Fungal granuloma of mediastinal lymph nodes in an immunocompetent host / 中华医学杂志(英文版)

This is a case report of mediastinal fungal granuloma in an immunocompetent host. The definite diagnosis was made by pathological biopsy via video-assisted thoracoscopy and silver methenamine staining showed aspergillus hyphae and spores in the epithelioid granuloma. In conclusion, opportunistic pathogenic fungi can cause granulomatous inflammation in mediastinal lymph nodes in an immunocompetent host, as it can do in an immunocompromised host. More attention should be paid on tissue biopsy and pathological examination to ensure a correct diagnosis for these kinds of cases.

Result of surgical treatment and prognostic factors in giant mass lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the role of surgery in the treatment of giant mass lung cancer and to analyze prognostic factors affecting surgical result.</p><p><b>METHODS</b>From August 1992 to August 2005, the clinical data of 137 patients with giant mass lung cancer ( > or =8 cm in diameter) were retrospectively reviewed. 122 cases had radical resection with 63 lobectomies, 48 pneumonectomy and 11 other resection modes, the remaining 15 patients underwent palliative resection. The prognostic factors including sex, tumor size, p-TNM stage, T stage, N stage, histological types and operation extent were analyzed with SPSS 13.0 software. The survival rate was calculated by Kaplan-Meier method and logrank was used for comparing survival difference. Univariate and multivariate prognostic factors for survival were analyzed by Cox proportional hazard regression model.</p><p><b>RESULTS</b>The overall 1-, 3- and 5-year survival rate was 76.0%, 49.2% and 40.1%, respectively. Sex (P = 0.001), p-TNM stage (P = 0.001), N stage (P = 0.042), surgical approach (P = 0.026) and T stage (P = 0.006) were found to be prognostic factors in Cox univariate analysis. p-TNM stage (P = 0.001) were identified as an independent prognostic factor in Cox multivariate analysis.</p><p><b>CONCLUSION</b>p-TNM stage is the crucial prognostic factor in surgical treatment for giant mass lung cancer. Strict selection of candidate for resection and complete resection may be helpful in improving survival in patient with giant mass lung cancer.</p>

Study of prognostic factors in patients with stage I non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the prognostic factors in patients with stage I non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Fifty-eight patients with stage I NSCLC treated from 1991 to 1995 were retrospectively reviewed. The clinical features, histopathology and prognostic factors were analyzed by SPSS10.0 statistic software. The expression of c-myc, MDM2, c-erbB-2, EGFR, p53, p14(ARF), p16(INK4), p21(WAF1) and nm23 was detected by immunohistochemical assay. The overall survival rate, local-regional control rate and distant metastasis rate were observed.</p><p><b>RESULTS</b>The overall survival rate, local-regional recurrent rate and distant metastasis rate were 71.1%, 11.1% and 33.5%, respectively. In univariate analysis, tumor cell differentiation was an independent prognostic factor (P = 0.028); overexpression of c-myc or c-erbB-2 had significantly poor overall survival and high distant metastasis rate (P < 0.05). The total oncogene immunoreactive score (IRS) and comprehensive IRS were associated with poor overall survival. In multivariate analysis, tumor cell differentiation and comprehensive IRS were independent prognostic factors for overall survival. Among the high-risk group of patients, those who had received chemotherapy seemed to have a higher overall survival rate and a lower distant metastasis rate in this study, but the difference was not statistically significant.</p><p><b>CONCLUSION</b>For stage I NSCLC patients, tumor cell differentiation and comprehensive IRS are independent prognostic factors for overall survival. Adjuvant chemotherapy might somehow improve the survival for the patients with high-risk factors.</p>