Continuous Serratus Anterior Plane Block Improved Early Pulmonary Function After Lung Cancer Surgical Procedure.

BACKGROUND: Serratus anterior plane block (SAPB) has been proven to be an efficient way to control postoperative pain. This study explored whether the use of continuous SAPB in combination with flurbiprofen could improve early pulmonary function in lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS). METHODS: From July 2019 to April 2020, patients who scheduled for elective lung resection undergoing VATS were randomly allocated to receive patient-controlled SAPB in combination with intravenous flurbiprofen or patient-controlled intravenous analgesia. Postoperative pulmonary function variables, including forced expiratory volume in 1 second, and forced vital capacity were collected before and 24, 48, and 72 hours after Surgical Procedure. Pain intensity was measured at rest and on coughing. Comfort scores during breathing exercises, postoperative pulmonary complications, and adverse events were recorded. RESULTS: A substantial reduction in lung function was exhibited in both groups after Surgical Procedure (P < .001), but lung function variables in the continuous SAPB group were significantly higher (P < .001) throughout the postoperative period up to 72 hours, regardless of the surgical procedure type. Meanwhile, there were significant differences of pain intensity at rest and on coughing between the groups (P < .001). The incidence of pneumonia, pulmonary atelectasis, hypoxemia, vomiting, and the comfort score in the continuous SAPB group was significantly lower (P < .05). CONCLUSIONS: Postoperative acute pain treatment with continuous SAPB in combination with flurbiprofen enhanced pulmonary function and reduced postoperative pulmonary complications in lung cancer patients undergoing VATS.

Identified lung adenocarcinoma metabolic phenotypes and their association with tumor immune microenvironment.

BACKGROUND: Lung adenocarcinoma (LUAD), a subtype of non-small cell lung cancer (NSCLC), causes high mortality around the world. Previous studies have suggested that the metabolic pattern of tumor is associated with tumor response to immunotherapy and patient's survival outcome. Yet, this relationship in LUAD is still unknown. METHODS: Therefore, in this study, we identified the immune landscape in different tumor subtypes classified by metabolism-related genes expression with a large-scale dataset (tumor samples, n = 2181; normal samples, n = 419). We comprehensively correlated metabolism-related phenotypes with diverse clinicopathologic characteristics, genomic features, and immunotherapeutic efficacy in LUAD patients. RESULTS: And we confirmed tumors with activated lipid metabolism tend to have higher immunocytes infiltration and better response to checkpoint immunotherapy. This work highlights the connection between the metabolic pattern of tumor and tumor immune infiltration in LUAD. A scoring system based on metabolism-related gene expression is not only able to predict prognosis of patient with LUAD but also applied to pan-cancer. LUAD response to checkpoint immunotherapy can also be predicted by this scoring system. CONCLUSIONS: This work revealed the significant connection between metabolic pattern of tumor and tumor immune infiltration, regulating LUAD patients' response to immunotherapy.

Correlation of pulmonary venous circulating tumor cells with clinicopathological parameters in patients with early-stage lung adenocarcinoma.

BACKGROUND: Tumor recurrence following the surgical resection of lung cancer (LCa) reduces long-term disease-free survival rates. This study aimed to investigate the association of pulmonary venous blood (PVB) circulating tumor cells (CTCs) with the clinicopathological features of patients with early-stage lung adenocarcinoma. METHODS: A total of 120 cases were enrolled, including 24 healthy controls, 36 patients with lung benign tumors, and 60 early-stage lung adenocarcinoma patients. Cells displaying a profile of human chromosome 8 specific sequence (CEP8)+/4',6-diamidino-2-phenylindole (DAPI)+/leukocyte-specific antibodies (CD45)‒ were regarded as CTCs, and counts of ≥2 CTCs per 3.2 mL of PVB were considered positive. The association of CTC counts with clinical parameters were analyzed. RESULTS: The number of CTCs were significantly higher in early-stage lung adenocarcinoma patients compared to benign or normal control group. Moreover, increased CTCs in lung adenocarcinoma was closely associated with tumor invasion, pathological staging and the epidermal growth factor receptor (EGFR) mutations (P<0.05), whereas no significant difference was observed between CTC counts and age, sex, smoking history, pathological cell morphology or immunohistochemical indicators (P>0.05). Univariate and multivariate Cox's proportional hazards regression confirmed that CTC counts were an independent indicator for the prediction of tumor invasion, pathological staging, and EGFR mutations. CONCLUSIONS: Our data suggest that CTC counts correlate with tumor invasion, pathological staging, and EGFR mutations. CTCs therefore represent promising biomarkers for the surveillance of lung adenocarcinoma progression.

Prognostic significance of the number of lymph nodes examined in node-negative Siewert type II esophagogastric junction adenocarcinoma.

BACKGROUND: Involvement status of lymph node (LN) is one of the most important prognostic factors for esophagogastric junction (EGJ) adenocarcinoma. However, the prognostic value of the number of examined LNs remains unclear in node-negative (pN0) Siewert type II EGJ adenocarcinoma. METHODS: A cohort of 262 patients who underwent curative surgery for pN0 Siewert type II EGJ adenocarcinoma from January 2000 to August 2013 were retrospectively analyzed from high-volume center database. All enrolled patients were categorized into 3 groups according to the number of examined LNs (≤14, 15 to 21, ≥22). Kaplan-Meier curves were used for comparing the differences of cancer-specific survival among groups; Correlation between survival and the number of examined LNs were analyzed by using stratified, uni- and multivariate analyses. RESULTS: The hazard ratio for cancer-specific mortality decreased sequentially with increasing number of LNs examined. The 5-year cancer-specific survival rates were 45.1%, 58.4% and 65.7% for patients with ≤14 LNs, 15 to 21 and ≥ 22 LNs removed, respectively. The number of removed LNs was significantly correlated with survival in stratified analyses according to T stage. In multivariate model controlling for gender, age, surgical approach, tumor grade, and postoperative chemotherapy, the number of removed LNs and T stage were confirmed to be independent prognostic factors and significantly correlated with disease-specific survival. CONCLUSION: The number of examined LNs is an independent prognostic factor of survival for patients with pN0 Siewert type II EGJ adenocarcinoma. Adequate dissection of LNs (more than 15 LNs) is recommended for patients undergoing curative resection.

Roles of the hepcidin-ferroportin axis and iron in cancer.

Hepcidin is a low-molecular-weight hepatic peptide that regulates iron homeostasis, and acts by causing the degradation of its receptor, the cellular iron exporter ferroportin. On the basis of the major role of the hepcidin-ferroportin axis in iron regulation, recently several studies have discussed its expression and influence on the development and prognosis of cancer. Iron plays a pivotal role in homeostasis. However, insights into the mechanisms of normal iron regulation have provided a new perspective on the basic mechanisms, biological rationale, and pathophysiologic implications of changes in iron metabolism in cancer. Besides being a crucial stimulus for cancer, iron dysfunction also causes cancer-related anemia. In this review, we discuss aspects of the hepcidin-ferroportin axis and iron regulation, as well as the inherent connections between them in cancer. We also attempt to consider the possibility in theory of novel targets for further individualized therapy. However, many molecular mechanisms and functions of these regulators remain unclear.

Pulmonary artery pseudoaneurysm caused by a rare vascular tumor: epithelioid hemangioendothelioma.

We present a case of a 58-year-old female with a rare vascular tumor of intermediate malignancy. The initial manifestation was a pseudoaneurysm caused by the rupture of the right pulmonary artery after tumor invasion. The diagnosis of epithelioid hemangioendothelioma was confirmed by the morphologic and immunocytochemical features after surgery. The patient recovered smoothly and there has been no evidence of local recurrence or metastasis during the 2 years of follow-up.

Relationship between the depression status of patients with resectable non-small cell lung cancer and their family members in China.

PURPOSE: Less work on depression status has been done with family members of patients with non-small cell lung cancer (NSCLC). This study investigated depression status of patients and their family members; and the relationship of the depression status between these two groups. METHODS: This cross-sectional study enrolled 194 patients diagnosed with non-small cell lung cancer as well as their family members. In this study, a self-administered General Information Questionnaire was used to collect general information and the Self-rating Depression Scale (SDS) to assess depression status. Linear correlation analysis was used to probe the relationship of the depression status between patients and their family members. RESULTS: Of the 194 patients, 148 (76.3%) showed symptoms of depression. 148 (76.3%) family members had depression symptoms. The severity of depression in patients was positively correlated with that of family members (r = 0.577, p < 0.01). CONCLUSIONS: Patients with lung cancer and their family members suffered depression, and the two were correlated. A prospective study might prove helpful in determining the real relationship existing between the two groups' mental status and whether early detection and intervention might ameliorate this current situation.

Depression and social support between China' rural and urban empty-nest elderly.

This study compared levels of depression and social support among empty-nest elderly who living in the rural and urban area of Hunan province, China. This cross-sectional study enrolled 809 empty-nest elderly living throughout the province as the study respondents. The general information, depression conditions and social supports were investigated by using the self-made General Information Questionnaire, Geriatric Depression Scale (GDS) and Social Support Rating Scale (SSRS). Variables are presented as mean ± standard deviation (SD) or frequency. Independent t-test and χ(2)-tests were used to compare the socio-demographic factors, depression score and social support scores of the rural empty-nest elderly to the urban empty-nest ones; multilevel modeling was used to analyze the socio-demographic factors and social support predicted the level of depression among the empty-nest old subjects. The differences in gender, education level, marital status, economic status, self-perceived income, insurance, children visit frequency and religious beliefs factors between rural and urban empty-nester old people were statistically significant (p<0.05). The average GDS score of rural group was (14.57 ± 5.43), which was higher than the average GDS score (13.18 ± 6.51) of urban group (p<0.01). Objective support scores showed statistical significance between the rural and urban empty-nest elderly (p<0.05). There are differences between rural and urban empty-nest elderly in the aspects of general data, depression status, social support and so on, we should intervene them effectively according to their different characteristics.