Research on the application of uniportal video-assisted thoracoscopic segmental resection of the lung in elderly patients with non-small cell lung cancer aged over 65 years.

INTRODUCTION: The literature regarding the application of uniportal video-assisted thoracoscopic segmental resection of the lung in patients aged over 65 years with non-small cell lung cancer (NSCLC) is sparse. This paper reports 175 cases of uniportal video-assisted thoracoscopic segmental resection of the lung performed at one center, of which 63 patients were over 65 years old. AIM: To investigate the safety and feasibility of uniportal video-assisted thoracoscopic segmental resection of the lung in elderly patients aged over 65 years with NSCLC. MATERIAL AND METHODS: A retrospective analysis of 175 NSCLC patients who underwent uniport video-assisted thoracoscopic segmental resection of the lung in the center from August 2018 to August 2020 was conducted, and based on the age of 65 years, patients were divided into elderly and non-elderly groups. The general data and perioperative indicators of the two groups were compared. RESULTS: The procedures were completed in all patients without death or conversion to open surgery. In the general data of the two groups of patients, the prevalence of emphysema in the elderly group was significantly higher than that in the non-elderly group (p = 0.001). However, there was no statistically significant difference between the two groups in surgery time, intraoperative blood loss, thoracic drainage tube retention time, postoperative hospital stay, incision satisfaction, or postoperative complications (p > 0.05). CONCLUSIONS: Uniportal video-assisted thoracoscopic segmental resection of the lung is feasible and safe in elderly patients with NSCLC aged over 65 years.

Proteome profiling of formalin-fixed, paraffin-embedded lung adenocarcinoma tissues using a tandem mass tag-based quantitative proteomics approach.

Over the past few decades, increasing efforts have been made to improve the understanding of, and treatment options for, lung adenocarcinoma (LUAD). However, considering the heterogeneity of LUAD, precise proteomics-based characterization at the molecular level is an urgent clinical requirement for effective treatment. Formalin-fixed, paraffin-embedded (FFPE) tissue is a good option as the working tool for proteomics studies. The present study aimed to obtain a global protein profile using LUAD FFPE tissue samples. Using a quantitative proteomics approach, the study revealed that 360 proteins were significantly more highly expressed in LUAD than in adjacent nontumor lung tissues. Also, 19 differentially expressed membrane proteins were found to be primarily responsible for immune processes. Epidermal growth factor (EGF)-like domain and laminin EGF domain showed markedly different expression levels between cancer tissues and tumor-adjacent normal tissues. Furthermore, Gene Ontology functional enrichment analysis showed that significantly upregulated proteins were associated with the endoplasmic reticulum lumen, protein disulfide isomerase activity, vitamin binding, cell cycle G1/S phase transition, to name but a few. Also, numerous kinases and post-translational modification enzymes were significantly upregulated across all eight LUAD samples compared with paracarcinoma tissues. Proteomics analysis revealed that AAA domain containing 3A (ATAD3a), a member of the ATPase family, was highly expressed in LUAD tissues, which was supported by immunohistochemical analysis. Furthermore, the study confirmed that ATAD3a enhanced the cisplatin sensitivity of LUAD cells. Collectively, the findings of the present study provide new potential candidate targets in patients with LUAD, and may aid auxiliary LUAD diagnosis and surveillance in a noninvasive manner.

LncRNA GAS6-AS2 promotes non-small-cell lung cancer cell proliferation via regulating miR-144-3p/ MAPK6 axis.

The function of a new long non-coding RNA GAS6-AS2 in non-small cell lung cancer (NSCLC) is not fully understood. In this study, GAS6-AS2 was identified, and its roles as well as mechanisms in regulating proliferation of NSCLCs cells were investigated. qRT-PCR was used to analyze GAS6-AS2, miR-144-3p, and MAPK6 expression. Protein expression was detected by Western blotting. Cell Counting Kit-8 (CCK8) assay was used to examine the cell proliferation ability. The interaction between GAS6-AS2 and miR-144-3p was confirmed by dual-luciferase reporter assay and RNA pull down assay. A xenograft model was constructed to monitor the mice NSCLC tumor growth in vivo. GAS6-AS2 was up-regulated, while miR-144-3p was suppressed in NSCLC cells compared with normal lung cells. GAS6-AS2 suppression could inhibit the progression of NSCLC cells, and miR-144-3p could attenuate the effect. GAS6-AS2 could function as a competitive endogenous RNA (ceRNA) via direct sponging miR-144-3p-3p, which further regulating the expression of MAPK6. The knockdown of GAS6-AS2 could greatly suppress the tumor growth of NSCLC in vivo. GAS6-AS2 up-regulated MAPK6 by sponging miR-144-3p in NSCLC tissues and cells. Thus, GAS6-AS2 is an effective therapeutic target in NSCLC.

A prospective randomized, controlled trial deems a drainage of 300 ml/day safe before removal of the last chest drain after video-assisted thoracoscopic surgery lobectomy.

OBJECTIVES: To study the feasible and safe volume threshold for chest tube removal following video-assisted thoracoscopic surgical lobectomy. METHODS: One hundred and sixty-eight consecutive patients (18 were excluded) who underwent video-assisted thoracoscopic surgery lobectomy or bilobectomy with two incisions between August 2012 and February 2014 were included. Eligible patients were randomized into three groups: Group A (chest tube was removed at a drainage volume of 150 ml/day or less. n = 49); Group B (chest tube was removed when the drainage volume was less than 300 ml/day. n = 50); Group C (chest tube was removed when the drainage volume was less than 450 ml/day. n = 51). The postoperative care of all patients was consistent. The time of extracting the drainage tube, postoperative hospital stay, postoperative visual analogue scale grades, dosage of analgesic, and the incidence of complications and thoracocentesis were measured. RESULTS: Group B and C had a much shorter drainage time and postoperative hospital stay than Group A (P < 0.05). Compared with Group B, Group C had a notably shorter drainage time (P = 0.036). The postoperative hospital stay was not statistically different between Group B and Group C (P > 0.05). The mean dosage of pethidine hydrochloride was 248.9 ± 33.3 mg in Group B and 226.1 ± 32.7 mg in Group C (P > 0.05). The dosage of pethidine hydrochloride of Group A was significantly higher than that of Group B and C (P < 0.05). The total visual analogue scale (VAS) score during the five days showed no statistical differences compared with Group B and Group C (P > 0.05), Group A had a significantly higher total VAS score than Group B and C (P < 0.05). The number of patients who needed thoracentesis in Group C was more than those in Group B and A (P < 0.05). There were no statistically significant differences in the number of patients who needed reinsertion of chest drains among the three groups (P > 0.05). CONCLUSIONS: A 300-ml/day volume threshold for chest tube removal after video-assisted thoracoscopic surgery lobectomy is feasible and safe, demonstating more advantages than the 150-ml/day volume threshold. However, a 450-ml/day volume threshold for chest tube removal may increase the risk of thoracentesis compared with the 300- and the 150-ml/day volume threshold.