ObjectiveTo investigate the influence of programmed cell death protein-1 (PD-1) monoclonal antibody on the anti-lung cancer effect of cytokine-induced killer cells (CIK) which were programmed in vitro. MethodsPeripheral blood mononuclear cells from 20 patients (8 males and 12 females with an average age of 56.45±5.89 years ranging from 42 to 65 years) diagnosed with advanced lung cancer from January to May 2019 at the Department of Oncology of Dalian Central Hospital were collected and induced to amplify into CIK cells in vitro. PD-1 monoclonal antibody combined with CIK cell culture group, individual cell culture group and PD-1 monoclonal antibody group were set up to detect the cell killing activity of CIK cells against lung cancer under different effective target ratio conditions, and the ratio of perforin and granzyme positive expression in PD-1 monoclonal antibody combined CIK cell culture group and individual CIK cell culture group was detected by flow cytometry. ELISA method was used to detect the interleukin-2 (IL-2), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) cytokine secretion levels in the two groups.ResultsThe killing effect of CIK cells on A549 lung cancer cells increased with the increase of effective target ratio by CCK8, and PD-1 monoclonal antibody increased the killing effect of CIK cells on A549 lung cancer cells under different effective target ratio, E∶T=5∶1 (28.5%±1.9% vs. 20.3%±1.8%), 10∶1 (40.6%±2.4% vs. 31.7%±2.1%), 20∶1 (57.4%±3.5% vs. 44.7%±3.8%), 40∶1 (74.1%±8.3% vs. 60.8%±5.3%). The killing effect of PD-1 monoclonal antibody combined with CIK cells and CIK cells alone on A549 lung cancer cells was statistically different (P<0.05). The killing effect of cells in both groups on lung cancer A549 cells was stronger than that of the PD-1 monoclonal antibody group (P<0.01). The results of flow cytometry showed that PD-1 monoclonal antibody increased the positive ratio of perforin and granzyme release in CIK cells, and the positive ratios of perforin release (46.7%±3.5%% vs. 35.1%±2.2%) and granzyme release (34.6%±3.8% vs. 25.7%±3.3%) in PD-1 monoclonal antibody combination with CIK cells group and CIK cells group were statistically different (P<0.05). Similarly, the secretion levels of IL-2, TNF-α, and IFN-γ cytokines were also increased in the PD-1 monoclonal antibody combined with CIK cells group compared with the CIK group (5 409.0±168.8 pg/mL vs. 4 300.0±132.3 pg/mL, 252.7±16.7 pg/mL vs. 172.5±8.6 pg/mL, 327.2±23.5 pg/mL vs. 209.7±16.0 pg/mL, P<0.05).ConclusionPD-1 monoclonal antibody can promote the release of tumoricidal substances in CIK cells and improve the killing effect of CIK cells on lung cancer A549 cells. It is speculated that the infusion of PD-1 monoclonal antibody before CIK cell adoption in lung cancer patients may be more beneficial to the treatment of disease. PD-1 monoclonal antibody combined with CIK cell therapy is promising as a new type of lung cancer immunotherapy.
Thymectomy is the main treatment for thymoma and other thymic diseases. But the incidence of non-therapeutic thymectomy is high due to the difficulty in the differential diagnosis of anterior mediastinum lesions. Formerly, it was believed that the thymus gradually degraded and lost function with aging, and the preservation of the thymus was not valued. Recent studies have found that the removal of the thymus at all ages has adverse effects on overall health and leads to a significant increase in the risk of autoimmune diseases, malignancy, and all-cause mortality. Therefore, unnecessary thymectomy should be avoided. This article reviews the influence of thymectomy, including the changes of immunological indexes and clinical prognosis, and further discusses the current situation and avoidance methods of non-therapeutic thymectomy.
ObjectiveTo explore the mid-term effectiveness of large-head metal-on-metal total hip arthroplasty (THA).MethodsA retrospective analysis was made on the clinical date of 40 patients (43 hips) who were treated with the large-head metal-on-metal THA between April 2009 and June 2010. There were 18 males (20 hips) and 22 females (23 hips) with an average age of 55.1 years (range, 20-85 years). Unilateral hip was involved in 37 cases and bilateral hips in 3 cases. The disease causes included osteonecrosis of the femoral head in 14 cases (15 hips), osteoarthritis in 6 cases (7 hips), rheumatoid arthritis in 4 cases (4 hips), femoral neck fracture in 4 cases (4 hips), and developmental dysplasia of the hip in 12 cases (13 hips). Before operation, the Harris score and University of California Los Angeles (UCLA) score were 38.51±5.62 and 4.21±1.43, respectively. The visual analogue scale (VAS) score was 6.78±0.95.ResultsAll patients were followed up 6.7-8.3 years (mean 7.5 years). All incisions healed primarily and no neurovascular injury, infection, and hip dislocation occurred. At last follow-up, the Harris score and UCLA score were 93.33±3.21 and 7.32±1.45, respectively, showing significant differences when compared with preoperative scores (t=51.753, P=0.000; t=23.232, P=0.000). The thigh pain occurred in 3 cases (3 hips) in whom the inflammatory pseudotumor of soft tissues was found in 1 case (1 hip). Postoperative X-ray films showed that the acetabular abduction angle and anteversion angle were (46.5±3.2)° and (14.8±3.6) °, respectively. The initial stability of femoral stem prosthesis was excellent in 39 hips and good in 4 hips according to Mulliken standard. Osteolysis occurred in 2 hips and revision was performed in 1 hip of secondary loosening of prosthesis. The rest patients had no prosthesis loosening or sinking.ConclusionThe mid-term effectiveness of large-head mental-on-mental THA in treatment of the terminal diseases of hips are good.
ObjectiveTo investigate the characteristics and influencing factors of N1 in T2 stage of the 8th TNM stage of The International Association for the Study of Lung Cancer (IASLC) (3 cm <tumor size≤5 cm) non-small cell lung cancer (NSCLC), to provide the basis for dissecting intrapulmonary lymph node more accurately during the operation.MethodsWe collected the clinical information of patients who underwent the pulmonary malignant tumor surgery in Dalian Central Hospital between October 2011 and November 2016. Through the inclusion and exclusion criteria, a total of 68 patients were obtained, including 48 males and 20 females, aged 48–81 (63.1±7.6) years. According to the pathological results, we invesigated the characteristics and influencing factors of N1 in T2 stage non-small cell lung cancer.ResultsThe results showed that the highest positive rate of lymph node was 14.8% in the 12th group, 14.3% in the 13th group, and 13.9% in the 6th group, respectively. In the single factor analysis, it showed that male, T2b stage, poorly differentiated degree were the risk factors for intrapulmonary lymph node metastasis in T2 stage (P<0.05). But the intrapulmonary lymph nodes metastasis was no significant correlation with above factors according to the multivariate analysis.ConclusionIt is necessary to extract the intrapulmonary lymph node of T2 stage NSCLC at utmost, especially for the No.12 and No.13 high-risk areas. T2b stage with odd ratio (OR) at 3.038 and poorly differentiated degree (OR=1.945) may be the risk factors for the intrapulmonary lymph nodes metastasis of NSCLC in T2 stage. But they are not determining factors.
The announcement of the 9th edition of TNM staging system for thymic tumors was one of the highlights at the World Conference on Lung Cancer 2023. The revision, based on a larger and more detailed database, provides changes and confirmation from the last system. The 9th edition of TNM staging system aims to balance statistical significance and clinical feasibility. The birth of an improved TNM staging system heralds the changes that will follow in clinical practice and scientific research.
ObjectiveTo summarize the clinical experience of surgical resection of synchronous multiple ground-glass nodules (SMGN), and explore the individualized diagnosis and treatment strategy of SMGN.MethodsClinical data of 84 patients with SMGN who underwent thoracic surgery in Anhui Chest Hospital from July 2016 to August 2018 were analyzed retrospectively, including 18 males (21.4%) and 66 females (78.6%), aged 32-80 (55.6±10.3) years. The results of operation and the information of GGNs were analyzed.ResultsExcept for 1 patient who was converted to thoracotomy due to extensive dense adhesion of thoracic, other patients underwent video-assisted thoracoscopic surgery successfully. All patients recuperated successfully after operation, without severe perioperative complications or death. Finally, 79 patients were diagnosed as malignant tumors (94.0%), and 5 patients of benign lesions (6.0%). A total of 240 GGNs were removed, among which there were 168 pGGNs, including 68 benign lesions (40.5%) and 100 malignant tumors (59.5%), and 72 mGGNs, including 2 benign nodules (2.8%) and 70 malignant tumors (97.2%). Nodules diameter (P<0.001), consolidation/maximum diameter of nodule ratio (P<0.001), vacuole sign (P<0.001), air bronchograms sign (P=0.001), spine-like process (P=0.001), pleural indentation sign (P<0.001), lobulation sign (P<0.001), and vascular convergence (P=0.002) were correlated with malignant tumor.ConclusionAnalysis of the imaging features of GGNs by thin-section CT scan and three-dimensional reconstruction is of great value in predicting the benign and malignant nodules, which can guide the surgical decision-making and preoperative planning. Through reasonable preoperative planning and following certain principles, simultaneous surgical treatment for SMGN is safe and feasible.