目的 探讨单孔胸腔镜下前纵隔支气管囊肿切除的治疗效果。 方法 回顾性分析 2009 年 3 月至 2015 年 4 月我院 26 例前纵隔支气管囊肿患者的临床资料，其中男 17 例、女 9 例，平均年龄 32.4（25～51）岁。均行单孔胸腔镜手术治疗，分析其临床症状、影像学特点及手术疗效。 结果 本组 26 例患者平均手术时间 62.0（48～110）min，平均出血量 98.4（60～120）ml，术后平均住院时间 8.7（6～12）d。术后 25 例患者无手术并发症，1 例术后因不配合主动咳嗽，出现肺不张及胸腔积液，给予调整胸腔引流管，加强咳嗽后恢复良好。术后平均随访 9.6（1～18）个月，复查 CT 均无复发。 结论 前纵隔支气管囊肿难以根据影像学诊断，最终需术后病理检查确诊。单孔胸腔镜手术可作为治疗前纵隔支气管囊肿首选方法。
ObjectiveTo construct a prognostic model of esophageal squamous cell carcinoma (ESCC) based on immune checkpoint-related genes and explore the potential relationship between these genes and the tumor microenvironment (TME). Methods The transcriptome sequencing data and clinical information of immune checkpoint genes of samples from GSE53625 in GEO database were collected. The difference of gene expression between ESCC and normal paracancerous tissues was evaluated, and the drug sensitivity of differentially expressed genes in ESCC was analyzed. We then constructed a risk model based on survival-related genes and explored the prognostic characteristics, enriched pathway, immune checkpoints, immune score, immune cell infiltration, and potentially sensitive drugs of different risk groups. ResultsA total of 358 samples from 179 patients were enrolled, including 179 ESCC samples and 179 corresponding paracancerous tissues. There were 33 males and 146 females, including 80 patients≤60 years and 99 patients>60 years. 39 immune checkpoint genes were differentially expressed in ESCC, including 14 low expression genes and 25 high expression genes. Drug sensitivity analysis of 8 highly expressed genes (TNFRSF8, CTLA4, TNFRSF4, CD276, TNFSF4, IDO1, CD80, TNFRSF18) showed that many compounds were sensitive to these immunotherapy targets. A risk model based on three prognostic genes (NRP1, ICOSLG, HHLA2) was constructed by the least absolute shrinkage and selection operator analysis. It was found that the overall survival time of the high-risk group was significantly lower than that of the low-risk group (P<0.001). Similar results were obtained in different ESCC subtypes. The risk score based on the immune checkpoint gene was identified as an independent prognostic factor for ESCC. Different risk groups had unique enriched pathways, immune cell infiltration, TME, and sensitive drugs. Conclusion A prognostic model based on immune checkpoint gene is established, which can accurately stratify ESCC and provide potential sensitive drugs for ESCC with different risks, thus providing a possibility for personalized treatment of ESCC.