Clinical diagnosis and treatment of multiple pulmonary nodules / 中华肿瘤杂志

CT screening has markedly reduced the lung cancer mortality in high-risk population and increased the detection of early-stage pulmonary neoplasms, including multiple pulmonary nodules, especially those with a ground-glass appearance on CT. Multiple primary lung cancer (MPLC) constitutes a specific subtype of lung cancer with indolent biological behaviors, which is predominantly early-stage adenocarcinoma. Although MPLC progresses slowly with rare lymphatic metastasis, existence of synchronous lesions and distributed location of these nodules still pose difficulty for the management of such patients. One single operation is usually insufficient to eradicate all neoplastic lesions, whereas repeated surgical procedures bring about another dilemma: whether clinical benefits of surgical treatment outweigh loss of pulmonary function following multiple operations. Therefore, despite the anxiety for treatment among MPLC patients, whether and how to treat the patient should be assessed meticulously. Currently there is a heated discussion upon the timing of clinical intervention, operation mode and the application of local therapy in MPLC. Based on clinical experience of our multiple disciplinary team, we have summarized and commented on the evaluation, surgical treatment, non-surgical local treatment, targeted therapy and immunotherapy of MPLC in this article to provide further insight into this field.

Mechanisms of resistance to immune checkpoint inhibitors and strategies to reverse drug resistance in lung cancer / 中华医学杂志(英文版)

In recent years, the research of immune checkpoint inhibitors has made a great breakthrough in lung cancer treatment. Currently, a variety of immune checkpoint inhibitors have been applied into clinical practice, including antibodies targeting the programmed cell death-1, programmed cell death-ligand 1, and cytotoxic T-lymphocyte antigen 4, and so on. However, not all patients can benefit from the treatment. Abnormal antigen presentation, functional gene mutation, tumor microenvironment, and other factors can lead to primary or secondary resistance. In this paper, we reviewed the molecular mechanism of immune checkpoint inhibitor resistance and various combination strategies to overcome resistance, in order to expand the beneficial population and enable precision medicine.

Safety of polyethylene glycol recombinant human granulocyte colony-stimulating factor in treating non-small cell lung cancer patients at I b stage

OBJECTIVE@#To investigate resistance and safety of HHPG-19K in treating non-small cell lung cancer patients.@*METHODS@#A total of 30 cases were selected and randomly divided into 5 groups: three HHPG-19K groups of different dosage (60 μg/kg/day, 100 μg/kg/day, 200 μg/kg/day), positive control group (Filgrastim, namely G-CSF5 μg/kg/day) and negative control group. Safety indexes of 5 groups were observed and compared.@*RESULTS@#All patients had adverse event (100%) in three HHPG-19K groups, and increased ALP, ALT and AST were main events. The degree was mild to moderate. There was no significant difference in the incidence of adverse event between dosage groups and positive control group no difference. But the incidence of negative control group was 13%, which was significantly lower than dosage groups and positive control group.@*CONCLUSIONS@#non-small cell lung cancer patients have satisfactory tolerance to HHPG-19K, and have no resistance. Besides, dosage at 100 μ g/kg is the most safe.

First 30 endobronchial ultrasound-guided transbronchial needle aspirations: a single institution's early experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A new technique developed in 2002, real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), has been one of the most important tools in lymph nodes (LNs) staging before lung cancer surgery. EBUS-TBNA was introduced into China in 2008.</p><p><b>METHODS</b>Between June 2009 and October 2009, 30 patients with mediastinal/hilar lymphadenopathy and thoracic masses previously detected with CT scan underwent EBUS-TBNA without rapid onsite cytological examination.</p><p><b>RESULTS</b>From 30 patients, 33 samples were obtained from LNs and seven samples from intrapulmonary lesions. Twenty out of the 23 lung cancer diagnoses were clarified through the procedure, with sensitivity, specificity, positive predictive value, negative predictive value and accuracy being 87%, 100%, 100%, 70% and 90%, respectively. All three false negative cases were found in the first five procedures. Additionally, among the 33 LNs examined, three specimens that had no lymphocytes were also found within the first five procedures. There were no major complications, and the procedures were uneventful.</p><p><b>CONCLUSIONS</b>EBUS-TBNA seems a safe and effective technique in making diagnosis for mediastinal/hilar LNs and intrapulmonary masses. For pulmonologists experienced in bronchoscopy, the sensitivity of the procedure for diagnosing lung cancer should be no less than 90% after the initial five procedures.</p>

A multicenter, randomized, double-blind, placebo-controlled safety study to evaluate the clinical effects and quality of life of paclitaxel-carboplatin (PC) alone or combined with endostar for advanced non-small cell lung cancer (NSCLC) / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the efficacy and quality of life and safety for paclitaxel and carboplatin (TC) and TC combined with endostar in the treatment of advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>This is a prospective, multicenter, randomized, double-blind, placebo-controlled clinical study. A total of 126 cases of untreated advanced NSCLC were enrolled in this study. There were 63 patients in the TC control arm and TC combined endostar arm, respectively. All enrolled patients were continuously followed-up for disease progression and death.</p><p><b>RESULTS</b>The objective response rate (ORR) of TC combined with endostar arm was 39.3%, and that of TC control arm was 23.0%, P = 0.078. The progression-free survival rates for TC combined with endostar arm and TC control arm were 78.3% and 58.8%, respectively, in 24 weeks (P = 0.017). The hazard ratio for the risk of disease progression was 0.35 (95%CI 0.13 to 0.90, P = 0.030). The median time to progression (TTP) of the TC combined with endostar arm was 7.1 months and TC arm 6.3 months (P > 0.05). The follow-up results showed that the median survival time (mOS) of the TC + Endostar arm was 17.6 months; (95%CI 13.4 to 21.7 months), and the TC + placebo arm 15.8 months (95%CI 9.4 to 22.9 months) (P > 0.05). The quality of life scores (LCSS patient scale) after treatment of the TC combined with endostar arm was improved, and that of the TC group was improved after completion of two cycles and three cycles of treatment. The quality of life scores compared with baseline after the completion of one cycle treatment was significantly improved for both the TC combined with endostar arm (P = 0.028 and), and TC arm (P = 0.036). It Indicated that TC combined with endostar treatment improved the patient's quality of life in the early treatment. The difference of adverse and serious adverse event rates between the two groups was not significant (P > 0.05).</p><p><b>CONCLUSIONS</b>Compared with TC alone treatmrnt, TC combined with endostar treatment can reduce the risk of disease progression at early time (24 weeks), increase the ORR, and can be used as first-line treatment for advanced NSCLC. The TC combined with endostar treatment has good safety and tolerability, improves the quality of life, and not increases serious adverse effects and toxicity for patients with advanced NSCLC.</p>

Assessment of therapeutic efficacy on treating advanced non-small cell lung cancer in the aged by Chinese medicine adopting the international questionnaire of quality of life / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess the therapeutic efficacy of treating advanced non-small cell lung cancer (NSCLC) in the aged by Chinese medicine (CM) adopting the international questionnaire of quality of life (QOL).</p><p><b>METHODS</b>91 aged patients with advanced NSCLC were randomly assigned to three groups. There were 31 in the CM group (Group I), 30 in the chemotherapy group (Group II), and 30 in the CM and chemotherapy combination group (Group III). Oral administration of CM decoction and intravenous dripping of Chinese patent medicine was given to those in Group I. Patients in Group II received chemotherapeutic protocol alone. Patients in Group III received chemotherapeutic protocol while orally taking CM decoction. Twenty-eight days were taken as one therapeutic course, and two courses in total. Assessment was performed using European Organization for Research and Treatment of Lung Cancer Quality of Life Questionnaire LC-43 (EORTC QLQ-LC43) before treatment, the 10th day of the second therapeutic course, and the 28th day of the second therapeutic course, respectively.</p><p><b>RESULTS</b>After two therapeutic courses of treatment, compared with Group II, better effects were obtained in Group I and Group III in the aspects of the physical function, roles function, emotional functions, social functions, general health state, and short breath, cough, fatigue, insomnia, poor appetite, and constipation (P<0.05, P<0.01).</p><p><b>CONCLUSIONS</b>CM therapy could relieve the clinical symptoms of aged patients with advanced NSCLC and improve their QOL.</p>

Epidermal growth factor receptor gene mutations, amplification and clinicopathologic correlation in patients with lung cancer / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features of patients with lung cancers associated with epidermal growth factor receptor (EGFR) gene amplification and/or mutations.</p><p><b>METHODS</b>Mutations and amplification status of EGFR gene were detected by PCR-DNA sequencing and FISH, respectively, followed by subsequent clinicopathological correlative studies.</p><p><b>RESULTS</b>Among 454 patients, the overall mutation rate of EGFR was 48.2% (219/454). The EGFR mutation rate in females was significantly higher than that of males, 59.6% (118/198) vs. 39.5% (101/256), P<0.001. The mutation rate of EGFR gene of non-smokers was higher than that of smokers, 52.7% (147/279) vs. 41.4% (72/175), P=0.017. The mutation rate in patients with adenocarcinoma was higher than that in patients with other cancer types, 56.8% (193/340) vs. 22.8% (26/114), P<0.05. Moreover, a significant difference of mutation rates among different subtypes of adenocarcinomas was found (P=0.001). Among 134 patients with available FISH analysis, no statistical significance of EGFR gene amplification was found in age, gender, histopathological types and subtypes of adenocarcinomas (P>0.05). There was a significant correlation between EGFR mutation and its gene amplification (P=0.0005), although with poor consistency (P=0.275).</p><p><b>CONCLUSIONS</b>EGFR gene mutations occur more frequently in females, non-smokers and patients with adenocarcinoma subtype. A significant variation of the mutation types exits among the subtypes of adenocarcinoma. The presence of EGFR amplification appears not related to age, gender, histopathological types of lung cancer and subtypes of adenocarcinoma. There is a significant correlation between EGFR mutations and its gene amplification (P=0.0005), although with poor consistency.</p>

Clinical observation of gefitinib for the treatment of 125 cases with advanced non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gefitinib for the treatment of advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>125 patients with advanced NSCLC who had failed or not tolerated or refused chemotherapy received 250 mg oral doses of gefitinib once daily until the disease progression or intolerable toxicity.</p><p><b>RESULTS</b>A total of 125 NSCLC patients were studied, the overall response rate (RR) and the disease control rate (DCR) after administration of gefitinib were 35.2% (44/125) and 77.6% (97/125), respectively. The median progression-free survival and the median survival time were 5.8 and 11.2 months, respectively. The one-year survival rate was 40.5%. The response rate was significantly higher in females, adenocarcinoma and nonsmokers than that in males, non-adenocarcinoma and smokers (P < 0.05). The response rate did not show significant differences regarding ECOG score or previous treatment. The median progression-free survival was significantly longer in ECOG PS 0-1 and gefitinib effective patients than that in ECOG PS >or= 2 and gefitinib ineffective patients (P < 0.01). The median survival time was significantly longer in adenocarcinoma, nonsmokers and gefitinib effective patients than that in non-adenocarcinoma, smokers and gefitinib ineffective patients (P < 0.05). The most common side effects were rash (51.2%) and diarrhea (34.4%), but usually were mild.</p><p><b>CONCLUSION</b>Gefitinib is effective and safe in the treatment of advanced NSCLC patients.</p>

Randomized study of thalidomide combined with vinorelbine and cisplatin chemotherapy for the treatment of advanced non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy, median time to progression (TTP), quality of life and toxicity in the patients with advanced non-small cell lung cancer (NSCLC), treated with thalidomide plus vinorelbine and cisplatin (NP) or NP alone.</p><p><b>METHODS</b>Sixty six patients with advanced NSCLC were divided randomly into two groups, the trial and control groups. The trial group was treated with vinorelbine 25 approximately 30 mg/m(2) i.v. on D1 and D8, cisplatin 70 approximately 80 mg/m(2) i.v. on D1 (NP regimen), and thalidomide 200 mg orally and daily from D1. The control group received vinorelbine and cisplatin as above described.</p><p><b>RESULTS</b>Of 66 assessable patients, the overall response rate was 51.5% in the trial group and 36.4% in the control group (P = 0.22). The median TTP was 6.0 months for the trial group, and 3.6 months for the control group (P < 0.001). The score of quality of life in trial group was higher than that in the control group, but no significant difference was observed between the two groups (P > 0.05). There were no significant differences in toxicities between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>NP regimen combined with thalidomide can significantly prolong the median time to tumor progression in patients with advanced NSCLC. Thalidomide may have a synergic activity with NP regimen without increased toxicities.</p>

Lung adenocarcinoma stem cell phenotypes and their correlation with patient prognosis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the cancer stem cells and to evaluate their prognostic implication in patients with lung adenocarcinoma.</p><p><b>METHODS</b>Three phenotypic markers of cancer stem cells (SP-C, CCSP and OCT4) in lung adenocarcinoma were detected by immunofluorecence staining. The correlation among the clinicopathological parameters and phenotypes of cancer stem cells as well as survival were analyzed by Cox proportional hazard method.</p><p><b>RESULTS</b>Of the 57 cases, cancer stem cells were detected in 52, including OCT4(+) bronchioloalveolar stem cell (BASC) phenotype (SP-C(+) CCSP(+) OCT4(+)) in 40 cases and OCT4(-) BASC phenotype (SP-C(+) CCSP(+) OCT4(-)) in 12 cases. Statistical analysis revealed that the phenotype of cancer stem cells was related with the cellular differentiation, i.e. the OCT4(+) BASC phenotype occurred more frequently in the well-differentiated tumors, while the OCT4(-) BASC phenotype usually presented in most of the poorly-differentiated ones. Cox analysis showed that the OCT4(+) BASC phenotype was one of prognostic factors.</p><p><b>CONCLUSION</b>The lung adenocarcinoma stem cells have phenotypic features of bronchioalveolar stem cells (SP-C(+) CCSP(+)). The expression of self-renewal regulatory gene OCT4 in these cells indicates an aggressive nature and unfavorable prognosis.</p>

Evaluation on effect of feiji recipe on quality of life of patients with non-small cell lung cancer by adopting international questionnaire of QOL / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect of Feiji Recipe (FJR) on quality of life (QOL) of patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>One hundred and two patients with NSCLC were randomly assigned into 2 groups. The 61 patients in the combined treated group were given FJR and chemotherapy and the 41 patients in the control group were treated with chemotherapy alone. They were observed for two treatment courses with QOL estimated by EORTC QLQ-C43 questionnaire and FACT-L questionnaire, the two international questionnaires as the tools for measurement, and referred to the traditional evaluating indexes of clinical efficiency.</p><p><b>RESULTS</b>QOL in the combined treated group was improved after treatment with the improvement of scores in all domains, including functional and symptom sub-domain, while it in the control group deprived significantly, showing significant difference between the two groups (P < 0.05). Similar results were also shown in the evaluation of physical performance by Eastern Cooperative Oncology Group (ECOG) and Karnovfsky performance scoring. The gastrointestinal reaction and myelo-suppression were slighter in the combined treated group than those in the control group (P < 0.05), and no significant difference was shown between the response rate of the two groups (P > 0.05).</p><p><b>CONCLUSION</b>FJR can improve QOL of patients with NSCLC, reduce the adverse reaction of chemotherapy, and improve patients' physical performance.</p>

Analysis of EGFR mutations in 176 cases of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the incidence and profile of mutations in epidermal growth factor receptor (EGFR) in Chinese patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 176 cases of NSCLC tissue was enrolled in this study, among which 123 normal lung samples were also included. The tissue DNA was extracted and the EGFR gene in exon 19 to 21 was subjected for PCR amplification and direct sequencing.</p><p><b>RESULTS</b>The EGFR gene in exon 19-21 was of wild type in all normal lung tissues detected. Mutations were found in 57 cases of 176 lung cancer samples, with an incidence of 32. 4%. Mutations were mainly detected in the exon 19 (37/57 cases, 64. 9% ) and exon 21 (18/57 cases, 31. 6% ) , while that in the exon 20 was rare (2/57 cases, 3. 5% ). There were 7 types of EGFR mutation in the exon 19, resulting in the deletion of codon 746 to 753. A missense mutation was detected in exon 20, dealing with codon 789 to 793. The mutation in exon 21 belonged to the single missense substitution in codon 858. The EGFR mutations were more frequent in female patients than male ones, in adenocarcinoma and adenosquamous cell carcinoma versus cancer of other histologies.</p><p><b>CONCLUSION</b>EGFR mutation is a tumor-specific somatic abnormality. Some one third of Chinese NSCLC tumors harbor EGFR mutations, especially in exons 19 and 21. These mutations are more frequently detected in female, adenocarcinoma and adenosquamous cell carcinoma.</p>

Impact of mice apoptosis antigen of lung cancer induced by paclitaxel on function of dendritic cells / 上海第二医科大学学报

Objective To investigate the in vitro effect of low dosage of paclitaxel on normal murine bone marrow-derived dendritic cells(mDCs)and its role in reactivating tumor-pulsed DCs. Methods The concentration of paclitaxel which could induce 30% apoptosis of 3LL cell lines was figured out.mDCs were generated from murine bone marrow precursors.Cell culture insert system was used and four groups were divided as following: mDC,mDC+3LL,mDC+ low dose of paclitaxel,and mDC+3LL with 30% apoptosis induced by low dose of paclitaxel.The phenotypes,chemoattractive function to MIP1? and MIP-3?,and viability in activating allogeneic T cell proliferation of DCs in the four groups were analysed. Results Paclitaxel of 50 nmol/L could induce 30% apoptosis of 3LL,and had protective effects on DCs.It could stimulate the maturation of mDCs by up-regulating the phenotypes of CD11cCD80,CD11cCD86,CD11cCD40 and CD11cCDIab,and could enhance the chemoattractive function to chemokine MIP-3?.Compared with those cocultured with 3LL,DCs pulsed with apoptosis antigen of 3LL cell which was induced by 50 nmol/L paclitaxl up-regulated the phenotype of CD11cCD40,enhanced the the chemoattractive function to MIP1? and MIP-3?,and activated the proliferation of T cells. Conclusion Paclitaxel of 50 nmol/L can stimulate the maturation of DC,and can partially recover the phenotype and function of tumor-pulsed DC.

Clinical significance of serum VEGF and bFGF detection in patients with non-small cell lung cancer / 上海第二医科大学学报

Objective To investigate the levels of serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) in patients with non-small cell lung cancer(NSCLC) and relationships with c1inicopatho1ogica1 characteristics and their clinical significance. Methods The concentrations of serum VEGF and bFGF were detected by enzyme-linked immunosorbent assay(ELISA) in 40 patients with NSCLC before and after chemotherapy. Results The level of serum VEGF in patients with Ⅳ stage NSCLC was significantly higher than that of Ⅲ stage(P

Expression and prognostic significance of CgA and SYN in patients with non-small cell lung cancer / 上海第二医科大学学报

Objective To study the expression and prognostic significance of neuroendocrine differentiation markers chromogranin A(CgA)and synaptophysin(SYN) in patients with resectable non-small cell lung cancer(NSCLC).Methods From January 2000 to January 2003,123 patients with NSCLC who received operations were investigated.The resected specimens and clinical data were collected.Immunohistochemical Elivison method was used to detecte the expression of CgA and SYN.Kaplan-Meier survival curve and Cox proportional hazard model multivariate analysis were applied for the prognostic factors. Results The positive expression rates of CgA and SYN were 22%,17.9%,respectively.The expression of SYN was associated with histological differentiation(P=0.001).No significant association was found between NSCLC with neuroendocrine differentiation(NSCLC-ND) and sex,age,smoke index,TNM Stage and pathology classification.No evidence showed the patients with positive expression of CgA or SYN could be tolerant with more cycles of chemotherapy(P=0.406).Kaplan-Meier survival curve indicated the survival had a relation with the expression of CgA and SYN.It was revealed by Cox analysis that SYN(P=0.001),TNM stage(P=0.02)and the maximal diameter of tumor(P=0.049) were independent prognostic factors. Conclusion The patients with NSCLC-ND had a poorer prognosis.SYN may be one of the prognostic factors in patients with NSCLC.

Clinicopathologic study of 14 patients with pulmonary large cell neuroendocrine carcinoma / 上海第二医科大学学报

Objective To analyse the clinical characteristics,therapeutic modalities and prognosis of pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The clinical data of 14 patients with pulmonary LCNEC confirmed by surgery were retrospectively reviewed. Results No case was correctely diagnosed before surgery.The immunohistochemical amalysis of the specimens revealed the characters of endocrine carcinoma.Twelve cases received adjuvant chemotherapy of platinum agents,but recurrence or metastasis was found in 8 of them several months after surgery.The median survival time was 19 months.The 1-year,2-year and 3-year survival rate were 85.7%(12/14),21.4%(3/14) and not more than 14.3%(2/14),respectively.The statistical analysis showed that the stage,lymph node metastasis and postoperative adjuvant chemotherapy may have impacts on the prognosis of pulmonary LCNEC. Conclusion Pulmonary LCNEC is a carcinoma with poor prognosis,high tendency of invasion and metastasis.The stage of disease,lymph node metastasis,and adjuvant chemotherapy may be related to the prognosis.

Analysis of treatment and prognosis of 352 lung cancer patients with brain metastases / 上海第二医科大学学报

Objective To analyze the treatment and prognosis of lung cancer patients with brain metastases.Methods The clinical data of 352 lung cancer patients with brain metastases were retrospectively reviewed.According to the treatment modalities,patients were divided into palliative therapy group(n=28),simple whole brain radiotherapy(WBRT)or chemotherapy group(n=49)and comprehensive treatment group(n=275).Comprehensive treatment group was subdivided into WBRT plus chemotherapy group(n=192),stereotactic radiosurgery(?knife)plus chemotherapy/WBRT group(n=72,n=16 for?knife plus chemotherapy and n=56 for?knife plus WBRT and chemotherapy)and neurosurgical resection plus chemotherapy/WBRT group(n=11).In comprehensive treatment group,111 patients received chemotherapy≤3 cycles,and the other 164≥4 cycles.Survival curves of each group were drawn respectively,and both survival time and survival rates were compared among groups.Results The median survival time of palliative therapy group,simple WBRT or chemotherapy group,WBRT plus chemotherapy group,?knife plus chemotherapy/WBRT group and neurosurgical resection plus chemotherapy/WBRT group was 1.7,3.2,9.0,11.6 and 17.1 months,respectively.It was revealed by survival analysis that WBRT plus chemotherapy group was better than simple WBRT or chemotherapy group (P=0.0000),?knife plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group(P=0.0000),and neurosurgical resection plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group and WBRT plus chemotherapy group(P=0.0001,P=0.0229).There was no significant difference in survival rates between neurosurgical resection plus chemotherapy/WBRT group and?knife plus chemotherapy/WBRT group(P=0.2543),and there was no significant difference in survival rates between those with?knife plus chemotherapy and those with?knife plus WBRT and chemotherapy(P=0.3804).In comprehensive treatment group,the survival rates of those with chemotherapy≥4 cycles was significantly higher than that of those with chemotherapy≤3 cycles(P=0.0000). Conclusion Both WBRT plus chemotherapy and?knife plus chemotherapy and WBRT are effective modalities for the treatment of lung cancer patients with brain metastases,and the latter has the tendency to gain more survival benefit.There is no significant difference in the survival time between patients receiving?knife with WBRT and those without.It is proper for the patients to have no less than 4 cycles of chemotherapy.

Implication of micrometastatic cancer cells in the peripheral blood on prognosis of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the relationship of micrometastatic cancer cells in the blood and prognosis of patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Blood samples were collected from peripheral vein perioperatively and from the pulmonary vein intraoperatively in NSCLC patients. Cancer cells were detected by flow cytometry, as described previously. The patients were followed up and analyzed statistically.</p><p><b>RESULTS</b>Cancer cells in blood samples were detected in 20 of 58 patients (34.5%). Patients under 57 years of age or with stage III/IV lesions had higher positive findings than those over 57 years or with stage I/II lesions (P = 0.000 and 0.006, respectively). On the basis of 40 month follow-up data, the 2- and 3-year survival rates of patients with positive and negative results were 30.0% vs 20.0%, and 52.6% vs 50.0%, respectively. There was significant difference between the overall survival curves which favored patients with negative findings (P = 0.0291 and 0.0092, respectively).</p><p><b>CONCLUSION</b>This study indicates that cancer cells can be detected in the blood perioperatively from NSCLC patients which means poor prognosis.</p>

Clinicopathologic features,surgical methods and prognosis in peripheral<2 cm(of diameter) non-small cell lung cancer / 中国癌症杂志

1.0～(?)1.5 cm(14.81%)(P=0.10).There was no lymph node metastasis in tumors less than 1.0 cm in diameter. The 5-year survival rates for cases with or without lymph node involvement were 92.31% and 60.0%,respectively,the difference was significant(P=0.000).The 5-year survival rates of 12 patients showing ground-glass opacity(GGO)on chest CT was 91.67% without any lymph node involvement.Conclusions:There is mediastinal and hilar lymph node involvement even with tumor diameter less than 2 cm.The results of the present study suggested that routine lymph node dissection is necessary even for cases with tumor diameter less than 2 cm.However,if the tumor is within 1.0 cm in diameter with obvious GGO showing on chest CT,these are good candidates for partial resection without mediastinal lymph node dissection.