1.Primary enteric adenocarcinoma: A case report and literature review.
Yingjiao LONG ; Xiaopeng LIU ; Haiyan DU ; Ke ZHANG ; Hong PENG
Journal of Central South University(Medical Sciences) 2020;45(12):1504-1508
Primary enteric adenocarcinoma is a rare variant of primary pulmonary adenocarcinoma. This disease lacks a distinctive manifestation and often requires pathological examination to make a definite diagnosis. A male patient visited the Second Xiangya Hospital, Central South University for consistent cough and sputum production for about 1 year. Anti-infection therapy was given but it showed ineffectiveness. Enteric adenocarcinoma was diagnosed after percutaneous lung biopsy according to pathological findings. Combining this case with relevant literature, we summarized the characteristics to raise physicians' awareness for this rare subtype.
Adenocarcinoma/surgery*
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Adenocarcinoma of Lung
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Humans
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Lung
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Lung Neoplasms
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Male
2.Diagnostic Study of Multi-spectral Intelligent Analyzer in Diagnosis of the Infiltration Degree of Lung Adenocarcinoma.
Xianbei YANG ; Peihao WANG ; Qi QIN ; Kangshun GUO ; Yong CUI ; Yi LUO
Chinese Journal of Lung Cancer 2023;26(5):348-358
BACKGROUND:
Lung cancer is one of the most common malignant tumors in the world. The accuracy of intraoperative frozen section (FS) in the diagnosis of lung adenocarcinoma infiltration cannot fully meet the clinical needs. The aim of this study is to explore the possibility of improving the diagnostic efficiency of FS in lung adenocarcinoma by using the original multi-spectral intelligent analyzer.
METHODS:
Patients with pulmonary nodules who underwent surgery in the Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University from January 2021 to December 2022 were included in the study. The multispectral information of pulmonary nodule tissues and surrounding normal tissues were collected. A neural network model was established and the accuracy of the neural network diagnostic model was verified clinically.
RESULTS:
A total of 223 samples were collected in this study, 156 samples of primary lung adenocarcinoma were finally included, and a total of 1,560 sets of multispectral data were collected. The area under the curve (AUC) of spectral diagnosis in the test set (10% of the first 116 cases) of the neural network model was 0.955 (95%CI: 0.909-1.000, P<0.05), and the diagnostic accuracy was 95.69%. In the clinical validation group (the last 40 cases), the accuracy of spectral diagnosis and FS diagnosis were both 67.50% (27/40), and the AUC of the combination of the two was 0.949 (95%CI: 0.878-1.000, P<0.05), and the accuracy was 95.00% (38/40).
CONCLUSIONS
The accuracy of the original multi-spectral intelligent analyzer in the diagnosis of lung invasive adenocarcinoma and non-invasive adenocarcinoma is equivalent to that of FS. The application of the original multi-spectral intelligent analyzer in the diagnosis of FS can improve the diagnostic accuracy and reduce the complexity of intraoperative lung cancer surgery plan.
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Humans
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Lung Neoplasms/surgery*
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Adenocarcinoma of Lung/surgery*
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Adenocarcinoma/surgery*
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Hospitals
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Multiple Pulmonary Nodules
3.Clinical diagnosis and treatment of multiple pulmonary nodules.
Hua ZHONG ; Feng YAO ; Qun Hui CHEN ; Jin Dong GUO ; Lin Cheng ZHANG ; Yao ZHANG ; Bao Hui HAN
Chinese Journal of Oncology 2023;45(6):455-463
CT screening has markedly reduced the lung cancer mortality in high-risk population and increased the detection of early-stage pulmonary neoplasms, including multiple pulmonary nodules, especially those with a ground-glass appearance on CT. Multiple primary lung cancer (MPLC) constitutes a specific subtype of lung cancer with indolent biological behaviors, which is predominantly early-stage adenocarcinoma. Although MPLC progresses slowly with rare lymphatic metastasis, existence of synchronous lesions and distributed location of these nodules still pose difficulty for the management of such patients. One single operation is usually insufficient to eradicate all neoplastic lesions, whereas repeated surgical procedures bring about another dilemma: whether clinical benefits of surgical treatment outweigh loss of pulmonary function following multiple operations. Therefore, despite the anxiety for treatment among MPLC patients, whether and how to treat the patient should be assessed meticulously. Currently there is a heated discussion upon the timing of clinical intervention, operation mode and the application of local therapy in MPLC. Based on clinical experience of our multiple disciplinary team, we have summarized and commented on the evaluation, surgical treatment, non-surgical local treatment, targeted therapy and immunotherapy of MPLC in this article to provide further insight into this field.
Humans
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Multiple Pulmonary Nodules/surgery*
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Lung Neoplasms/surgery*
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Adenocarcinoma/surgery*
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Lung/pathology*
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Tomography, X-Ray Computed
4.Progress on the Study of Tumor Spread Through Air Spaces in the Clinicopathological Characteristics of Lung Adenocarcinoma and Its Influence on the Surgical Treatment and Prognosis of Lung Cancer.
Chinese Journal of Lung Cancer 2019;22(6):363-368
Tumor spread through air spaces (STAS) as a new pathological invasion mode is closely related to many clinicopathological factors. In lung adenocarcinoma, micropapillary and solid pathological subtypes are most related; STAS for early stage lung adenocarcinoma, surgical type of lobectomy seems to benefit better than sublobar resection, which may up-regulate the pathological stage of early lung cancer; Moreover, STAS is closely related to squamous cell carcinoma and other non-small cell lung cancer (NSCLC). In addition, intraoperative frozen-section pathological detection of STAS is difficult and controversial. STAS as an independent risk factor for tumor recurrence is also an important factor indicating poor prognosis. This paper reviews the research status and progress of STAS.
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Adenocarcinoma of Lung
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diagnosis
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pathology
;
surgery
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Animals
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Humans
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Lung Neoplasms
;
diagnosis
;
pathology
;
surgery
;
Neoplasm Invasiveness
;
Prognosis
5.A Case of New Rapidly Progressing Ground-glass Nodule Lung Adenocarcinoma Near Primary Lesion after Stereotactic Body Radiation Therapy.
Sicong WANG ; Linfeng LI ; Yuanda CHENG
Chinese Journal of Lung Cancer 2024;26(12):957-960
Ground-glass nodule (GGN) lung cancer often progresses slowly in clinical and there are few clinical studies on long-term follow-up of patients with operable GGN lung cancer treated with stereotactic body radiation therapy (SBRT). We present a successful case of GGN lung cancer treated with SBRT, but a new GGN was found in the lung adjacent to the SBRT target during follow-up. The nodule progressed rapidly and was confirmed as lung adenocarcinoma by surgical resection. No significant risk factors and related driving genes were found in molecular pathological findings and genetic tests. It deserves further study whether new GGN is related to the SBRT. This case suggests that the follow-up after SBRT should be vigilant against the occurrence of new rapidly progressive lung cancer in the target area and adjacent lung tissue.
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Humans
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Lung Neoplasms/pathology*
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Radiosurgery
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Retrospective Studies
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Adenocarcinoma of Lung/surgery*
;
Lung/pathology*
6.Primary lung adenocarcinoma complicated with lung hamartoma: A case report and literature review.
Li WANG ; Liang ZHOU ; Jianyong ZHANG
Journal of Central South University(Medical Sciences) 2022;47(4):529-534
The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B (KIF20B) gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.
Adenocarcinoma of Lung/complications*
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Hamartoma/surgery*
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Humans
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Kinesins
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Lung/pathology*
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Lung Neoplasms/surgery*
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Male
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Middle Aged
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Retrospective Studies
7.Clinical significance of PD
Junmi LU ; Juan FENG ; Hongmei ZHENG ; Qiuyuan WEN ; Songqing FAN
Journal of Central South University(Medical Sciences) 2020;45(10):1149-1154
OBJECTIVES:
To explore the expression of programmed death ligand-1 (PD-L1) as well as the correlation between the expression and the clinicopathological features or prognosis in non-small cell lung cancer (NSCLC).
METHODS:
The expression of PD-L1 protein in 254 cases of surgically resected lung adenocarcinoma (L-ADC), 228 cases of surgically resected lung squamous cell cancer (L-SCC), and 99 cases of non-cancerous control lung tissues was detected with immunohistochemical SP method. The correlation between the PD-L1 expression and clinicopathological features was analyzed. Kaplan-Meier univariate and Cox multivariate regression analyses were performed to assess the prognosis of patients with L-ADC and L-SCC, respectively.
RESULTS:
Positive percentage of PD-L1 protein expression was higher in the tissues of L-ADC and L-SCC than that in the non-cancerous control lung tissues respectively (both
CONCLUSIONS
The positive percentage of PD-L1 protein expression is higher in the L-SCC patients than that in the L-ADC patients. Positive expression of PD-L1 protein can be served as an independent prognostic factor of poor prognosis in the patients with L-ADC.
Adenocarcinoma of Lung
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B7-H1 Antigen/genetics*
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Biomarkers, Tumor
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Carcinoma, Non-Small-Cell Lung/surgery*
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Humans
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Lung Neoplasms/surgery*
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Patients
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Prognosis
8.Solitary Metastasis of Bronchogenic Adenocarcinoma to the Internal Auditory Canal: A Case Report.
Ki Hong CHANG ; Chang Eun SONG ; Jae Hyun SEO ; Sang Won YEO
Journal of Korean Medical Science 2009;24(6):1227-1229
We report a patient with an isolated metastasis to the internal auditory canal (IAC) of bronchogenic adenocarcinoma. A 58-yr-old man who had received 6-cycle of chemotherapy under diagnosis of non-small cell lung carcinoma (T4N2M0) two years ago was referred to our department with vertigo, right-sided facial paralysis and right-sided hearing loss. A provisional diagnosis of vestibular schwannoma or meningioma involving right IAC was made from magnetic resonance imaging. The patient underwent a translabyrinthine removal of the tumor. Histopathological study of the resected lesion showed a poorly differentiated adenocarcinoma compatible with bronchogenic origin. The patient died 9 months after surgery from extensive brain metastasis despite postoperative radiation therapy. In patients with a previous history of treatment of malignancy elsewhere in the body, the possibility of IAC metastasis must be considered when an IAC lesion is detected.
Adenocarcinoma/*pathology/surgery
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Ear Neoplasms/*secondary/surgery
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Fatal Outcome
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Humans
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Lung Neoplasms/*pathology
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Male
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Middle Aged
9.Prognostic significance of micropapillary pattern in pulmonary adenocarcinoma.
Dong-mei LIN ; Ying MA ; Xiang-yang LIU ; Shan ZHENG ; Li-yan XUE ; Xiu-yun LIU ; Shuang-mei ZOU ; Ning LÜ ; Zu-gen HE ; Fu-sheng LIU
Chinese Journal of Pathology 2006;35(3):151-154
OBJECTIVETo evaluate the prognostic significance of micropapillary pattern (MPP) in adenocarcinoma of lung.
METHODSNinety-one consecutively excised cases of pulmonary adenocarcinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups: those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows: MPP + (constituting 1% to 10% of the tumor), MPP ++ (constituting 11% to 30% of the tumor) and MPP +++ (constituting more than 30% of the tumor).
RESULTSThe overall 5-year survival rate was 64.8%. The 5-year survival rates were 88.9% for stage I tumors, 46.2% for stage II tumors, and 23.8% for stage III tumor respectively (P = 0.000). The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate (P = 0.065, 0.358 and 0.206, respectively). On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group (number = 41) and 84.0% for patients in the MPP-negative group (number = 50). The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group (P = 0.000). In pulmonary adenocarcinoma, this characteristic histology correlated with tumor stage and size, but not with patient's gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows: for stage I, 78.6% versus 92.6% (P = 0.1548), for stage II, 30.0% versus 100% (P = 0.0598), and for stage III, 17.7% versus 28.6% (P = 0.4045).
CONCLUSIONSMPP in primary pulmonary adenocarcinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert clinicians for more active treatment and closer follow up.
Adenocarcinoma ; pathology ; surgery ; Adenocarcinoma, Bronchiolo-Alveolar ; pathology ; surgery ; Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung ; pathology ; surgery ; Lung Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Analysis
10.Diagnosis and treatment of the pituitary metastases.
Wei LIAN ; Zuyuan REN ; Changbao WU
Chinese Medical Sciences Journal 2004;19(1):68-71
Three cases of pituitary metastases were reported. They all had operations and the pathological examination confirming the diagnosis. The clinical features of diabetes insipidus and extraocular nerve palsy were presented. In two cases, the original tumors were bronchioloalveolar carcinoma; in the other one, the original tumor was unknown. All three cases had poor outcome. These cases illustrate the fact that a pituitary metastasis can closely mimic a pituitary benign tumor, such as pituitary adenoma. Especially in the presence of suggestive symptoms such as diabetes insipidus and/or cranical nerve paralysis, the possibility of metastatic disease in the differential diagnosis of a pituitary mass should always be considered.
Adenocarcinoma
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secretion
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surgery
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Adenocarcinoma, Bronchiolo-Alveolar
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secondary
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surgery
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Adult
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Aged
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Female
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Humans
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Lung Neoplasms
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pathology
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Male
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Middle Aged
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Neoplasms, Unknown Primary
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Pituitary Neoplasms
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secondary
;
surgery