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Objective:To systematically evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) combined with radiotherapy in the treatment of lung adenocarcinoma with central nervous system (CNS) metastasis.Methods:PubMed, EMBASE, Medline, Cochrane Library, clinical trials and other databases were searched to collect the clinical control studies of EGFR-TKI combined with radiotherapy versus EGFR-TKI or radiotherapy alone in the treatment of lung adenocarcinoma with CNS metastasis published at home and abroad from January 2012 to April 2019. After evaluating the data, Revman 5.3 software was used for meta-analysis.Results:10 studies involving 1 379 participants were included. The results indicated that compared with EGFR-TKI or radiotherapy alone, EGFR-TKI plus radiotherapy had a significant benefit on overall response rate (ORR) [ OR: 3.81, 95% CI(1.73, 8.39); P<0.01], overall survival (OS) [ HR: 0.60, 95% CI(0.41, 0.89); P=0.01], neurological progression free survival (nPFS) [ HR: 0.65, 95% CI(0.46, 0.91); P=0.01] compared with EGFR-TKI or radiotherapy alone. Conclusions:EGFR-TKI plus radiotherapy had better ORR, OS, nPFS compared with TKI or radiotherapy alone.
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CT guided FNAC is a simple and safe procedure of diagnostic value in patients with lung lesionssuspected to have lung malignancy. We undertook a study on 41 patients and were able to diagnose/rule out malignancy in 85.37% of these patients, while in 14.63 % of patients the smears were nondiagnostic. Once malignancy was diagnosed in these patients, then the next most important step wasto categorize the lesions. 44% of patients had squamous cell carcinoma, 12.12 % had adenocarcinoma,9.75% had small cell carcinoma, 7.31 % had poorly differentiated carcinoma, 4.87% each hadmetastasis & tuberculosis and 2.43% had aspergillosis. Squamous cell carcinoma was the commonestsubtype in our study, which is contrary to changing trends in incidence of lung carcinoma whereadenocarcinoma has replaced squamous cell carcinoma as the commonest lung malignancy. Threeof our patients had minor complication in the form of mild pneumothorax, and it resolved in all patientswithin 24 hours.
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Background: Blood supply to the thyroid is relatively high when compared to that of liver. Despite this documented metastatic deposit in thyroid remains a rarity. Synchronous nonthyroidal metastatic deposit in thyroid from a lung primary is relatively rare. Metastasis to thyroid portends to poor prognosis, and hence a metastatic deposit has to be excluded in any suspicious lesion of thyroid. Materials and Methods: Details of a rare presentation of a malignant thyroid lesion, a secondary deposit from an asymptomatic primary papillary adenocarcinoma of lung, who had presented to this tertiary care center was retrieved and analyzed. Results: Patient with an initial diagnosis of papillary carcinoma on FNA was taken up for total thyroidectomy and cervical lmphadenectomy. HPR was mucinous carcinoma of thyroid with high lymph nodal metastasis. In view of the exrathyroidal disease an adjuvant external beam radiotherapy was considered for him. Unfortunately, the radiotherapy planning CT scan revealed left sided lung lesions with pleural effusion which was proved to be papillary adenocarcinoma of lung on biopsy, with metastases to thyroid. He was treated with chemotherapy but he succumbed to his illness 9 months from the date of diagnosis. Conclusion: Although encountered rarely, metastatic lesions in thyroid from nonthyroidal primaries need to be excluded while evaluating thyroid lesions
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Objective The prognostic expression level and prognostic significance of CX3CL1 in patients with non-small cell lung cancer(NSCLC) need further investigation. The purpose of this paper was to investigate the effects of various CX3CL1 mRNA expression levels on patients with NSCLC.Methods By retrieving lung-cancer related gene expression profile data in NCBI GEO database and TCGA of UCSC Cancer Browser, 8 datasets were included based on inclusion and exclusion criteria. All the datasets were collated and standardized through R statistical software. Univariate and multivariate Cox models were conducted for prognosis analysis of CX3CL1 in each dataset. HR values of all the datasets were pooled by meta algorithm.Results High-expression of CX3CL1 mRNA in tumor tissues of lung adenocarcinoma was a positive prognostic factor for overall survival(pooled HR=0.53; 95% CI=0.43-0.65 in univariate analysis; pooled HR=0.52; 95% CI=0.42-0.64 in multivariate analysis). However, in lung squamous cell carcinoma, there was no significant association between CX3CL1 expression and overall survival (pooled HR=1.09; 95% CI=0.82-1.45 in univariate analysis; pooled HR=1.18; 95% CI=0.88-1.58 in multivariate analysis).Conclusion The mRNA level of CX3CL1 in lung adenocarcinoma was positively correlated with better prognosis, but there was no correlation between CX3CL1 mRNA level and prognosis in patients with lung squamous cell carcinoma. CX3CL1 may be used as a potential prognostic marker for patients with lung adenocarcinoma.
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This case report describes a patient admitted with shortness of breath of 15 days duration and found to have cardiac tamponade, which masked concomitant pulmonary embolism that was diagnosed by echocardiographic signs of dilate RA/RV with PAH only after successful pericardiocentesis. Subsequently patient was found to have widely metastatic adenocarcinoma of lungs. This case emphasizes the diagnostic challenge when cardiac tamponade is associated with pulmonary thromboembolism and requires high index of clinical suspicion in patients with underlying malignancy.
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Objective To study the mechanism of apoptosis inducing and anti-invasive effects of curcumin on human lung adenocarcinoma cell (A549). Methods MTT colorimetry method, fluorescence mieroscopy, and FCM combining with PI and AnnexinV-FITC double pigmentation method were used to study the growth and apoptosis of A549 cells after being treated with curcumin, and Western blotting was used to identify apoptosis-inducing and anti-invasive effects. Results Under the effect of the curcumin, the nucleoli of A549 cells were found to be fragmented into different sized apoptosis bodies under fluorescence microscopy, and cell proliferation was obviously suppressed under the effect of curcumin in different concentrations, with the IC 50 value of 18?mol/L. When the curcumin concentration was increased from 5?mol/L to 40?mol/L, Annexin-FITC single positive cells (early apoptosis cell) were increased from 3.4% to 65.9%, and the proliferation of cells was blocked at G 2 phase. When curcumin concentration was increased from 10?mol/L to 20?mol/L curcumin effects 30 minutes, the expression of PARP in A549 cells was increased after 30 minutes. Curcumin could also down-regulate MMP-2 and up-regulate TIMP-2 expression. Conclusions Curcumin can interfere with cell growth cycle of A549 cells and suppress cell growth, which is concentration dependent. The anti- invasive effects of curcumin is probably the result of down-regulation of MMP-2 and up-regulation of TIMP-2 expression.