Systemic Therapy for Low-grade Pulmonary Neuroendocrine Tumor / 中国肺癌杂志

The lung is the second most common site of neuroendocrine tumors (NETs). Typical and atypical carcinoids are low-grade NETs of the lung. These rare tumors have received little attention and education is needed for treating physicians. The article describes the classifcation of lung NETs, the epidemiology and pathological characteristics. When lung NETs are diagnosed at an early stage, surgical intervention is often curative. For advanced lung NETs patients, different treatment methods including chemotherapy, somatostatin analogs, m-TOR inhibition, peptide receptor radioligand therapy, and biologic systemic therapy are discussed. The conclusions are generally extrapolated from the outcome of extra-pulmonary carcinoids. Prospective randomized well-designed trials are urgently needed to inform current recommendations on systemic treatment.
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Expression and clinicopathologic significance of Cdc42 and WAVE1 in non-small cell lung cancer / 中国肿瘤临床

Objective:To investigate the expression and clinical significance of cell division cycle 42 (Cdc42) and WASP family verprolin-homologous protein l (WAVE1) in non-small cell lung cancer (NSCLC). Methods:The expression of Cdc42 and WAVE1 was detected in 106 paraffin-embedded NSCLC tissues and 46 adjacent normal lung tissues (control group) using immunohistochemis-try. Results:The expression levels of Cdc42 and WAVE1 was distinctly higher in NSCLC than in the control group. The expression of Cdc42 in NSCLC significantly correlated with tumor differentiation, TNM stage, and lymph node metastasis (P<0.05). The expression of WAVE1 in NSCLC was significantly correlated with TNM stage and lymph node metastasis (P<0.05 or P<0.01). The expression of Cdc42 was significantly correlated with WAVE1 in NSCLC (r=0.469, P<0.01). The 3-year survival rates were significantly lower in the group with high Cdc42 expression (44.16%) than in the low expression group (72.41%;P<0.01). Similarly, the 3-year survival rates were significantly lower among patients with high WAVE1 expression (39.44%) than in those with low expression (77.14%;P<0.01). Lymph node metastasis and the common high Cdc42 and WAVE1 expression were independent prognostic factors for NSCLC. Conclu-sion:The Cdc42 expression is correlated with WAVE1 expression. They may act together and have an important function in NSCLC. The expression of both Cdc42 and WAVE1 in NSCLC tissue may be used as markers for assessing the clinicopathologic features and prognosis.

Clinical analysis for patients with severe chronic emphysema treated by lung volume reduction surgery / 中华全科医师杂志

Objective To study effectiveness and safety of lung volume reduction surgery(LVRS) in treatment for severe chronic emphysema(chronic obstructive pulmonary disease).Methods Clinical data of 24 patients of severe chronic emphysema undergone with LVRS during January 2004 to June 2007 were analyzed retrospectively.LVRS was performed for the patients after respiratory tract preparation based on their pulmonary function,results of blood gas analysis,cardiac function,as well as physical activity capacity.and surgical incision Was selected based on"target"location of emphysema with chest computerized tomography and isotope lung perfusion scanning,22 cases with standard unilateral LVRS via outer post-lateral incision and two with bilateral LVRS via mid-sternal incison.A linear device for cutting and stitching was used in surgical operation to excise the lung tissues of severe emphysema with strips of bovine pericardium to prevent air leakage.Results All the patients were followed-up for 19 months in average and complications occurred in seven of them after operation,including four with leakage of the alveoli.two with cardiac arrhythmia and one with pneumonia,and no death was observed.Pulmonary function and symptoms of dyspnea improved obviously in all the patients after operation,and they all could care for themselves,in general,with scales of dyspnea increased to grade Ⅰ in one case,to grade Ⅱ in 10 cases and to grade Ⅲ in three cases.Conclusions LVRS can improve pulmonary function of selected patients with severe emphysema,to certain extent,and its safety will depend on strict selection of the patients and correct peri-operative care.

Surgical Treatment and Prognostic Analysis in Patients with Malignant Thymoma / 天津医药

Objective: To observe the clinical outcome of surgical treatment for malignant thymoma,and evaluate the prognostic factors thereof. Mothods:All patients (63 eases)were operated and followed by radiotherapy. The Logistie regression analysis was used for the relationship between the prognosis, Masaoka staging,L/B pathology ,and the differences of the operation given.Rosults:Patients with early Masaoka stage and who received radical resection of thymoma had higher 3 and 5 year survival rates (P＜0.05).The radiotherapy after surgery was related to 3 and 5 year survival rates. The differences of L/B pathology was not related to 3 and 5 year survival rates.Conclusion :The survival rate is enhanced for patients with malignant thymoma when both surgical and radiotherapy intervention axe given as early as possible.The Masaoka staging, not L/B pathology, is closely related to the prognosis.