Correlations between Vessel Changes and the Histopathologic Subtypes of Lung Adenocarcinoma with Pure Ground-glass Nodule on Computed Tomography / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the correlations between vessel changes and the histopathologic subtypes of lung adenocarcinoma with pure ground-glass nodule (pGGN) on computed tomography (CT).</p><p><b>METHODS</b>Totally 107 patients (116 lesions) with lung adenocarcinomas with pGGN who had undergone curative resection were included. Vessel changes included vascular convergence and/or vessel dilation or distortion within the pGGN. According to the vessel appearances within the pGGN, all patients were categorized into two groups: no change group and change group. Pearson chi-square test was used to analyze the relationships between vessel changes and histopathologic subtypes. Mann-Whitney rank test and t-test were used to identify the relationship of vessels changes with pGGN density and diameter.</p><p><b>RESULTS</b>Among these 116 pGGNs, there were 21 without vessel changes and 4 with vessel changes in 25 preinvasive lesions; 14 without vessel changes and 15 with vessel changes in 29 minimally invasive adenocacinomas; 16 without vessel changes and 46 with vessel changes in 62 invasive lung adenocarcinomas. There were statistically significant differences of vessel changes (P=0.000) among histopathologic subtypes. The lesion diameter was significantly different between these two groups (P=0.000), while the lesion density showed no significant difference (P=0.826).</p><p><b>CONCLUSION</b>Vessel changes may indicate the invasiveness of lung adenocarcinoma with pGGNs and are related with the lesion diameter.</p>

Value of Baseline Clinical and CT Characteristics for Predicting the Progression of Persistent Pure Ground-glass Nodule 10 mm or Less in Diameter / 中国医学科学院学报

Objective To explore the risk factors of the progression of persistent pure ground-glass nodule (pGGN) and make the risk stratification for pGGN 10 mm or less in diameter. Methods From June 2008 to April 2015,100 patients (108 lesions) with persistent pGGN≤10 mm in diameter were included in this study. Patients were followed up at least 1 year using thin-section computed tomography (CT). Patients' baseline clinical data and CT characteristics of pGGN were compared between progression group (size increased or/and solid component appeared) and non-progression group. Cox regression analysis was used to assess the relationship between clinical data,CT characteristics of pGGN,and lesion progression. The risk indices of lesion progression were calculated according to the results of Cox regression analysis and the relative factors of lung adenocarcinoma in previous studies. Logistic regression analysis was used to assess the relationship between risk indices and lesion progression. The optimal cutoff value was decided on receiver operating characteristic curve of risk indices and verified for predicting lesion progression. Results Fifteen of 108 lesions showed progression. The mean follow-up duration was (1016.36±486.00) days. There were statistically significant differences of lesion size,air bronchogram,and vessel changes between progression group and non-progression group (P=0.040,P=0.003,P=0.030,respectively).Lesion density (CT value≥-542.5 HU) and air bronchogram were the risk factors of lesion progression (P=0.003,P=0.021,respectively). The optimal cutoff value of total risk indices on predicting lesion progression was 4.25,with the sensitivity of 46.7%,specificity of 89.2%,and consistency of 83.3%. Conclusions CT value ≥-542.5 HU of pGGN and air bronchogram within lesion may predict lesion progression in persistent pGGN 10 mm or less in diameter. A risk index of less than 4.25 often suggests small probability of disease progression and thus a longer follow-up interval is recommended.

Correlations between pathologic subtypes/immunohistochemical implication and CT characteristics of lung adenocarcinoma ≤ 1 cm with ground-glass opacity / 中国医学科学院学报

<p><b>OBJECTIVE</b>To discuss the correlation of pathologic subtypes and immunohistochemical implication with CT features of lung adenocarcinoma 1 cm or less in diameter with focal ground-glass opacity (fGGO).</p><p><b>METHODS</b>CT appearances of 59 patients who underwent curative resection of lung adenocarcinoma ≤ 1 cm with fGGO were analyzed in terms of lesion location, size, density, shape (round, oval, polygonal, irregular), margin (smooth, lobular, spiculated, lobular and spiculated), bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface. Histopathologic subtypes were classified according to International Association for the Study of Lung Cancer/ American Thoracic Society/European Respiratory Society classification of lung adenocarcinoma. Common molecular markers in immunohistochemical study included human epidermal growth factor receptor (HER)-1,HER-2,Ki-67, vascular endothelial growth factor (VEGF) and DNA topoisomerase 2Α.Patients' age and lesions' size and density were compared with pathologic subtypes using analysis of variance or nonparametric Wilcoxon tests. Patients' gender, lesion location, shape and margin, bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface were compared with histopathologic subtypes and immunohistochemical implication using ψ² test or Fisher's exact test.</p><p><b>RESULTS</b>The patients' gender, age, lesion location, shape, air bronchogram, pleural tag, and tumor-lung interface were not significantly different among different histopathologic subtypes (P=0.194, 0.126, 0.609, 0.678, 0.091, 0.374, and 0.339, respectively), whereas the lesion size,density,bubble-like sign, and margin showed significant differences (P=0.028, 0.002, 0.003, 0.046, respectively). The expression of Ki-67 significantly differed among nodules with different shapes(P=0.015). Statistically significant difference also existed between tumor-lung interface and HER-1 expression (P=0.019) and between bubble sign and HER-2 expression (P=0.049).</p><p><b>CONCLUSIONS</b>Of lung adenocarcinoma ≤ 1 cm with fGGO,bubble-like sign occurs more frequently in invasive pulmonary adenocarcinoma and less frequently in atypical adenomatous hyperplasia. In addition, preinvasive lesions (atypical adenomatous hyperplasia and adenocarcinoma in situ) more frequently demonstrates smooth margin,while invasive lesions (minimally invasive adenocarcinoma and invasive pulmonary adenocarcinoma) more frequently demonstrates lobular and spiculated margin. Some CT features are associated with immunohistochemical implication of lung adenocarcinoma ≤ 1 cm with fGGO.</p>

Efficacy observation on navel-warming therapy combined with western medication for yang-deficiency tympanites / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of navel-warming therapy on clinical efficacy in patients with yang-deficiency tympanites based on regular treatment of western medication.</p><p><b>METHODS</b>One hundred and twenty cases of yang-deficiency tympanites were randomly divided into a navel-warming therapy group and a western medication group, sixty cases in each one. The regular treatment of western medicine was applied in the western medication group, including oral administration of antiviral drug and diuretics as well as intravenous drip of hepatic protector. Based on western medicine treatment, the navel-warming therapy was applied in the navel-warming group. A medical cake was laid on Shenque (CV 8), and then a medical cylinder was placed above the medical cake and ignited. The treatment was given once daily. One month was considered as a treatment session in both groups and totally one session was required. The TCM symptom score, B-ultrasound ascites and temporary use of diuretics before and after treatment were observed in both groups; also the efficacy was evaluated.</p><p><b>RESULTS</b>The total effective rate was 81.7% (49/60) in the navel-warming therapy group, which was superior to 56.7% (34/60) in the western medication group (P < 0.05). After the treatment, the TCM symptom score and ascites were improved in both groups (all P < 0.05), which was more significant in the navel-warming therapy group (all P < 0.05). The temporary use of diuretics was statistically different between the two groups (P < 0.05), indicating the navel-warming therapy group could obviously reduce or stop the use of diuretics.</p><p><b>CONCLUSION</b>Based on regular treatment of western medication, the navel-warming therapy could significantly improve therapeutic efficacy, effectively relieve clinical symptoms and ease ascites.</p>

Treatment of premenopausal patients with advanced or recurrent breast cancer by chemical ablation / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of luteinizing hormone releasing hormone (LH-RH) analog in premenopausal patients with advanced or recurrent breast cancer.</p><p><b>METHODS</b>LH-RH analog (enantone 3.75 mg/2 ml) were administered to 28 premenopausal patients with advanced recurrent breast cancer and its efficacy and side effect were observed.</p><p><b>RESULTS</b>The response rate (complete response and partial response) was 42.9%, and after 8 weeks of treatment, the plasma estrogen in all patients decreased to the level of postmenopause. No major adverse events were observed.</p><p><b>CONCLUSIONS</b>LH-RH analog is effective and safe for premenopausal breast cancer with low adverse reaction and its administration method is easy.</p>