According to very reliable data from evidence based medicine the operative guideline for lung cancer was approved. These include preoperative evaluation, the choice of operative modes, mediastinal lymphadenectomy and surgery for small cell lung cancer.

Stage Ⅳ non-small cell lung cancer should be restaged according different prognosis. Some patients with advanced NSCLC who received operative resection may be cured. Based on completely resection of primary lung cancer that no mediastinal lymphnode metastasis solitary brain metastasis or adrenal metastasis or ipsilateral lung metastasis should be considered for resection. Palliative surgery should be a part of multidisciplinary therapy for selective patients with advanced NSCLC.

Non-small-cell lung cancer (NSCLC) patients with the same TNM stage may suffer from large prognosis variations. Even patients with early-stage NSCLC still demonstrated lower-than-expecting survival rates after surgical resection, indicating that the current staging methods which were based on anatomy do not adequately predict outcome. Especially the insufficient growth of very early period tumors limited the prognostic prediction of anatomy characteristics, therefore studies focusing on tumor biologic characteristics were developed in order to identify prognostic gene markers. A variety of prognostic genomic models were based on microarray analysis and quantitative polymerase chain reaction (PCR) and analyzed by bioinformatics data processing. However, the prognostic gene lists reported to date overlapped poorly in the studies with similar background. To improve the cloudy situation, the research protocol should be standardized.On the other hand, instead of simple addition of several genes, sequential combination of prognostic gene markers based on signal pathway should be developed which may possess much more rationality and systematicness.

Gemcitabine is important pyrimidine antimetabolites drug. Ribonucleotide reductase is oneof its targets whose overexpression has been observed in several gemcitabine- resistant cell lines. Meanwhile,the NSCLC patients with high RRM1 expression levels have a relatively poor survival when treated with gem-citabine. To this day, the relationship between RRM1 expression levels in peripheral blood mononuclear cellsand gemcitabine is still uncertain and it deserves further research.

Pemetrexed is an antimetabolite antineoplastic agent that exerts its action by inhibiting three enzymes-thymidylate synthetase (TS), glycinamide ribonucleotide formyltransferase (GARFT) and dihydrofolate reductase (DHFR), which are essential for the synthesis of purine and pyrimidine. It causes arrest of tumor cells in S phase of the cell cycle, thus inhibiting their growth.Pemetrexed has been approved as first-line treatment in malignant pleural mesothelioma and second-line treatment in non-small-cell lung cancer (NSCLC). This paper summarizes the current developments in the treatment of NSCLC.

Effect of supernatant from bronchial carcinoma tissue, normal lung tissueand sera from patients with bronchial carcinoma on colony forming unit-T lymphocyte(CFU-TL) of patients themselves were surveyed. Fourteen blood bank donors were takenas normal control. The results showed that the mean value of growth rate of CFU-TLbefore discharging tumor load was 160.73?124.02/10~5 (X?SD). It was lower than that,(306.53?79.86/10~5) after discharging tumor load and (397.81?133.89/10~5) of normalcontrol (P

Objective To investigate the protective effects of ulinastatin on the lungs in patients undergoing lung resection after chemotherapy for lung cancer.Methods Thirty ASA Ⅱ or Ⅲ patients with lung cancer(Ⅲ a)aged 54-71yr weighing 55-74 kg undergoing lung resection after chemotherapy were randomly divided into 2 groups(n=15 each):Ⅰ ulinastatin group received ulinastatin 10 000 U?kg~(-1) after induction of anesthesia and Ⅱ control group received normal saline instead of ulinastatin.The patients were premeditated with intramuscular pothidine 70 mg and scopolamine 0.3 mg or atropine 0.5 mg.Anesthesia was induced with midazolam 0.05 mg?kg~(-1),fentanyl 4 ?g?kg~(-1) propofol 0.5-1.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 1%-2% isoflurane inhalation and vecuronium infusion at 0.06-0.08 mg?kg~(-1)?h~(-1).Blood samples were taken after induction of anesthesia(T_1,baseline),at 40 and 90 rain of one-lung ventilation(T_2,T_3) for determination of serum IL-6,IL-8,IL-10 and TNF-? concentrations.Lung specimen was taken from the operated lung at 90 min of one-lung ventilation for microscopic examination with light and electron microscopo.Results Serum IL-6,IL-8,IL-10 and TNF-? concentrations were all significantly increased during one-lung ventilation as compared to the baseline values at T_1 in both groups.Serum IL-6,IL-8 and TNF-? concentrations were significantly lower while Serum IL-10 concentration was significantly higher in ulinastatin group than in control group during one-lung ventilation(P＜0.05).The histopathologic changes of lung tissue were significantly less in group utinastatin than in group control.Conclusion Ulinastatin can effectively protect the lung in patients with lung cancer after chemotherapy by reducing systemic inflammatory response.