Role of active screening in the diagnosis and treatment of early lung cancer and suggestions for health management / 中华健康管理学杂志

Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1<d≤2 cm, patients with sublobectomy and lymph node sampling (46.9% vs 32.9%, 59.2% vs 43.8%, 4.0% vs 2.1%, 80.5% vs 56.8%, 4.0% vs 2.1%, 72.0% vs 56.8%, 14.5% vs 7.6%, 42.5% vs 33.3%, 6.3% vs 2.9%, 2.4% vs 1.0%, respectively, all P<0.05). Conclusion:Active screening is helpful to find early lung cancer, and the health management and physical examination center should pay attention to the management of such physical examination population.

Research Progress of Pulmonary Epithelioid Hemangioendothelioma / 中国肺癌杂志

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that develops from vascular endothelial cells. It has been reported to occur many sites of body, but the most common EHE presentations are soft tissue (limbs), bone, liver and lung. Compared with other pulmonary tumors, pulmonary epithelioid hemangioendothelioma (P-EHE) is relatively rare. According to a literature review, more than 100 cases have been described all over the world. Due to the low incidence of P-EHE, lack of specificity in clinical symptoms and radiological findings, it is often misdiagnosed. Meanwhile, many patients do not receive appropriate treatment, resulting in poor prognosis in some cases. Histology and immunohistochemical methods are essential for diagnosis. However, there is no established standard treatment for P-EHE, because of the rarity of the disease. When the lesions are small and limited in number, surgical is the best treatment, achieving the purpose of diagnosis and treatment at the same time. This article tries to present the etiopathogenesis, clinical manifestations, diagnosis, treatment and prognosis of P-EHE.
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Delayed Bleeding of Coronary Artery after Thoracoscopic Intradiaphragmatic Bronchogenic Cyst Resection / 中国肺癌杂志

Bronchogenic cyst occurring in the diaphragm is rare and thoracoscopic cyst resection is mainly effective treatment. The coronary artery bleeding after video-assisted thoracoscopic surgery (VATS) has never been described; here we report a case of left coronary artery injury after thoracoscopic itradiaphragmatic bronchogenic cyst resection, which may be caused by metallic troca or chest tube.

Surgical treatment of special thoracic solitary fibrous tumors / 中国肿瘤临床

Objective:To summarize the surgical treatment experience of thoracic solitary fibrous tumors(SFTs),especially some spe-cial SFTs.Methods:Patients with SFTs in our department between January 2009 and May 2017 were recruited in this study and the clinical characteristics were summarized.Results:Twenty-one patients(11 men and 10 women)with an average age of 48.3 years were included.Tumor sizes ranged from 3 to 30 cm and 13 patients(61.9%)harbored pleural tumors,while 8 patients harbored tu-mors from other special thoracic sites (including 1 case of trachea SFT and 1 case of pulmonary SFT). Surgical treatment was per-formed in 19 patients,17 of whom underwent complete tumor resection and two patients underwent palliative resection.One patient did not undergo surgery and was lost to follow-up,and another patient who did not undergo surgery died because of a heart attack af-ter discharge.The 19 patients who underwent surgery were followed up for 1-96 months,3 patients of whom underwent reoperation for tumor recurrence at 12,26,and 72 months after surgery,respectively,while the remaining patients had no recurrence.Seven pa-tients(33.3%)were confirmed with malignancy after operation or biopsy.Conclusions:Thoracic SFTs are mainly from the pleura and the surgical results are favorable.Resection after recurrence can achieve favorable results.

Clinical features and experience of perioperative managements of thymomas with and without myasthenia gravis / 中华胸心血管外科杂志

Objective To explore different clinical and pathological features of thymomas with and without myasthenia gravis(MG),and accumulate the experience of perioperative managements.Methods Patients with thymoma admitted by our department between June 2010 and June 2016,were retrospectively reviewed.Results Of the 273 patieuts,150 were males and 143 were fenales(median age:48 years).115 of all patients(42.1％) were combined with paraneoplastic diseases.There was no mortality during perioperative period.Video-assisted Thoracoscopic surgery was successfully performed for 246 cases(90.1％).The female thymoma patients with with MG(TMG) were more than those without MG and thymic hyperplasia (53.0％ VS 39.5％,P =0.036).Compared to the thymoma patients without MG and thymic hyperplasia,the TMG was associated with younger age of onset [(46.6 ± 12.9) years VS.(50.6 ± 14.32) years,P =0.026],longer hospital stay [(18.3 ± 9.4)days VS.(14.6 ±5.7) days,P =0.000],higher postoperative complications morbidity(22.0％ VS.11.6％,P =0.027).Although the TMG has a lower recurrence rate,there was no significant difference between the two groups for recurrence rate(0 VS.2％,P =0.274).Conclusion Extended thymectomy should be recommended for thymoma and thymic hyperplasia whether combined with or without paraneoplastic diseases.

PRKAR1α expression in non-small cell lung cancer and its clinicopathologic significance / 中南大学学报(医学版)

To evaluate the expression of cAMP-dependent protein kinase type I-alpha regulatory subunit (PRKAR1α) in non-small cell lung cancer (NSCLC) and its correlation with clinicopathological features.
 Methods: PRKAR1α expressions in 79 NSCLC patients and matched adjacent non-carcinoma tissues were analyzed by using qRT-PCR and immunohistochemistry.
 Results: The negative rates of PRKAR1α protein in NSCLC, lung squamous cell carcinoma (SCL) and lung adenocarcinoma (ACL) were 58.2%, 77.8%, 32.4%, respectively. Compared to the matched adjacent non-carcinoma tissues, there were significant differences in levels of PRKAR1α mRNA and protein in ACL (P0.05). The expression of PRKAR1α protein was positively correlated with histological type, TNM stage, and lymph node metastasis (P0.05).
 Conclusion: Low expression of PRKAR1α in ACL might be involved in the pathogenesis, which might serve as a novel diagnostic candidate.

Effect of perioperative treatment with ambroxol on lung cancer patients after video-assisted thoracic surgery lobectomy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the influence of perioperative intravenous administration of ambroxol on pulmonary function, postoperative complications, postoperative hospital stay, and cost after video-assisted thoracic surgery lobectomy for lung cancer.@*METHODS@#Sixty patients who underwent video-assisted thoracic surgery lobectomy for lung cancer in Xiangya Hospital, Central South University between May 2011 and May 2012 were randomly assigned into 2 groups: An ambroxol group (n=30) and a control group (n=30). In the ambroxol group, patients were given ambroxol (1 000 mg/d) on the day of operation and on the first 3 postoperative days. In control group, placebo was given. The pulmonary function tests, arterial blood gases, incidence of perioperative morbidity, postoperative mechanical ventilation time, duration of ICU stay, length and costs of postoperative hospital stay were compared between the 2 groups.@*RESULTS@#The 2 groups were well matched for demographics and operative variables. The ambroxol group showed better the percent predicted forced expiratory volume in 1 second (FEV1%), the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC%), the percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) and arterial oxygen pressure than the control group. The postoperative pulmonary complications was significantly reduced, the duration of mechanical ventilation and the length of ICU stay were shortened, and the length and costs of postoperative hospital stay were significantly decreased in the ambroxol group compared with the control group (all P<0.05).@*CONCLUSION@#Perioperative intravenous administration of ambroxol can improve the postoperative lung function, reduce the incidence of pulmonary complications, shorten the length of postoperative hospital stay, and lower the total cost of hospitalization after video-assisted thoracic surgery lobectomy for lung cancer.

Expression of SH2B1 adaptor protein in oesophageal cancer and its clinical significance / 中南大学学报(医学版)

OBJECTIVE@#To explore the expression of SH2B1 adaptor protein in oesophageal cancer and its clinical significance.@*METHODS@#SH2B1 expression in tissue specimens of 120 primary oesophageal cancers, tissues of 120 paired adjacent non-cancer and another 120 normal tissues was analyzed by immunohistochemical SABC staining and Western blot. SH2B1 expression in the oesophageal cancer tissues was analyzed with clinicopathological parameters. SH2B1 expression of normal human esophageal epithelial cells (HEEC) and 2 oesophageal cancer cell lines, TE-1 and Eca109, were evaluated by RT-PCR and Western blot.@*RESULTS@#SH2B1 expression in the normal oesophageal tissues, adjacent non-cancer tissues and cancer tissues was gradually increased (P0.05). SH2B1 expression was detectable in all cell lines by RT-PCR and Western blot, but the expression in the two oesophageal cancer cell lines was significantly higher than that in the normal HEEC.@*CONCLUSIONS@#Over-expression of SH2B1 might play an important role in the occurrence and development of human oesophageal cancer and closely correlate with malignant progression of invasion and metastasis of oesophageal cancer.