Evaluation of the value of EBUS-TBNA in diagnosis of mediastinal lesions / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosis of mediastinal lesions and to discuss its optimal indication.</p><p><b>METHODS</b>One hundred and twenty three patients with mediastinal lesions who underwent EBUS-TBNA were included in this study. The accuracy, sensitivity, specificity, positive and negative predictive value of EBUS-TBNA in diagnosis of mediastinal lesions were analyzed according to the final diagnosis and evaluate its value and the optimal indication.</p><p><b>RESULTS</b>In the 123 patients, EBUS-TBNA was successfully performed to obtain samples from 286 stations of lymph nodes (2.33 stations/per patient). The puncture success rate was 100%. The procedure was uneventful without complications. Final diagnosis indicated that there were 83 positive and 40 negative patients. EBUS-TBNA had a sensitivity of 95.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 90.0%, and overall accuracy of 96.8%. For diagnosis of the epithelial cancer, EBUS-TBNA had an accuracy of 98.8%, sensitivity of 98.8%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 100%. EBUS-TBNA failed to reveal three lymphomas. For diagnosis of benign mediastinal diseases, EBUS-TBNA had a diagnosis rate of 47.2% which had a confirmed clinical application value.</p><p><b>CONCLUSIONS</b>EBUS-TBNA may be expected to replace the mediastinoscopy as a superior choice for diagnosis of mediastinal epithelial cancers. EBUS-TBNA can not replace mediastinoscopy but being a promising tool for diagnosis of benign mediastinal lesions including granulomas. For certain special diseases such as lymphoma, mediastinoscopy cannot be replaced. However, EBUS-TBNA can be a potentially favorite choice for early stage screening.</p>

CT-guided hookwire localization of small solitary pulmonary nodules in video-assisted thoracoscopic surgery / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Video-assisted thoracoscopic surgery (VATS) provides a minimally invasive approach to resect small solitary pulmonary nodules (SSPN). The aim of this study is to evaluate the efficacy and safety of preoperative CT-guided hookwire localization for SSPN in VATS.</p><p><b>METHODS</b>Hookwire was used to localize 26 SSPN under CT guidance in 24 patients (14 male, 10 female, age range 21-61 years, mean 52.3 years), preoperatively, and wedge resection was performed through VATS. The lesion size, distance from the lesion to parietal pleura, the time of localization and complications were evaluated.</p><p><b>RESULTS</b>All the 26 pulmonary nodules were preoperatively detected and localized with hookwire under CT-guidance. The mean lesion size was 10.05 +/- 3.08 mm in diameter, and the mean distance from lesion to parietal pleura was 10.09 +/- 2.62 mm. The mean localization time was 20.18 +/- 7.16 min, and then the nodules were removed by VATS within 18 +/- 6.65 min. The major complication of CT-guided hookwire localization was mild pneumothorax in 6 patients (25.0%), but no one needed chest tube drainage. The dislodgment of hookwire was found in only one patient (4.2%) during the operation, but the lesion was still successfully resected under VATS. Of those patients, 8 were confirmed to have a primary NSCLC by rapid pathologic diagnosis during VATS wedge resection, and then VATS lobectomies were performed.</p><p><b>CONCLUSION</b>The preoperative CT-guided hookwire localization for small solitary pulmonary nodules is an effective and safe technique to assist VATS resection of the nodules.</p>

Effects of anti-CD25 monoclonal antibody on the level of cytokines in aqueous humour after rat penetrating keratoplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the toxicity of anti-CD25 monoclonal antibody (mAb) to rat cornea and its effects on the cytokines in the aqueous humour after penetrating keratoplasty (PKP), thereby evaluating the effect of anti-CD25 mAb in preventing corneal allograft rejection.</p><p><b>METHODS</b>The corneal toxicity of anti-CD25 mAb at 50, 100 and 200 microg administered via subconjunctival injection was evaluated in 12 SD rats by histological examination and transmission electron microscopy. Another 93 SD rats were randomized into 5 groups, and transplantation of corneal allograft from Wistar rats was performed in 4 groups with the other group as the normal control. The 4 allograft groups were treated with saline, 100 microg anti-CD25 mAb, 100 microg anti-CD25 mAb with 50 microg dexamethasone, and 50 microg dexamethasone, respectively. The graft rejection was observed, the aqueous humour levels of IFN-gamma and IL-4 were measured with ELISA, and IFN-gamma mRNA expressions in the grafts detected with RT-PCR.</p><p><b>RESULTS</b>anti-CD25 mAb at 50 or 100 microg did not show significant toxicity on the cornea, but at 200 microg, the mAb caused swelling of the corneal stromal cells and endothelial cells. After corneal allograft transplantation, a significant delay in allograft rejection was observed in the 3 groups with mAb or dexamethasone treatment as compared with that in saline group (P<0.05). IFN-gamma mRNA expression in the allograft on days 11 after PKP and in the aqueous humour on days 6 and 11 was markedly increased in saline group compared with that in the 3 treatment groups (P<0.05). The mean IL-4 level in the aqueous humour was significantly higher in the mAb group than in saline group (P<0.05), but markedly lower in anti-CD25 mAb+dexamethasone and dexamethasone groups than in anti-CD25 mAb group (P<0.05).</p><p><b>CONCLUSIONS</b>Anti-CD25 mAb at 20 and 100 microg does not obviously affect the rat corneas. Anti-CD25 mAb inhibits IFN-gamma expression and promotes IL-4 the expression to reduce corneal allograft rejection, whereas anti-CD25 mAb with low-dose dexamethasone inhibits both IFN-gamma and IL-4 expressions to more effectively promote the graft survival.</p>

Serum proteomic patterns may assist the diagnosis of solitary pulmonary nodules / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To screen relatively specific biomarkers in serum from lung adenocarcinoma patients by surface-enhanced laser desorption and ionization time of flight mass spectrometry (SELDI-TOFMS), and to investigate the clinical value of SELDI-TOF-MS in differentiation of benign from malignant solitary pulmonary nodules (SPN).</p><p><b>METHODS</b>Serum samples from 71 lung adenocarcinoma patients and 71 healthy volunteers with matched gender, age and history of smoking were analyzed using WCX2 ProteinChip to screen potential biomarkers. 28 patients received surgical treatment among total 53 patients with SPN. The clinical value of SELDI-TOF-MS in differentiation of benign from malignant solitary pulmonary nodules was evaluated by pathological diagnosis.</p><p><b>RESULTS</b>Five highly expressed potential biomarkers were identified with the relative molecular weights of 4047.79 Da, 4203.99 Da, 4959. 81 Da, 5329. 30 Da and 7760.12 Da. The postoperative pathologic diagnosis was lung adenocarcinoma in 24 patients with SPN, validating the clinical value of the 5 potential biomarkers.</p><p><b>CONCLUSION</b>SELDI-TOF-MS technology is a quick, easy, convenient, and high-throughput analyzing method capable of screening several relatively specific potential biomarkers from the serum of lung adenocarcinoma patients and may have attractive clinic value in differentiation of solitary pulmonary nodules.</p>