Background and purpose:Visceral pleural invasion (VPI) and vessel invasion (VI) are poor prognostic factors in patients with non-small cell lung cancer (NSCLC). The primary initial recurrence site may be local recurrence in VPI and distant metastasis in VI. The purpose of this study was to validate the prognostic impact and effect of the initial recurrence site of VPI and VI on survival outcomes for NSCLC.Methods:Two hundred and ninety patients who were diagnosed as having NSCLC and underwent lobectomy between Jan. 2007 and Dec. 2013 were retrospectively analyzed. VPI was identiifed in 51 patients as VPI group, the other 239 patients without VPI as non-VPI group. VI was identiifed in 29 patients as VI group, the other 261 patients without VI as non-VI group. Clinical characteristics, overall survival (OS), disease-free survival (DFS) were compared.Results:There were statistically signiifcant differences between VPI group and non-VPI group in tumor size, lymph node metastasis, TNM stage and initial recurrence site (P<0.05). Furthermore, there were statistically signiifcant differences between VI group and non-VI group in lymph node metastasis and TNM stage (P<0.05). The 1-, 3- and 5-year OS rates in VPI group (88.2%, 56.7% and 52.7%) were lower than those in non-VPI group (95.8%, 83.7% and 74.0%,P<0.001). The 1-, 3- and 5-year OS rates in VI group (79.3%, 56.8% and 48.7%) were lower than those in non-VI group (96.1%, 81.3% and
72.3%,P=0.001). Cox regression showed TNM stage was a significant prognostic factor for DFS, whereas lymph node metastasis and VPI were signiifcant prognostic factors in patients with NSCLC.Conclusion:The primary initial recurrence site in VPI patients is local recurrence. Patients with VPI or VI may need more postoperative therapy because of their poor prognosis.

Objective To observe the change of the serum ABCG2 level of patients with non‐small cell lung cancer(NSCLC)be‐fore and after chemotherapy ,and explore its clinical significance .Methods Venous blood specimens of 15 healthy adults and 50 pa‐tients with NSCLC were collected before and chemotherapy ,the serum ABCG2 level of these specimens were detected by ELISA . the relation between the ABCG2 level and the chemosensitivity was investigated .Results The serum ABCG2 level of patients with NSCLC before chemotherapy was significantly higher than that in healthy adults(P<0 .05);the serum ABCG2 level was not related with TNM stage in NSCLC(P<0 .05);The serum ABCG2 level of patients with NSCLC after chemotherapy was significantly high‐er than that of before(P<0 .05);in chemosensitive patients ,the different of serum ABCG2 level was not significantly before and af‐ter chemotherapy(P>0 .05);among chemoresistant patients ,the serum ABCG2 level of patients with NSCLC after chemotherapy was significantly higher than that of before(P<0 .05);the serum ABCG2 level was higher in patients with pleural effusion than the patients without pleural effusion ,but the different was not significantly(P>0 .05) .Conclusion The serum ABCG2 level of patients with NSCLC is higher than that of healthy adults ;serum ABCG2 level may become a useful indicator in predicting the effect of NSCLC chemotherapy .

BACKGROUNDKu70, Ku80 and DNA-PKcs proteins take part in the repairment of DNA double-strand breaks as regulatory subunits of DNA-dependent protein kinase. The aim of this study is to investigate the expression and clinical significance of Ku70, Ku80 and DNA-PKcs proteins in patients with stage I-II non-small cell lung cancer (NSCLC).

METHODSA total of 86 patients with stage I-II NSCLC who received adjuvant chemotherapy after radical surgery were retrospectively analyzed. The expression of Ku70, Ku80 and DNA-PKcs proteins was detected by tissue microarray technique and immunohistochemical two-step method.

RESULTSThe positive rate of Ku70, Ku80 and DNA-PKcs in lung cancer tissues was 68.6%, 72.1% and 87.2%, respectively. Their expression was not related to histological classification (P > 0.05). The patients with worse prognosis seemed to have higher expression of Ku70, Ku80 and DNA-PKcs proteins, however there was no statistical significance (P > 0.05).

CONCLUSIONSKu70, Ku80 and DNA-PKcs are overexpressed in stage I-II lung cancer without prior chemotherapy. They may be not good for guidance of postoperative chemotherapy in completely resected stageI-II NSCLC.

BACKGROUNDTo maximize the preservation of functional pulmonary parenchyma and improve the quality of life of patients with centrally located lung cancer, trachea-bronchoplasty has been used in clinical application with good efficacy. The aim of this study is to explore the appropriate admission and management of trachea-bronchoplasty and prevent complications of trachea-bronchial sleeve resection in the treatment of centrally located lung cancer.

METHODSSeventy-six patients with central lung cancer, who were treated with trachea-bronchoplasty from June, 1988 to October, 2004, were analyzed. There were 49 cases of squamous cell carcinoma, 16 adenocarcinoma, 7 adenosquamous carcinoma, 3 small cell lung cancer and 1 adenoid cystic adenocarcinoma. Seventeen patients were in stage I, 39 in stage II, 17 in stage IIIA and 3 in stage IIIB. There were 55 cases of sleeve lobectomy, 12 lobectomy with wedge resection of the main bronchus, 8 big arc resection of superior lobar bronchus-main trachea-lateral wall of trachea, 1 resection of right upper lobe-right main bronchus-carina-lateral trachea and carinal reconstruction.

RESULTSPostoperative complications happened in 7 patients. Pneumonia and atelectasis occurred in 6 cases, in which 1 died of heart and respiratory failure. Another one died of haemorrhage of upside alimentary canal. Seventy-one patients were followed up (93.4%). The 1-, 3-, 5-year survival rate was 82.4% (56/68), 57.8% (26/45) and 41.7% (15/36) respectively.

CONCLUSIONSThe trachea-bronchoplasty can not only preserve functional pulmonary parenchyma as much as possible and improve the quality of life of patients, but also provide an operative opportunity to those patients with poor pulmonary function in the treatment of centrally located lung cancer.

Objective    To explore the potential role of tumor spread through air spaces (STAS) as a prognostic indicator of non-small cell lung cancer (NSCLC) through meta-analysis. Methods    PubMed, EMbase and Web of Science, from inception to February 2022 were searched by computer about the research of the 5-year overall survival (OS) and recurrence free survival (RFS) of NSCLC patients with or without STAS. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of each study. Results    Totally 13 published articles were included with 4 647 patients, and 1 424 (30.6%) patients had STAS. The NOS score of all studies≥6 points. The meta-analysis showed that compared with the NSCLC patients without STAS, those with STAS had a worse prognosis of 5-year RFS, and the combined HR was 1.89 (95%CI 1.61-2.23); they had a shorter 5-year OS, and the combined HR was 2.25 (95%CI 1.79-2.84). There was no statistical heterogeneity among studies. Conclusion    The presence of STAS may be a poor prognostic factor for patients with NSCLC, and enough attention should be paid. The STAS should be recorded in the pathological report to guide the comprehensive treatment and evaluate the prognosis of patients.