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Objective:To explore the effect of pre-hospital health education based on "Internet +" on self-management efficacy, anxiety and depression of patients undergoing pulmonary tumor surgery, and provide reference for pre-hospital nursing care of this group.Methods:It was a randomized controlled trial. A total of 100 outpatients in Department of Pulmonary Oncology, Tumor Hospital of Tianjin Medical University to be hospitalized for surgery during November 2021 to March 2022, were divided into experimental group ( n=50) and control group ( n=50) by random number method according to the order of outpatient visits. Patients in control group received routine thoracic surgery nursing and health education after admission. Those in experimental group received "Internet +" pre-hospital health education during patients waiting for hospital beds for surgery, nursing care after admission was the same as that of the control group. The scores of Strategies Used by People to Promote Health (SUPPH) and Hospital Anxiety and Depression Score (HADS) were compared between the two groups 1 day before discharge. Results:At the time of outpatient visit, there was no statistically significant difference between the two groups in the comparison of all dimensions and total scores of SUPPH and the score of HADS ( P>0.05). Total SUPPH score, and self-decompression, self-decision and positive attitude score of experimental group were (110.62 ± 17.73) points, (38.74 ± 6.56) points, (11.98 ± 2.20) points, (59.90 ± 10.18) points, respectively, while in the control group, the scores were (92.86 ± 18.91) points, (32.46 ± 7.39) points, (9.76 ± 2.00) points and (50.64 ± 11.50) points, respectively, with statistically significant differences ( t values were -5.29--4.27, all P<0.01). Besides, the anxiety and depression scores of HADS in experimental group were (3.92 ± 2.25) points and (3.36 ± 2.38) points, respectively, while those in control group were (7.12 ± 3.49) points and (7.00 ± 3.53) points, respectively, and the differences were statistically significant ( t=5.45, 6.04, both P<0.01). Conclusions:The "Internet +" pre-hospital health education model can promote the self-management efficacy of patients undergoing pulmonary tumor surgery, and improve their psychological state during treatment. The study provided reference for promoting diversified extended nursing services in clinical practice.
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@#The widespread use of low-dose computed tomography (LDCT) in lung cancer screening has enabled more and more lung nodules to get identified of which more than 20% are multiple pulmonary nodules. At present, there is no guideline or consensus for multiple pulmonary nodules whose management is based primarily on the pulmonary imaging characteristics and associated risk factors. Herein, this review covers the imaging methods, CT appearances and management of multiple pulmonary nodules.
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RESUMEN Introducción: el cáncer de pulmón es un problema de Salud Pública en el mundo y en nuestro país por su alta mortalidad e incidencia. Los carcinógenos medioambientales y el tabaquismo están directamente relacionados como factores de riesgo. Objetivo: Caracterizar los factores etiológicos de fumador activo y carcinógenos medioambientales de los pacientes con cáncer de pulmón detectados durante 9 años en el Instituto Nacional del Cáncer, Paraguay. Metodología: estudio observacional retrospectivo descriptivo analítico de una base de datos del período 2004-2013. Las variables medidas fueron datos demográficos, carga tabáquica, tabaquismo, la exposición a carcinógenos medioambientales categoría I. Resultados: se incluyeron 478 pacientes con cáncer pulmonar, 88,1% de sexo masculino y 11,9% femenino. La edad promedio del sexo masculino fue 60±10 años y del sexo femenino 58±12 años. La prevalencia de exposición carcinógenos medioambientales categoría I fue 36,90%. La media del índice tabáquico fue 4,48±20. El modelo de regresión lineal múltiple entre exposición ambiental, tabaquismo y tipo histológico para predecir la severidad clínica fue 3,6%. En el análisis de regresión logística de la relación de tipos histológicos con tabaquismo, género y exposición ambiental no mejoran el modelo de predicción. Conclusiones: Los factores etiológicos relacionados con carcinógenos medioambientales estuvieron presentes en más de un tercio de la población, el hábito tabáquico es mayor en hombres que en mujeres. El tipo histológico más frecuente para ambos sexos, con y sin el hábito tabáquico, es el carcinoma de células no pequeñas.
ABSTRACT Introduction: Lung cancer is a public health problem in the world and in our country due to its high mortality and incidence. Environmental carcinogens and smoking are directly related as risk factors. Objective: To characterize the etiological factors of active smokers and environmental carcinogens of patients with lung cancer detected during 9 years at the National Cancer Institute, Paraguay. Methodology: Retrospective observational descriptive analytical study of a database for the period 2004-2013. The variables measured were demographic data, smoking load, smoking, exposure to category I environmental carcinogens. Results: Four hundred seventy-eight patients with lung cancer, 88.1% male and 11.9% female were included. The mean age of the male sex was 60±10 years and 58±12 years of the female age. The prevalence of exposure to category I environmental carcinogens was 36.90%. The mean smoking index was 4.48±20. The multiple linear regression model between environmental exposure, smoking and histological type to predict clinical severity was 3.6%. In the logistic regression analysis of the relationship of histological types with smoking, gender and environmental exposure, the prediction model was not improved. Conclusions: The etiological factors related to environmental carcinogens were present in more than one third of the population, and smoking was greater in men than in women. The most frequent histological type for both sexes, with and without the smoking habit, was non-small cell carcinoma.
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Objective@#To investigate the clinical features of ciliated muconodular papillary tumor(CMPT) of the lung.@*Methods@#We retrospectively reviewed 11 cases with final pathology being diagnosed as CMPT in our department from April 2017 to April 2018. There were 8 males and 3 females with a mean age of(63.7±5.6) years. The clinical data, histopathological features, treatment, and prognosis were reviewed. All patients received CT scan before operation.@*Results@#The radiological features of CMPT include: located peripherally and most in right lower lobe; most CMPT lesions are GGO, some with air spaces in center and few being solid. All patients underwent video-assisted thoracic surgery(VATS) successfully, and there were no severe perioperative complications. The mean operating time was(78.0±28.2) min. The mean blood loss was(37.3±14.9) ml. The mean postoperative hospital stays were(3.45±0.93) days. Pathology examination of all patients were CMPT. Follow-up time ranged from 6 to 18 months and no recurrence was found.@*Conclusion@#CMPT is rare tumor, without specific clinical manifestation, but sometimes misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma. VATS is feasible and safe for CMPT, and the prognosis is good.
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Objective To investigate the clinical features of ciliated muconodular papillary tumor( CMPT) of the lung. Methods We retrospectively reviewed 11 cases with final pathology being diagnosed as CMPT in our department from April 2017 to April 2018. There were 8 males and 3 females with a mean age of(63. 7 ± 5. 6) years. The clinical data, histopatho-logical features, treatment, and prognosis were reviewed. All patients received CT scan before operation. Results The radio-logical features of CMPT include:located peripherally and most in right lower lobe;most CMPT lesions are GGO, some with air spaces in center and few being solid. All patients underwent video-assisted thoracic surgery( VATS) successfully, and there were no severe perioperative complications. The mean operating time was(78. 0 ± 28. 2) min. The mean blood loss was (37. 3 ± 14. 9) ml. The mean postoperative hospital stays were(3. 45 ± 0. 93) days. Pathology examination of all patients were CMPT. Follow-up time ranged from 6 to 18 months and no recurrence was found. Conclusion CMPT is rare tumor, without specific clinical manifestation, but sometimes misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma. VATS is feasible and safe for CMPT, and the prognosis is good.
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Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.
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Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.
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Objective To explore the value of contrast enhanced ultrasound (CEUS) in the diagnosis of peripheral pulmonary lesions,and to evaluate the diagnostic efficiency of CEUS combined with tumor markers peripheral lung cancer.Methods According to the pathological results,105 patients with 105 peripheral pulmonary lesions were divided into benign (50 cases) and malignant group (55 cases).Before CEUS examination,lesions' location,size,shape and internal echogenicities were recorded by twodimensional (2D) ultrasound.After contrast agent injection,arrive time (AT) in the lesion,difference of AT between the lesion and lung (tAT),and lesions' enhanced morphology were observed.The time intensity curve (TIC) was used to obtain the rise time (RT),mean transit time (MTT),time from peak to one half of peak(TPH),time to peak (TTP),peak intensity (PI) and wash-in slope (WIS).The parameters of TIC between the two groups were compared.Serum carcino-embryonic antigen (CEA),neuron specific enolase (NSE) and cyrokeratin fragment antigen 21-1 (CYFRA21-1) level were detected and analyzed between the two groups.Results Lesions' shape and intralesional bronchial syndrome had significant difference in the diagnosis of peripheral pulmonary benign and malignant lesions (P ＜0.01).In benign group,27 lesions (54.00％,27/50) were enhanced in late pulmonary arterial phase and 32 lesions(64.00％,32/50) showed homogeneous enhancement.At the meantime,in malignant group,most of lesions (76.36％,42/55) were enhanced in bronchial arterial phase and 36.00％ (18/50) of lesions indicated inhomogeneous enhancement.The difference of enhanced phase and morphology between benign and malignant lesions were significant (all P ＜0.05).While the statistical differences of such quantitative parameters AT,tAT,RT,TTP,PI and WIS,except to MTT and TPH were found between benign and malignant lesions (all P ＜0.05) in experiment group.In the diagnosis of peripheral lung cancer,the accuracy and specificity of tAT combined with joint detection of 3 kinds of tumor markers were 76.37％ and 75.00％,respectively,and higher than any single detection,but the sensitivity was a little lower (76.47％).Conclusions CEUS quantitative analysis has certain value in the diagnosis of benign and malignant peripheral lung lesions,and combined with tumor markers can improve the diagnostic efficiency of peripheral lung cancer.
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Os avanços científicos das últimas décadas permitiram que a compreensão do câncer evoluísse de uma visão simplista, na qual o principal motor seria uma atividade celular hiperploriferativa, para uma visão mais complexa onde o estado fisiológico geral permite a gênese e progressão tumoral. Essa evolução permite o desenvolvimento de novas abordagens terapêuticas e traz novas esperanças para o tratamento de muitos tipos de cânceres ainda extremamente deletérios. Dentro desse novo panorama, terapias que estimulem a imunidade antitumoral têm se mostrado extremamente promissoras. Nesse trabalho, procuramos investigar os efeitos antitumorais desencadeados pela combinação da indução de morte celular e imunoestimulação. Para tanto, visamos à recuperação da via de p53 (pela transferência gênica do próprio p53 ou p19) associada à transferência gênica de IFNbeta. A transferência gênica foi mediada por vetores adenovirais do sorotipo 5. Nossas observações, em um modelo murino de carcinoma pulmonar, permitem concluir que esta linhagem é sensível a morte induzida pela transferência gênica de p19 e não p53. Porém, a transferência gênica intratumoral de IFNbeta se mostrou chave no controle do crescimento do tumor primário. Destacamos, entretanto, que a associação de IFNbeta com p19 produziu efeitos imunoprotetores superiores à transferência de IFNbeta ou p19 sozinhos. Tal efeito parece ser dependente da indução de fatores quimiotáxicos e conseqüente recrutamento de neutrófilos para o sítio tumoral. O efeito da transferência gênica combinada de ambos os genes IFNbeta e p19 se mostrou ainda mais promissor quando associado à cisplatina, induzindo uma notável redução no crescimento tumoral...
Scientific advances from the last decades enabled the evolution of our knowledge of cancer from a simplistic vision, in which the main motor was an excessive cell proliferation, to a more complex one, where the general physiologic state enables tumorigenesis and tumor progression. This evolution enabled the development of new therapies and brings new hopes for the treatment of several types of cancers. In this context, therapies that induce an antitumor immunity are very promising. In this work, we are investigating the antitumor effects triggered by the combination of cell death induction and immunostimulation. To this end, we aimed to restore p53 pathway (by p53 or p19 gene transfer) associated with immunostimulation by IFNbeta gene transfer. The gene transfer was mediated by Adenovectors Serotype 5. Our observations in a murine model of lung cancer showed that this cell line is sensitive to cell death induced by p19 gene transfer, but not p53. Nevertheless, intratumoral gene transfer of IFNbeta, was crucial in controlling tumor growth. Moreover, p19 and IFNbeta association induced higher immunoprotecting effects than p19 or IFNbeta alone. This effect seems to be depending on the induction of chemotactic factors, and the recruitment of neutrophils to the tumor site. The effect of combined gene transfer of p19 and IFNbeta was even more promising when associated with Cisplatine, inducing a remarkable reduction in tumor growth...
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Humains , Souris , Thérapie génétique , Immunothérapie , Interféron bêta , Tumeurs du poumonRÉSUMÉ
In patients under 15 years of age primary lung tumors are infrequent, most thoracic tumors being originated in the mediastinum or the thoracic wall. The great majority of pulmonary masses are non-neoplastic corresponding to inflammatory processes or malformations. Amongst neoplasms metastasis from solid extracraneal tumors are the predominant lesions. Other malignant neoplasms are: bronchial carcinoid, mucoepidermoid carcinoma, pulmonary lymphoma, pleuropulmonary blastoma and metastasis. In the spectrum of benign lesions the following are found: miofibroblastic inflammatory tumor, nodular lymphoid hyperplasia and hamartomas. The diagnosis of primary pulmonary neoplasms is frequently late because of its low incidence, lack of clinical suspicion and the variability of its manifestations. Radiological and tomographical signs are very proteiform and unspecific, representing a great diagnostic challenge.
En pacientes menores de 15 años los tumores pulmonares primarios son infrecuentes, generalmente los tumores torácicos son de origen mediastínico o de la pared torácica. La gran mayoría de las masas pulmonares son de origen no neoplásico, correspondiendo a procesos inflamatorios o malformaciones. Dentro de las neoplasias pulmonares, las metástasis de tumores sólidos extracraneanos son las lesiones predominantes. En el espectro de lesiones benignas se encuentran el tumor miofibroblástico inflamatorio, la hiperplasia nodular linfoidea, los síndromes linfoproliferativos y los hamartomas. Entre las neoplasias malignas se incluyen el tumor carcinoide bronquial, carcinoma mucoepidermoide, linfoma pulmonar, blastoma pleuropulmonar y las metástasis. El diagnóstico de las neoplasias primarias pulmonares frecuentemente es tardío, por su baja incidencia y la falta de sospecha clínica o por su presentación atípica. Los hallazgos radiológicos y tomográficos de los tumores pulmonares son muyproteiformes, según su estirpe y lugar de origen, y no son específicos en la mayoría de los casos, constituyendo habitualmente un gran desafo diagnóstico.
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Enfant , Tumeurs du poumon , Radiographie thoracique , Tomodensitométrie , Métastase tumorale , Tumeurs du poumon/secondaire , PédiatrieRÉSUMÉ
Objective To evaluate maximum intensity projection(MIP) images and apparent diffusion coefficient(ADC) values of MR diffusion weighted imaging with background body signal suppression (DWIBS) on pulmonary diseases.Methods Sixty-one patients with pulmonary diseases underwent DWIBS.The findings in three dimensional(3D) MIP image were observed and the ADC values of diseased region were measured.The diagnostic value of DWIBS on pulmonary diseases was evaluated.Results Lung cancer and inflammatory disease were all demonstrated as dense intensity area on DWIBS.The mean ADC value of central lung cancer was (1.05±0.23)×10-3 mm2/s.The mean ADC value of peripheral lung cancer was(1.10±0.17)×10-3 mm2/s.The mean ADC value of the inflammatory disease was(1.69±0.29)×10-3 mm2/s.The mean ADC value had significant difierence between peripheral lung cancer and the inflammatory disease (P＜0.05). The MR sensitivity,specificity and accuracy in diagnosing the pulmonary diseases with DWIBS(86.84%,82.60%,85.24%,respectively) was higher than conventional MRI(78.94%,78.26%,and 78.68%,respectively).Conclusion DWIBS can demonstrate clearly the lesion's shape with 3D display.The quantitative measurement of ADC values iS feasible.DWIBS may be a potential diagnostic method for differentiation on pulmonary diseases.
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Objective: To diagnose occult micrometastasis of mediastinal lymph node in patients with non small cell lung cancer (NSCLC) and to evaluate its prognostic significance. Methods: Using assays of reverse transcriptase polymerase chain reaction (RT PCR), two hundred and forty two stations of mediastinal lymph node, which were free from tumor determined by routine histopathological examination (pN 0), from fifty eight patients were studied to detect mRNA for MUC1 gene and diagnose nodal occult micrometastasis. Survival rate was calculated by method of Kaplan Meier and survival difference between patients with and without nodal occult micrometastasis was compared with Log Rank test; Logistic regression analysis was carried to determined independent predictive factors of prognosis. Results: The mRNA for MUC1 gene was identified in twenty three stations of lymph node from sixteen patients (27 6%), and nodal occult micrometastasis was diagnosed in those patients. TNM staging for those patients was up regulated from stage I A～II B to stage III A. The survival rate of 3 year in patients with nodal occult micrometastasis (43.7%) was lower than that in patients without nodal occult micrometastasis (73.8%) (P
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Objective To study the radiographic features of pulmonary sclerosing hemangioma (PSH), and to correlate the imaging with the pathologic findings so as to improve the imaging diagnostic abilities. Methods The clinical features of 45 patients with pathology proved PSH between 1976 and 2002 were reviewed. Of the 45 patients, there were 3 men and 42 women, their age ranged from 18 to 67 years (median age, 49 years), and 19 patients were asymptomatic. 20 patients had chest radiography and CT scans. The radiographic findings were studied retrospectively and were correlated with that of pathology. (7 patients) underwent unenhanced CT and 13 patients had enhanced CT. Results Of the 20 patients who had chest X-ray, 18 patients presented as a solitary, round or oval shaped lesion with well-defined margin. On CT scans, the greatest dimension of the lesion ranged from 1.9 cm to 7.0 cm. A homogeneous soft-tissue attenuation was revealed on unenhanced scans. Homogeneous enhancement was detected in 9 patients and heterogeneous enhancement in 4 patients on enhanced CT. Cystic change was found in 1 patient showing lower attenuation than the enhanced solid tumor, and calcification was found in 5 patients. Correlation of radiographic and pathologic findings indicated that higher attenuation areas corresponded to the angiomatous areas. Conclusions PSH should be considered with the following features: (1) female patients between (40-60) years of age; (2) well-defined round or oval shaped lesion on chest radiography; (3) a homogeneous soft-tissue mass on unenhanced CT; cystic-like area within the tumor and/or calcification can occasionally be found; (4) homogeneous or heterogeneous enhancement after contrast administration.
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Objective: To investigate the frequency , distribution and features of lymph node metastasis in lung cancer, and to provide evidence for lymph node dissection. Methods: 348 patients with lung cancer were retrospectively studied, all patients received R_3 surgery plus systemic lymph node dissection according to the mapping system developed by Naruke. Results: Total 3 689 groups of lymph nodes were dissected . The metastatic rates of N_1 and N_2 were 23.4% and 16.5%, respectively. N_1 or N_2 metastasis was not found in Tis tumor. There was a significant difference of N_2 metastasis rates between squamous cell carcinoma and adenocarcinoma in T_1 or T_2 tumor (P