS</b>Between January 2003 and August 2006, single lung transplantation was performed in 6 patients for emphysema with cold low potassium solution flushing. A triple-drug regimen was adopted using steroids, mycophenolate mofetil and tacrolimus as the maintenance immunosuppressants. Chest radiograph score, oxygenation index, and pulmonary arterial pressure of the patients in early after the transplantation were reviewed.</p><p><b>RESULTS</b>All the 6 patients survived for over 30 days after the operation, and 4 of them remained alive with good quality-of-life. Four patients recovered from acute rejection successfully after methylprednisolone pulse therapy for 3 days. One patient underwent reoperation for hemorrhage in the thoracic cavity and finally recovered; spontaneous pneumothorax of the autologous lungs occurred in two patients, who underwent reoperation but finally died 74 days and 77 days after the transplantation, respectively.</p><p><b>CONCLUSION</b>Single lung transplantation is effective for end-stage emphysema. Carefully selected recipients and comprehensive design of the surgical procedures are critical to successful lung transplantation.</p>

Bronchial sleeve resection and reconstruction of pulmonary artery by video-assisted thoracic small incision surgery for central lung cancer: a report of 139 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and practicability between bronchial sleeve resection or reconstruction of the pulmonary artery by video-assisted thoracic small incision and routine posterolateral incision for lung cancer.</p><p><b>METHODS</b>The clinic data was analyzed retrospectively, including 139 cases in our hospital underwent sleeve lobectomy and bronchoplasty by video-assisted thoracic small incision surgery for lung cancer from January 1995 to July 2007 and 99 cases in the HUAXI Hospital of SICHUAN University underwent routine posterolateral incision from April 2000 to December 2005. All patients whose bronchus and/or pulmonary artery were involved underwent the operation and experienced the bronchial sleeve resection or reconstruction of the pulmonary artery.</p><p><b>RESULTS</b>All patients were done operation successfully with no perioperative mortality and no occurrence of anastomosis stenosis as well as fistula. The median survival period of video-assisted thoracic small incision patients and the posterolateral incision patients were 63.17 months and 42.00 months, respectively (P > 0.05). There was no sign of reperfusion injury in the reconstruction of the pulmonary artery patients. The small incisions' length was from 8 to 13 cm and the mean length was 10 cm. The routine posterolateral incisions' mean length was 30 cm. Compared to the patients underwent the routine posterolateral incision, patients underwent the operation of video assisted thoracic small incision had less operation time, less chest tube time, less hospitalization time and less postoperative shoulder joint dysfunction.</p><p><b>CONCLUSIONS</b>The bronchial sleeve resection and reconstruction of the pulmonary artery by video-assisted thoracic small incision surgery for lung cancer can finish the same work as the traditional thoracic lateral incision with less trauma and recovery time.</p>

The preliminary study on molecular biologic staging of non-small cell lung cancer lymph nodes / 中国基层医药

Objective To analyze negative lymph nodes of 34 non-small cell lung cancer(NCLC) patients with total correction by means of fluorescent quantitation PCR and immunohistcchemistry,and to form molecular bi- ology staging.Methods Clinical data and tissue samples of 193 lymph nodes were collected from 34 patients under- going resection for non-small cell lung cancer.Using fluorescent quantitation reverse transcription-polymerase chain reaction(RT-PCR) and immunohistochemistry method,lymph nodes were examined for CEA gene mRNA,P53 and CK to form molecular biology staging.All the patients were followed-up for an average of forty months.Results The CEAmRNA was identified in 21.7% (42/193) lymph nodes negative patients from 17 patients(17/34,50%); TMN staging was up-regulated in 8 patients;positive lymph nodes were increased in 9 patients.P53 and AE1/AE3 were identified 9.8%(19/193) from 11 patients,18.6 % (36/193)from 15 patients,separately;TMN staging was up-regulated in 2 patients of P53 examination and 5 patients of AE1/AE3 analysis;positive lymph nodes were in- creased in in 7 patients of P53 examination and 11 patients of AE1/AE3 analysis.There was obvious statistical sig- nificance in them,but the molecular biology staging based on the three markers was not an independent factor on re- currence and metasis of lung cancer.Conclusion CEAmRNA.P53 and AE1/AE3 analysis could find lung cancer micrometasis more sensitively to form molecular biology staging which was relative to the prognosis,but not an inde- pendent prognostic indicator.It might be good to the therapy strategy after operation.