Objective To analyze and screen the risk factors of both immunohistochemistry and pathology for lung cancer lymphatic metastasis, and to build a mathematical model for preliminary evaluation. Methods By conducting retrospective studies, the information of lung cancer patients in the General Hospital of Air Force from 2009 to 2011 were collected. Both single and multiple unconditional logistic regression analyses were applied to screen total 27 possible factors for lymphatic metastasis. After the factors with statistical significance were selected, the relevant mathematical model was built and then evaluated by means of receiver operating characteristic (ROC) analysis. Results A total of 216 patients were included. The single analyses on 27 possible factors showed significant differences in the following 10 factors: pathological grade (P=0.00), age (P=0.00), tumor types (P=0.01), nm23 (P=0.00), GSTII (P=0.01), TTF1 (P=0.01), MRP (P=0.01), CK14 (P=0.02), CD56 (P=0.02), and EGFR (P=0.03). The multiple factors unconditional logistic regression analyses on those 10 risk factors screened 4 relevant factors as follows: pathological grade (OR=2.34), age (OR=1.02), nm23 (OR=1.66), and EGFR (OR=1.47). Then a mathematical diagnostic model was established based on those 4 identified risk factors, and the result of ROC analysis showed it could improve the diagnostic sensitivity and specificity compared with the single factor mathematical diagnostic model. Conclusion Pathological grade, age, nm23, and EGFR are related with lung cancer lymphatic metastasis, and all of them are the risk factors which have higher adjuvant diagnostic value for lung cancer lymphatic metastasis.
ObjectiveTo analyze the surgical techniques and perioperative patient management of bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty in the treatment of locally advanced central type of lung cancer and summarize the experiences. MethodsWe retrospectively analyzed the clinical data of 21 locally advanced central type of lung cancer patients with bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplast in our hospital from December 2011 through November 2014. There were 17 males and 3 females with a mean age of 63.2±6.2 years. All operations were successful. The time of operation was 3.29±0.75 h. The hospitalization time was 25.48±22.31 days. No death ocurred during perioperative period. Postoperative complications were found in 3 patients, including 2 patients with atelectasis and 1 patient with bronchopleural fistula. ConclusionBronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty apply to treat locally advanced central type of lung cancer not only maximally remove the lung cancer tissue, but also maximally reserve the healthy lung tissue.
Objective To establish the evidence-based treatment strategy for an advanced lung cancer case with spinal metastasis, regarding the patient’s condition and treatment expectations. Methods According to PICO principles, questions in the patient’s treatment were converted into a search strategy. The literature searching was performed in several databases. In accordance with the five evidence grading standards in evidence-based medicine, the best clinical evidence was interpreted to guide the treatment decisions. Results A total of 148 papers were detected and screened, of which 4 systematic reviews or meta-analyses were included finally. Four issues that patients concerned, including restoring spinal cord function (walking and sphincter function), local pain control, long-term survival, and treatment complications, were all supported by grade-1 evidence. The patient finally chose surgical decompression, which was of a higher complication risk, but better possibility of restoring nerve function, significant pain relief, and improved long-term survival. The patient obtained fully recovery and regained walking function after surgery. Conclusion The evidence-based treatment is able to provide reasonable treatment options for lung cancer patients with spinal metastasis. Decompression surgery for patients with walking dysfunction should be carried out as soon as possible, in order to early restore spinal marrow function, relieve pain and improve long-term survival. But both doctors and patients should fully acquaint themselves with the higher risk of surgical complications.
Objective Through the analysis of hospital costs of 16 866 cases of patients with lung cancer in Sichuan Province, in oder to find the main influencing factors of hospital costs of patients with lung cancer, and to provide references for reducing the hospital costs of patients with lung cancer. Methods We selected information of in-patients with lung cancer in 6 hospitals in Sichuan province from January 2008 to December 2011 based on full consideration into the local economic levels geographics distribution of different regions in Sichuan province. Then we extracted baseline data, hospitalization data and costs, and then analysis on relevant influencing factors was performed using single factor analysis of variance and multiple stepwise regression analysis. Results A total of 16 918 cases are chosen, of which, 16 866 were effective for further analysis. The results of statistical analysis showed that, the cost of western medicine accounted for the most of the average of the total hospital costs (50.79%) , followed by the cost of diagnosis and treatment (40.79%). The reuslts of multiple stepwise regression analysis showed that, the top three factors influencing hospital costs most included hospital stay, operation, and regions. Conclusion Facing daily increasing costs of hospital costs of lung cancer, effectively reducing drug expenses of patients could be a breakthrough. We could ultimately reduce the hospital costs of patients with lung cancer as well as the the economic burden of patients and society, by strengthening hospital management, shortening hospital stay, and rationally regulating drug use.
Objective To evaluate the association between the Thr241Met polymorphism in the XRCC3 gene and the risk of lung cancer in Chinese population by meta-analysis. Methods Databases including PubMed, EMbase, CNKI, VIP and WanFang Data were searched to identify domestic and foreign case-control studies concerning the association between Thr241Met polymorphism in XRCC3 gene and the risk of lung cancer in Chinese population from the inception to August 20th, 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and assessed quality. Then meta-analysis was performed using RevMan 5.0 software and Stata 10.0 software. Results A total of 5 case-control studies involved 2 999 lung cancer cases and 2 994 controls were included. The results of meta-analysis showed that, Chinese population who carry the variant genotype or allele had no increased risk of lung cancer: Met/Met vs. Thr/Thr: OR=1.00, 95%CI (0.38, 2.59), P=0.99; Met/Met vs. Thr/Met: OR=1.06, 95%CI (0.83, 1.36), P=0.63; Met/Met vs. Thr/Met+Thr/Thr: OR=0.99, 95%CI (0.38, 2.57), P=0.98; Thr/Met+Met/Met vs. Thr/Thr: OR=1.06, 95%CI (0.82, 1.37), P=0.65; Met vs. Thr: OR=1.05, 95%CI (0.82, 1.35), P=0.68. Conclusion Currently, Thr241Met polymorphism in the XRCC3 gene is not found to be associated with the risk of lung cancer in Chinese population. Considering the limited quality of the included case-control studies, more high quality studies with large sample size are needed to verify the above conclusion.
Objective To study the risk factors of lung cancer and provide scientific evidence for preventing and managing such disease. Methods?The database of MEDLINE, CNKI, and CBM were searched and literature domestically and internationally from January 1997 to January 2007 was collected. The RevMan 4.2 software was used for meta-analysis. Results A total of 40 studies involving 16 559 cases and 25 119 controls were included. The pooled OR values and population attributable risk percentage (PARP) for smoking, female passive smoking from husband, female passive smoking from colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, and family history of lung cancer were 5.75 (69.16%), 1.32 (14.52%), 1.21 (5.87%), 1.68 (7.45%), 2.70 (10.18%), 1.58 (1.91%), 1.24 (8.92%), and 1.59 (5.33%), respectively. Conclusion Risk factors related to the incidence of lung cancer are smoking, female passive smoking from husband and colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, family history of lung cancer and so on. Besides, the results of PARP indicate that smoking is the most important factor, followed by female passive smoking from husband, emphysema, family history of cancer sequentially, which suggest that environmental and genetic factors play important roles in the development of lung cancer.
Objective To evaluate whether the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer” met the standards set in the STARD statement. Methods Based on each of the 25 items of STAndards for the Reporting of Diagnostic accuracy studies (STARD statement), the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer” was checked and evaluated. Results In the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer”, the reporting of 1 item of the STARD statement was adequately standardized, 7 items were relatively standardized, 5 items were inadequately standardized, 2 items were not standardized, and the other 10 were not reported. Conclusion Generally speaking, the reporting of diagnostic accuracy studies has not been standardized adequately in China. The methodological quality and applicability of diagnostic accuracy studies should be improved.
Objective To investigate the expressions of insulin like growth factor binding protein -3 （ IGFBP-3 ） in serum and bronchoalveolar lavagae fluids （ BALF ） of patients with non-small cell lung cancer ， and explore the clinical significance in dignosis and prognosis of lung cancer.Methods The bronchoalveolar lavagae fluids （ BALF ） were collected by bronchoscopy in 80 cases with non-small cell lung cancer and 14 healthy subjects.The expression of IGFBP-3 in serum and BALF were detected by immunoradioassay.Results The expression of IGFBP-3 in serum and BALF of lung cancer group were significantly lower than that of health group（Plt;0.05）.IGFBP-3 levels were significantly lower in those patients with lymphoid node metastasis or metastasis or TNMⅢ-TNMⅣ than those without metastasis or TNMⅠ-TNMⅡ（Plt;0.05）.In lung cancer group，the levels of the IGFBP-3 in serum and BALF had a significantly positive correlation（r=0.415，r=0.355，Plt;0.01）.Conclusion The IGFBP-3 may play an important role in the development of non-small cell lung cancer and is valuable in dignosis and prognosis of lung cancer.
Objective An animal model of lung cancer was established to study whether wasabi could inhibit the expression of hnRNP A2/B1 in lung.Methods Thirty-six Wistar rats were randomly divided as model group and wasabi group.0.1 mL of arcinogenic iodized oil [50 mg 3-methylcholanthrene (MCA) in 1 mL carcinogenic iodized oil] were instilled intratracheally to induce lung cancer.A week before instillation of MCA，the wasabi group was orally administered wasabi extract solution until the animals were killed while the model group was given isometric saline at the same time.Six rats in each group were randomly killed on 30th day，60th day and 90th day.Immunohistochemisty and RT-PCR were used to measure the protein and mRNA expression of hnRNP A2/B1，respectively.Results Wasabi lowered the protein expression of hnRNP A2/B1 with a total inhibitory rate of 48.5%.At the 30th，60th and 90th day，the inhibitory rate was 51.0%，51.0% and 45.1% respectively.Meanwhile，wasabi lowered the mRNA expression of hnRNP A2/B1 with a total inhibitory rate of 60.5%.At the 60th and 90th day，the inhibitory rate was 79.5% and 58.0%，respectively.Conclusion Wasabi solution can down-regulate the expression of hnRNP A2/B1 which may be a molecular mechanisms by which wasabi inhibits lung cancer.
Objective To investigate the clinical characteristics, short-term therapy outcome and survival in patients of lung cancer with different smoking status. Methods 3751 cases were enrolled and the differences in age, sex, pathological type, stage, treatment modality, efficiency and survival were compared according patients′smoking status. Results 1206 ( 32. 2% ) patients were never smokers and 2545 ( 67. 8% ) were smokers. 80. 3% male patients and 10. 5% female patients were smokers. Among never smoking lung cancer patients, proportion of female gender, adenocarcinoma, second primary neoplasm,advanced stages and non-operative treatment were high. In the smokers, much more COPD and pulmonary tuberculosis, squamous cancer and operative treatmentwere found. No statistical differences were detected in overall outcome and survival. Conclusions The clinical characters and treatmentmodalities of patients with lung cancer of different smoking status were significant different, but had the same survival. Patients’smoking status should be accountted into the diagnosis and treatment of lung cancer.