1. Surgical treatment of lung cancer patients with idiopathic pulmonary fibrosis
Hai TANG ; Lei ZHANG ; Yunlang SHE ; Hang SU ; Chang CHEN
Chinese Journal of Surgery 2019;57(12):956-960
Lung cancer is the leading cause of death in malignant tumors. Surgery is one of the main treatments for early stage lung cancer. Idiopathic pulmonary fibrosis (IPF), one of the most common interstitial lung disease, is a chronic, progressive lung disease, characterized by insidious onset and progressive deterioration. It is reported that there are common pathways in idiopathic pulmonary fibrosis and lung cancer, and patients with IPF have a higher risk of lung cancer than the general population, whose prevalence was 3.34 times than that of the general population. The incidence of acute exacerbations of IPF and postoperative mortality was significantly higher in lung cancer patients complicated with IPF than those without IPF. The long-term outcomes of patients with IPF are dramatically worse than those without IPF. It was concluded that lobectomy has been still the standard surgical procedure for such patients, but sublobectomy should be taken as potential alternative choice for patients with high risk after preoperative evaluation. Moreover, further studies should be conducted on the prevention and treatment of acute exacerbation of IPF after surgery.
2.Advances in the application of convolutional neural network in the diagnosis and treatment of early lung cancer
Yuhang XUE ; Donglai CHEN ; Yunlang SHE ; Chang CHEN ; Yongbing CHEN ; Weihua XU
Chinese Journal of Thoracic and Cardiovascular Surgery 2020;36(9):569-572
In recent years, convolutional neural network(CNN) has exhibited its promising prospect and research value in assisting the analysis of lung cancer. The CNN can automatically learn from the images to extract specific clinically relevant features. This review summarized the construction of CNN by inputting CT images for end-to-end analysis to predict lung cancer risk and the efficacy of clinical treatment, as well as the application of CNN for analyzing pathological slides of resected pulmonary nodules via inputting histopathologic images.
3.Research progress on prediction of lymph node metastasis in non-small cell lung cancer
Yang WANG ; Yifan ZHONG ; Jiajun DENG ; Yunlang SHE ; Xuefei HU ; Chang CHEN
Chinese Journal of Thoracic and Cardiovascular Surgery 2022;38(7):434-440
Accurately predicting the risk of mediastinal lymph node metastasis before surgery is of great significance for tumor staging, treatment plan decision, and prognosis evaluation in patients with non-small cell lung cancer(NSCLC). Traditional imaging methods such as CT, MRI and PET/CT are currently the most commonly used clinical methods in clinical evaluation of lymph node status. However, it is subjective to judge lymph node metastasis only by the change of image morphological characteristics, and inflammatory lymphadenopathy will also lead to a high false positive rate. The clinicopathological characteristics obtained by analyzing the clinical data of patients with NSCLC can improve the accuracy of lymph node metastasis prediction to a certain extent. The clinical prediction model based on medical images combined with the clinical characteristics of patients can provide more intuitive and rational information for doctors and patients, but the performance and applicability of the model will inevitably decrease due to changes in disease risk factors and treatment measures. In recent years, with the significant improvement of image analysis technology and computing ability, radiomics models based on medical images can deeply dig into the data in radiological images for quantitative analysis, providing new ideas for predicting mediastinal lymph node metastasis in NSCLC patients, which has attracted extensive attention at home and abroad. This article reviews the progress and makes prospects of the above methods in the prediction of mediastinal lymph node metastasis in NSCLC.
4.Research progress of artificial intelligence convolutional neural network in whole slide image analysis
ZHAO Mengmeng ; WANG Yang ; DENG Jiajun ; SHE Yunlang ; CHEN Chang
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(11):1063-1068
Histopathology is still the golden standard for the diagnosis of clinical diseases. Whole slide image (WSI) can make up for the shortcomings of traditional glass slices, such as easy damage, difficult retrieval and poor diagnostic repeatability, but it also brings huge workload. Artificial intelligence (AI) assisted pathologist's WSI analysis can solve the problem of low efficiency and improve the consistency of diagnosis. Among them, the convolution neural network (CNN) algorithm is the most widely used. This article aims to review the reported application of CNN in WSI image analysis, summarizes the development trend of CNN in the field of pathology and makes a prospect.
5.Quality control standard and evaluation of lung transplantation
Dong XIE ; Chang CHEN ; Ye NING ; Yuping LI ; Yang YANG ; Yunlang SHE ; Wenxin HE ; Zhixin LI ; Xiaogang LIU ; Yuming ZHU ; Gening JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(08):860-865
The quality control of lung transplantation involves many aspects, such as team building, selection of recipients, preoperative diagnosis and evaluation of recipients, maintenance of brain-dead donors, evaluation and acquisition of donors, surgical operation, postoperative management and postoperative follow-up. Precision management is the core concept of operation quality control. Only by normalizing the operation quality control of lung transplantation to provide basic guarantee for multi-team cooperation and development of lung transplantation management in the future, building a complete lung transplantation database to excavate data resources and improve the quality of transplanta-tion, and comprehensively building a Chinese lung transplantation quality control system with multi-team participation and cooperation, can we improve the overall level of surgical diagnosis and treatment of lung transplantation in China.
6.Application standard of mechanical suture technique in thoracoscopic surgery and management of complications
Dong XIE ; SHE Yunlang ; Hang SU ; Ye NING ; Zhixin LI ; Ziwen FAN ; Yuming ZHU ; Chang CHEN ; Gening JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(07):732-736
The precise resection and suture of bronchia, vascular and pulmonary tissue are the key techniques in thoracic surgery. Mechanical suture technique has gradually become a routine operation in thoracic surgery. However, at present, there is still a lack of consensus and guidelines on the application of this technique in thoracic surgery, neither strong evidence-based medical support. In this study, we discuss the application standard of mechanical suture technique in thoracoscopic surgery, irregular treatment techniques, intraoperative complications, and management principles to promote the standardized application of mechanical suture technique. We also explain the shortcomings of the technique in order to promote the further improvement and perfection.
7.Interpretation of updated NCCN clinical practice guidelines for lung cancer screening (version 2. 2022)
Haojie SI ; Long XU ; Fang WANG ; Hang SU ; Yunlang SHE ; Chenyang DAI ; Xuefei HU ; Deping ZHAO ; Yuming ZHU ; Peng ZHANG ; Gening JIANG ; Chang CHEN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(11):1407-1413
Lung cancer is the most common cancer and the leading cause of cancer-related death in China. Early screening of lung cancer proves to be effective in improving its prognosis. The National Comprehensive Cancer Network (NCCN) has updated and released version 2, 2022 NCCN clinical practice guidelines for lung cancer screening in July, 2022. Based on high-quality clinical evidence and the latest research progress, the guidelines have developed and updated criteria for lung cancer screening which have been widely recognized by clinicians around the world. Compared with Chinese lung cancer screening guidelines, this article will interpret the updated content of the brand new 2022 NCCN screening guidelines, providing some reference for the current lung cancer screening practice in our country.