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Objective:To investigate the clinical value of bronchoscopic narrow band imaging combined with serum heat shock protein family 70 (HSP70) and netrin-1 (Ntn1) in the diagnosis of bronchogenic carcinoma.Methods:A retrospective cohort study was conducted. A total of 96 patients with suspected central lung cancer combined with airway obstruction admitted to Shanxi Province Cancer Hospital from January 2021 to January 2022 were retrospectively analyzed. Bronchoscopy and narrow band imaging were performed in all patients. Serum HSP70 and Ntn1 levels were measured by using enzyme-linked immunosorbent assay (ELISA). Pathological biopsy was taken as the gold standard. Receiver operating characteristic (ROC) curves were used to analyze the value of bronchoscopic narrow band imaging combined with serum HSP70 and Ntn1 in the diagnosis of bronchogenic carcinoma.Results:There were 70 males and 26 females in 96 suspected patients, with the age of (46±5) years. According to the pathological results, 72 were diagnosed with central lung cancer, including 43 cases of squamous cell carcinoma, 24 cases of adenocarcinoma, 3 cases of small cell carcinoma, 2 undifferentiated cases,and 24 cases of benign lesions in lung. The sensitivity, specificity, and accuracy of bronchoscopic narrow band imaging in the diagnosis of bronchogenic carcinoma were 90.3%, 79.2% and 87.5%, respectively. The serum HSP70 and Ntn1 levels in patients with lung cancer were higher than those in benign patients (all P < 0.05). ROC curves showed that the optimal cut-off values of HSP70 and Ntn1 in the diagnosis of bronchogenic carcinoma were 10.08 ng/ml and 562.82 pg/ml, respectively. The sensitivity, specificity, and accuracy of serum markers (HSP70 + Ntn1) in the detection of bronchogenic carcinoma were 93.1%, 58.3% and 84.4%, respectively. The sensitivity, specificity, and accuracy of bronchoscopic narrow band imaging combined with serum markers in the diagnosis of bronchogenic carcinoma were 98.6%, 87.5% and 95.8%, respectively; and the diagnostic accuracy of the combined method was higher than that of a single detection method such as bronchoscopic narrow band imaging or serum indexes ( χ2 values were 4.36, 7.07, all P < 0.05). Conclusions:Bronchoscopic narrow band imaging has a good diagnostic value for bronchogenic carcinoma, and the combination of serum HSP70 and Ntn1 can further improve the clinical diagnostic efficacy.
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Objective:To investigate the expressions of Yes-associated protein 1 (YAP1), YTH domain-containing family protein 2 (YTHDF2) and microRNA-888-3p (miR-888-3p) in patients undergoing radical resection for lung cancer, and their predictive value for short-term prognosis of patients.Methods:A total of 420 lung cancer patients who underwent radical resection for lung cancer in Shanxi Province Cancer Hospital from May 2015 to May 2022 were selected and divided into a modeling set (280 cases) and a validation set (140 cases) in a ratio of 2∶1 by using the computer-generated random number method. The paracancerous normal lung tissues removed by surgery (>5 cm from the edge of the cancer tissues) were used as the control. The relative expressions of YAP1 and YTHDF2 proteins in cancer tissues and paracancerous tissues of the modeling set was detected by Western blotting, and the relative expression of miR-888-3p was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The patients were followed up for 1 year to analyze the prognosis, and the patients in the modeling set who had recurrence, metastasis or cancer-caused death were considered as the poor prognosis group, and the rest of the patients were considered as the good prognosis group. The relative expressions of YAP1 protein, YTHDF2 protein, miR-888-3p and general information of the patients in the two groups were compared; the Cox proportional hazards model was used to analyze the influencing factors of the short-term prognosis of radical resection for lung cancer in the modeling set; a Nomogram prediction model was constructed for the short-term prognosis of radical resection for lung cancer, and its efficacy was verified.Results:The relative expression of miR-888-3p in the modeling set of cancer tissues and paracancerous tissues was 0.49±0.08 and 0.16±0.05, and the difference was statistically significant ( t = 58.53, P < 0.001); the relative expression of YAP1 protein was 0.48±0.06 and 0.12±0.03, and the difference was statistically significant ( t = 89.80, P < 0.001); the relative expression of YTHDF2 protein was 0.23±0.04 and 0.59±0.07, and the difference was statistically significant ( t = 74.72, P < 0.001). After 1 year of follow-up in the modeling set, 32 cases were lost, and 81 (32.66%) of the remaining 248 cases had a poor prognosis (poor prognosis group), while 167 cases (67.34%) were in the good prognosis group. Compared with the good prognosis group, the relative expressions of YAP1 protein and miR-888-3p in cancer tissues was elevated in the poor prognosis group (both P < 0.05), and the relative expression of YTHDF2 protein was decreased ( P < 0.05); the proportions of patients with smoking, coronary artery disease, TNM stage Ⅲ-Ⅳ, maximum tumor diameter ≥ 5 cm, and undifferentiated/lowly differentiated tissues were high in the poor prognosis group, the physical status (PS) score was elevated, and the proportion of patients with regular postoperative radiotherapy was reduced (all P < 0.05). The results of multivariate Cox regression analysis showed that the proportion of patients with smoking ( HR = 2.098, 95% CI 1.143-3.852, P = 0.009), TNM stage ( HR = 2.421, 95% CI 1.350-4.341, P = 0.002), maximum tumor diameter ( HR = 1.883, 95% CI 1.036-3.424, P = 0.011), degree of tissue differentiation ( HR = 3.133, 95% CI 1.590-6.173, P < 0.001), regular postoperative radiotherapy ( HR = 0.417, 95% CI 0.219-0.797, P = 0.003), YAP1 ( HR = 7.043, 95% CI 2.842-17.452, P < 0.001), YTHDF2 ( HR = 0.560, 95% CI 0.418-0.752, P < 0.001), and miR-888-3p ( HR = 4.100, 95% CI 1.789-9.394, P < 0.001) were the independent influencing factors for the short-term prognosis of radical resection for lung cancer. A Nomogram prediction model was constructed, and internal validation showed that the consistency index of the model was 0.822 (95% CI 0.774-0.870); the result of receiver operator characteristic curve showed that the sensitivity of the Nomogram prediction model for predicting the short-term prognosis of radical resection for lung cancer in the modeling set was 97.5% (95% CI 86.8%-99.9%), and the specificity was 82.4% (95% CI 73.0%-89.6%), and the area under the curve (AUC) was 0.943 (95% CI 0.889-0.976); the sensitivity of predicting the short-term prognosis of radical resection for lung cancer in the validation set was 91.53% (95% CI 81.3%-97.2%), and the specificity was 81.5% (95% CI 71.3%-89.2%), and the AUC was 0.922 (95% CI 0.865-0.961). Conclusions:YAP1, YTHDF2 and miR-888-3p are all influencing factors for short-term prognosis of radical resection for lung cancer, and the Nomogram prediction model constructed based on these factors has good predictive efficacy for the short-term prognosis of radical resection for lung cancer.
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Objective To compare the clinical efficacy of single utility port and multiple utility ports thoracoscopic lobectomy in the treatment of peripheral lung cancer, and to study the operation skills, relative merit and feasibility of the single utility port thoracoscopic lobectomy. Methods The clinical data was analyzed retrospectively for 223 cases with stage Ⅰ orⅡ of peripheral lung cancer who underwent thoracoscopic lobectomy from July 2011 to November 2014 in Shanxi Provincial Cancer Hospital. Among 223 cases, 78 cases received single utility port thoracoscopic lobectomy (single utility port group), 145 cases received 2 or 3 utility ports thoracoscopic lobectomy (multiple utility ports group). The clinical outcomes involved time of operation, intraoperative blood loss,chest drainage, postoperative hospital stay, stations of lymph node dissection, numbers of lymph node dissection, rate of turn to open, postoperative complications, 2-year survival rate and disease free survival rate. Results No perioperative death occurred in both groups. There was no statistical difference between single utility port group and multiple utility ports group in operation time [(157.4 ±13.6) min vs. (151.3 ±23.2) min], intraoperative blood loss [(180.77 ±59.97) ml vs.(171.31 ±77.51) ml],chest drainage [(370.26 ±146.09) ml vs. (351.17 ±159.07) ml], lymph node dissection stations (4.29±0.65 vs. 4.21±0.73), lymph node dissection number (11.50±2.30 vs. 11.04±2.29), rate of turn to open [(5.13 ％ (4/78) vs. 4.83 ％ (7/145)], incidence of postoperative complications [17.95 ％ (14/78) vs. 15.86％(23/145)], postoperative hospital stay [(8.74±0.51) d vs. (9.48±0.63) d], 2-year survival rate [96.15 ％(75/78) vs. 93.79％(136/145)] and 2-year disease free survival rate [80.77 ％ (63/78) vs. 82.07 ％ (119/145)] (all P>0.05). Conclusions The single utility port thoracoscopic lobectomy could achieve the same clinical results as the multiple utility ports. The single utility port thoracoscopic lobectomy is a safe, effective and feasible surgical procedure.