Analysis of prognostic factors in 135 patients with pulmonary metastasis from esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To investigate the prognostic factors of patients with esophageal squamous cell carcinoma with pulmonary metastasis.Methods:Clinical characteristics of 135 esophageal squamous cell carcinoma patients presenting with pulmonary metastasis after treatment in Zhejiang Cancer Hospital from 2008 to 2018 were retrospectively analyzed. Thesurvival rate was calculated by Kaplan-Meier method. Univariate analysis was performed by log-rank test. Multivariate prognostic analysis was conducted by Cox models.Results:The median follow-up time of 135 patients with esophageal squamous cell carcinoma was 94.2 months (19.5-258.9 months), and 109 patients died (80.7%). The 1-and 2-year overall survival rates were 47.4% and 25.1%, with the median survival time was 11.1 months (7.3-14.9 months). Univariate prognostic analysis showed that age, number of lung metastases, treatment of lung metastases, lymph node metastasis, distant organ metastasis, and the interval between the first treatment and lung metastasis were the prognostic factors of esophageal squamous cell carcinoma with lung metastasis (all P<0.05). Multivariate analysis demonstrated that age and number of lung metastases were the independent prognostic factors for patients with esophageal squamous cell carcinoma with lung metastases (all P<0.05). Conclusions:Age and number of lung metastases are the independent prognostic factors for patients with esophageal squamous cell carcinoma with lung metastases. Surgery or radiotherapy-based regional therapy can enhance clinical prognosis.

Cost-effectiveness of lung cancer screening worldwide: a systematic review / 中华流行病学杂志

Objective: From the economic point of view, this study was to systematically assess the status quo on lung cancer screening in the world and to provide reference for further research and implementation of the programs, in China. Methods: PubMed, EMbase, The Cochrane Library,CNKI and Wanfang Data were searched to gather papers on studies related to economic evaluation regarding lung cancer screening worldwide, from the inception of studies to June 30(th), 2018. Basic characteristics, methods and main results were extracted. Quality of studies was assessed. Cost were converted to Chinese Yuan under the exchange rates from the World Bank. The ratio of incremental cost-effectiveness ratio (ICER) to local GDP per capita were calculated. Results: A total of 23 studies (only 1 randomized controlled trial) were included and the overall quality was accepted. 22 studies were from the developed countries. Nearly half of the studies (11 studies) took 55 years old as the starting age of the screening program. Smoking history was widely applied for the selection of criteria on target populations (18). Low-dose computed tomography (LDCT) was involved in every study used to evaluate the economic effectiveness. Annual (17) and once-life time (7) screening were more common frequencies. 22 studies reported ICERs for LDCT screening, compared to no screening, of which 17 were less than 3 times local GDP per capita, and were considered as cost-effectiveness, according to the WHO's recommendation. 15 and 7 studies reported ICERs for annual and once-life time screening, of which 12 and 7 studies were in favor the results of their cost-effectiveness, respectively. Additionally, the cost-effectiveness of once-lifetime screening was likely to be superior to the annual screening. Differences of cost-effectiveness among the subgroups, by starting age or by the smoking history, might exist. Conclusions: Based on the studies, evidence from the developed countries demonstrated that LDCT screening programs on lung cancer, implemented among populations selected by age and smoking history, generally appeared more cost-effective. Combined with the local situation of health resource, the findings could provide direction for less developed regions/countries lacking of local evidence. Low frequency of LDCT screening for lung cancer could be adopted when budget was limited. Data on starting ages, smoking history and other important components related to the strategy of screening programs, needs to be precisely evaluated under the situation of local population.

Hamartoma Pulmonar Gigante. Reporte de un caso y revisión de la literatura / Giant Pulmonary Hamartoma. Case report and review of the Literature

Los hamartomas pulmonares son las lesiones benignas más frecuente del pulmón con un tamaño promedio de 1.0 a 2.0 cm. Se realiza el reporte de un caso de un hamartoma pulmonar gigante de 21 x 13 x 9,5 cm en un varón de 79 años quien presento un cuadro corto de síntomas respiratorios. En la tomografía de tórax se constató la presencia de una masa en el campo medio e inferior del hemitórax izquierdo. Se realizó la resección por toracotomía. El estudio histopatológico confirmo el diagnóstico de un hamartoma pulmonar gigante de tipo condroide.

Pulmonary hamartomas are the most common benign neoplasm in the lung, with an average size of 1.0 to 2.0 cms. We report a case of a giant pulmonary hamartoma in a 79 year old male who presented respiratory symptoms. Chest tomography revealed a heterogeneous mass that occupies the lower half of the left hemitoriax. The patient underwent thoracotomy and resection of the mass. Gross examination of the surgical specimen showed a well circumscribed mass measuring 21 x 13 x 9.5 cms. The histopathological study confirmed the diagnosis of a giant pulmonar hamartoma of the chondroid tape

Pulmonary Placental Transmogrification Presenting as a Small Lung Nodule / 대한내과학회지

Pulmonary placental transmogrification (PT) is a rare lung disease that takes on the histologic appearance of placental chorionic villi. We herein report a case of PT in a 66-year-old woman who presented with a single nodule on chest radiography performed during a routine health examination. She had no complaints of any symptoms. Chest radiography showed a focal ill-defined nodular opacity in the right lower lobe; chest computed tomography revealed a 17-mm lobulated, focal irregular mass with fissural retraction in the right lower lobe, suggestive of lung cancer. Pathology of a percutaneous needle aspiration biopsy revealed papillary structures resembling placental villi. These were lined by cytotrophoblast-like cells and syncytiotrophoblasts. This characteristic pathologic finding led to a diagnosis of PT. PT of the lung is found mainly in bullous or cystic lesions. However, this patient presented with a single nodule on chest radiography.

Assay of the Activities of Human Tumor Necrosis Factor and Natural Killer Cell in Patients with Lung Cancer / 中国医师杂志

To study the changes of activities of tumor necrosis factor(TNF),natural killer cell (NKC) in patients with lung cancer and clarify the influence of clinical factors on the activities,we observed the level of TNF from peripheral blood cells by detective method of whole blood cell-derived TNF,and NKC activity was also observed with DNA-fluorometric assay for cytotoxic effect in thirty-five patients with lung cancer.The results showed that the NK activity in lung cancer patient was seriously inhibited and got worse with disease phase progress,tumor size and the extent of lymph node metastasis,but it was not associated with the pathological type.The extent and time of reduction of NK activity were related to the quality of primary lesion.As for the changes of TNF activity,PBMC (peripheral blood mononuclear cells) were activated under the presence of tumor to secrete a high level of TNF,which was not related to the stage of disease,the tumor diameter,the extent of lymph node metastasis and type of pathology.These results indicate that the cellular immune function in lung cancer patient is seriously impaired,and the function of immunoregulation is in a complicated chaotic status.We consider that the determination of the activities of TNF and NKC may provide a theoretical evidence for comprehensive treatment of patients with lung cancer.