This paper summerized the surgical treatment of primary bronchogenic carcinoma in 3568 cases between 1957-1991. The resectability rate was 90. 3%, postoperative morbidity rate 8.32% and operative mortality 0. 89%. Pathological diagnoses of the resected specimens included squa-mous cell carcinoma for 48.7%, adenocarcinoma 22.9%, small cell cancer 15. 4%, large cell cancer 1. 3% and squa-mous-adenocarcinoma in 10.1%. The follow-up rate was 93%. The 5-and 10-year survival rates were 34.6% and 22.79% respectively. Analyses of the data demonstratad that the histologic type, pathological stage and metastasis of mediastinal lymph node are the important factors affecting the prognosis. According to UICC P-TNM,42. 6% of the patients in this group were in stage III. The 5 year survival rate was 19% in IIIa patients and 6% in IIIb. According to authors experience, it is recommended that in IIIa patients with nonsmall cell cardinoma, active surgical treatment should be adopted; in patients with small cell carcinoma, chemotherapy and radiotherapy should be given pre-and postoperatively, in IIIb patients with small cell carcinoma, surgical treatment is generally not indicated.

CD98 is a transmembrane heterodimer of cell surface.It regulates cell signaling pathway by activating some correlated proteins,and controls cell polarization,proliferation,adhesion and migration.CD98 plays an important role in the development of cancer and may be a novel tumor marker for diagnosis and prognosis in lung cancer.

Objective To investigate the proliferation and apoptosis in stage-ⅠNSCLC and their prognostic implications.Methods Immunohistochemical technology and TUNEL assay was applied to detect proliferation and apoptosis in 118 lung cancer tissues and 30 normal lung tissues as controls.Results Proliferation Index(PI)was up-regulated in lung cancer tissues compared with that in normal lung tissues and was closely related to T-staging,differentiation and smoking.Apoptotic Index(AI)was up-regulated in lung cancer tissues compared with that in normal lung tissues and was closely related to T-staging.PI was not related to AI in stage-ⅠNSCLC.The patients with high PI had a shorter 5-year survival than those with low PI(33.57% and 73.12%,P=0.0001),and the patients with low AI had a shorter 5-year survival than those with high AI(41.48% and 68.80%,P=0.008).Multivariate analysis showed that PI was a significantly independently predictive factor for patients with stage-ⅠNSCLC(RR=2.473,95%CI:1.278~4.784,P=0.007).Conclusion Stage-ⅠNSCLC is a subgroup with high proliferation and apoptosis.Proliferation plays a more important role in stage-ⅠNSCLC.The assessment of proliferation and apoptosis may provide new insight into prognosis and adjuvant treatment for stage-Ⅰ NSCLC.

Objective To study the relationship between monoeyte chemoattractant protein 1 (MCP-1)-2518A/G polymorphism and lung cancer in Han nationality of North China. Methods One hun-dred and thirty-four unrelated consecutive patients with lung cancer(112 with NSCLC, 22 with SCLC)and 82 healthy individuals were studied. The polymorphisms of MCP-1-2518A/G were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results The distribution of AA, AG and GG genotypes of MCP-1-2518 was significantly different in lung cancer patients compared with controls (X~2=8. 486,P=0. 014). There was a significant increase in the frequency of the AA genotype (OR=2. 645, X~2=6. 532, P=0.011) and a significant decrease in the frequency of the GG genotype (OR=0.519, X~2=4.929, P=0. 026)in the lung cancer patients, compared with controls. In the NSCLC patients the fre-quency of the AA genotype was higher than controls(OR=3. 138, X~2=8. 905, P=0.003) and the frequency of the GG genotype was lower than controls(OR=0. 516 ,X~2=4. 613, P=0. 032). The frequencies of AA, AG and GG genotypes in SCLC patients and controls had no difference. Conclusion This preliminary study showed that MCP-1-2518A/G polymorphism was associated with NSCLC but not SCLC.

The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss, tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%, and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4(+)T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/microL (26-755/microL) and 239/microL (17-833/microL), respectively. HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of patients with AIDS and have a persistent surveillance.

Objective To evaluate the clinical significance of dissection of pulmonary ligament was operated on videoassisted thoracic surgery(VATS) with bullectomy for spontaneous pneumothorax.Methods From Jan 2012 to Dec 2013, 232 patients (188 males, 44 females) underwent VATS with bullectomy for spontaneous pneumothorax or hemopeumothorax, whose age were between 14 and 45 years and mean age was(26.4 ± 10.1) years.202 patients resulted from upper lobe spontaneous pneumothorax, 23 patients for lower lobe spontaneous pneumothorax, 7 patients for hemopeumothorax, and 18 cases because of recurrence after bullectomy (7.7 ％, 18/232).all the patients were accepted bullectomy with or without dissection of pulmonary ligament.Results Between 112 patients who underwent upper lobe bullectomy with dissection of pulmonary ligament, at 1 st postoperative day, it was found 92 patients whose pleural effusion were less than 300 ml (82.1％ ,92/112);20 patients whose pleural effusion were greater than or equal to 300 ml(17.9％, 20/112), and the mean drainage from thoracic cavity was(147.0 ± 61.0)ml.At 3 rd day, the mean drainage was(33.4 ± 20.0) ml.Within 23 cases who underwent lower lobe bullectomy with dissection of pulmonary ligament, the mean drainage from thoracic cavity, at 1 st postoperative day, was (155.2 ±41.1)ml,and the mean drainage, at the 3rd day, was(52.1 ± 21.3)ml.Also,within 90 patients who underwent bullectomywithout dissection of pulmonary ligament, 9 patients whose pleural effusion, at 1 st postoperative day, were less than 300ml(10％ ,9/90);81 patients whose pleural effusion were greater than or equal to 300ml (90％, 81/90);the mean drainage for 90 patients was(65.1 ± 28.0)ml.At the 3rd day, 40 patients' pleural effusion were greater than or equal to 300ml (44.4％,40/90) , and the mean drainage was(40.2 ± 25.5) ml.2 of 7 hemopeumothorax patients bled for the vessels injury during pulmonary ligament avulsion.Conclusion There was significant difference in clinical outcomes between two groups, and the dissection of pulmonary ligament was able to reduce the pooling of pleural effusion, facilitate the drainage of pleural effusion, and prevent pneumothorax recurrence, but there is no convincing evidence that dissection of pulmonary ligament can lead to bronchial deformation, stenosis, and reduce the free thoracic space.

Animals ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; antagonists & inhibitors ; metabolism ; Lung Neoplasms ; drug therapy ; metabolism ; Protein-Serine-Threonine Kinases ; antagonists & inhibitors ; metabolism ; Signal Transduction ; drug effects ; Sirolimus ; therapeutic use ; TOR Serine-Threonine Kinases

BACKGROUNDWith the development of social industrialization and aging of the population, patients with lung cancer have the tendency of becoming youthful and elderly, therefore the way of treatment should be also changed. In resent years, lung cancer in young and elderly patients have been reported respectively, but simultaneous contrast analysis of clinical feature and prognosis in elderly, normal and youthful patients have been rarely reported. Based on the clinic data in the patients, the clinical feature and prognosis of patients with non-small cell lung cancer at different ages were analyzed.

METHODSFrom January 1996 to January 2003, 1380 patients with NSCLC were treated surgically in thoracic department in our hospital, the patients were divided into three group based on their age, group 1 (G1) (range ≤40), group 2 (G2) (range 41-69), group 3 (G3) (range ≥70). The clinical feature and prognosis were analyzed in each group.

RESULTSThe mean age in the whole group was 58.16±0.26, and 35.76±0.57 (range 12-40) in G1, 58.00±0.22 (range 41-69) in G2, 72.30±0.21 (range 70-80) in G3. The ratio of lung cancer in female between G1 and G3 was significant different (P=0.024). The coexisting diseases in G3 were more common than those of other groups (P=0.000). Squamous cell carcinoma was the main type in histology, accounting for 41.79% (28/67), 54.12% (644/1190) and 58.54% (72/123) in each group respectively (P=0.080), but the ratio of adenocarcinoma, higher than that of other groups, were 43.28% (29/67), 29.50% (351/1190) and 26.82% (33/123) (P=0.036). Lobectomy and pneumonectomy were the main surgical procedures, accounting for 58.21%, 65.29%, 78.86% (P=0.004) and 34.33%, 26.22%, 12.20% (P=0.001), respectively. The ratio of stage III were 43.28% (29/67), 38.82% (462/1190), and 26.02% (32/123) in each groups (P=0.015). 55.22% (37/67) in G1 received adjuvant chemotherapy, 47.48% (565/1190) in G2, and 29.27% (36/123) in G3 (P=0.000). 5-year survival rate was 38.96% in the whole group, 29.99% in G1, 39.61% in G2, and 37.99% in G3 (P=0.494).

CONCLUSIONSIn young patients with non-small cell lung cancer, female and adenocarcinoma make up the majority of the number, and a lot of patients are in advanced stage and likely to adopt adjuvant chemotherapy. While in elderly, squamous cell carcinoma accounts for the majority of the number, and more coexisting diseases are accompanied, much more complications occur after surgical procedure. Nevertheless, their prognosis has no significant difference.

BACKGROUNDHepatoma-derived growth factor (HDGF), a novel growth factor, has a widely expression in many normal cells and tumor cells. It plays an important role in cell proliferation, differentiation and angiogenesis. It is considered as a promising marker for predicting the invasion, matastasis and prognosis of carcinomas in clinical researches. The aim of this study is to evaluate the expression of HDGF and its clinical implication in patients who undergone complete resection for stage I non-small cell lung cancer (NSCLC).

METHODSImmunohistochemical technology was applied to detect the expression of HDGF in 118 lung cancer tissues and 30 normal lung tissues as control.

RESULTSHDGF staining was observed in nuclear as well as in cytoplasm. HDGF positively staining was seen in all patients, and remarkably higher than that in normal lung tissues (52.23±10.35 vs 156.73±70.95, P < 0.01). Expresson of HDGF was closely related to histological classification, but not to other clinicopathological factors, and the expression of HDGF in adenocarcinoma was much stronger than that in squamous cancers (P=0.001). Univariate analysis and multivariate Cox regression analysis showed that the patients with high HDGF expression had a shorter overall survival and HDGF was a significantly independent predictive factor for patients with stage I NSCLC (RR=1.011, P=0.002).

CONCLUSIONSHDGF may be a promising predictive factor for stage I NSCLC, and the assessment of HDGF may provide new insight on carcinogenesis and development of stage I NSCLC .

BACKGROUNDThe latest studies have demonstrated that postoperative adjuvant chemotherapy may improve survival in patients with stage I non-small cell lung cancer (NSCLC), so it was a challenge for clinician to choose the patients who might benefit from adjuvant chemotherapy. The aim of this study is to evaluate the prognostic implications of angiogenesis and tumor blood vessel invasion (BVI) in stage I NSCLC patients who underwent complete resection.

METHODSOne hundred and eighteen stage I NSCLC patients undergoing complete resection from 1994-2002 were retrospectively reviewed. Angiogenesis was assessed by vascular endothelial growth factor (VEGF) and microvessel density (MVD), BVI was assessed by examining the direct invasion of tumor cells marked by CD34 within vessel lumen.

RESULTSLow VEGF expression was seen in 44 patients (37.3%), high VEGF expression was in 74 patients (62.7%). The MVD of high VEGF expression cases was much higher than that of low VEGF expression ones (33.4±17.8 vs 24.7±14.8, P=0.010). There was a positive correlation between VEGF and MVD (r=0.216, P=0.019). The 5-year survival rate in patients with high VEGF expression was much lower than in those with low VEGF expression (36.48% vs 72.20%, P=0.003). The BVI was present in 32 patients (27.1%) and absent in 86 patients (72.9%). The 5-year survival rate in patients with presence of BVI was much lower than those with absence of BVI (34.38% vs 60.47%, P=0.018). Multivariate COX regression analysis showed that high VEGF expression and BVI were significantly independent predictive factors for overall survival. Finally, the presence of both risk factors, BVI and high VEGF expression was highly predictive of poor outcome (P= 0.001 ).

CONCLUSIONSTumor vessel invasion and high VEGF expression are independent prognostic factors for overall survival of postoperative stage I NSCLC. The assessment of these factors may improve prognostic stratification for adjuvant therapy or a targeted and specific treatment in stage I NSCLC.