Lung cancer is the most common cancer and the leading cause of cancer-related deaths in the world. More than 50 % of advanced NSCLC are diagnosed in patients older than age 65 years. Aging is inextricably associated with decreases in marrow reserve, drug clearance, and lean body mass. Elderly cancer patients often present with medical and physiologic challenges that make the selection of their optimal treatment daunting. This article reviews the progress in diagnosis and treatment of lung cancer in the elderly in recent years.

Esophageal carcinoma is one of the top frequently occur malignant cancers, especially in Chinese.Studies on esophageal carcinoma have suggested that genetic predisposition, dietary or environmental factors, such as nitrosamine, tobacco smoking, malnutrition, trace element deficieny and fungus toxin could be important in the carcinogenesis of this cancer.

Background and purpose:Clinical data show that Endostar, a recombinant human endostatin, has the therapeutic beneift for patients with non-small cell lung cancer (NSCLC) while combined with chemotherapy or ra-diotherapy. However, the microenvironment changes induced by Endostar monotherapy in NSCLC is not yet clear. The purpose of this study was to prospectively study tumor vascular effects of Endostar monotherapy in patients with locally advanced or advanced NSCLC by dynamic contrast-enhanced perfusion computed tomography (CT perfusion, CT-p). Methods:Previously untreated patients with histologically or cytologically conifrmed locally advanced or advanced NSCLC were eligible. All patients received daily Endostar (7.5 mg?m2) for 14 days. CT-p scans were acquired at the baseline and post-treatment. CT-p parameters, such as blood lfow (BF), blood volume (BV) and permeability surface PS (area product), were measured in all patients.Results:Of all 7 patients enrolled, four were staged asⅢB and three as stageⅣ (2 with malignant pleural effusion, 1 with brain metastasis). The median BF, BV and PS values of baseline and post-treatment were 27.1/48.9 mL/100 mL/min, 86.8/84.8 mL/100 mL and 45.0/54.0 mL/100 mL/min, respectively. After administration of Endostar for 14 days , BF showed a signiifcant increase compared with that at baseline (P=0.028), whereas no signiifcant changes were found in BV (P=0.398) and PS (P=0.237) values.Conclusion:Our results suggest that Endostar monotherapy induces a signiifcant increase in BF whereas no signiifcant difference in BV and PS.

Objective: To evaluate the efficacy and adverse effects ofindividualized chemotherapy combined with traditional Chinese medicine (TCM) in treatment for advanced non-small cell lung cancer (NSCLC) and its prognosis. Methods: A prospective randomized controlled trial was designed to recruit 100 eligible patients with refractory stage IIIB-IV NSCLC from Shanghai Chest Hospital of Shanghai Jiao Tong University between January 1, 2013 and May 31, 2014. The 100 patients were randomized divided into study group (N = 50) and control group (N = 50). The patients in the study group received individualized chemotherapy according to the results of detection of molecular targets combined with traditional Chinese medicine by syndrome differentiation, while the patients in the control group received chemotherapy with vinorelbine and gemcitabine. The response after treatment and the quality of life score and TCM symptom score before treatment and three months after four cycles of chemotherapy (or last chemotherapy) between two groups were compared. The progression-free survival (PFS) was calculated by Kaplan-Meier method. The treatment-related adverse reactions were observed. Results: In study group, 7 patients achieved partial response (PR), 30 patients achieved stable disease (SD), and 13 patients achieved progressive disease (PD); in the control group, 3 achieved PR, 22 achieved SD, and 25 achieved PD. The response of study group was significantly better than that of the control group (P = 0.037). The median PFS in study group and the control group were 3.8 and 3.3 months, respectively; there was a significant difference between the two groups (P = 0.043). Before treatment, there were no significant differences in quality of life and TCM symptom scores between two groups (both P > 0.05). After treatment, the quality of life and TCM symptom scores of the study group were significantly improved as compared with those of the control group (both P < 0.05). The rates of fatigue and constipation in the study group were significantly higher than those in the control group (both P < 0.05). Conclusion: The treatment with individualized chemotherapy combined with TCM may benefit the response, clinical symptoms, quality of life and PFS of patients with advanced NSCLC.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.

Objective:To analyze the correlation between blood routine-derived inflammation indicators and respiratory function in patients with pneumoconiosis.Methods:In January 2021, 492 male pneumoconiosis patients hospitalized in Hefei Institute of Occupational Disease Control and Prevention from 2012 to 2020 were randomly selected as the case group, 492 dust exposed non pneumoconiosis workers who underwent occupational health examination at the same time were taken as the control group. The occupational history and clinical examination data of the two groups of subjects were collected, the correlation between blood routine-derived inflammatory indexes and pulmonary function and blood gas analysis was analyzed retrospectively.Results:Compared with the control group, the lymphocyte monocyte ratio (LMR) in the case group was decreased, and the neutrophil lymphocyte ratio (NLR) was increased, and the difference was statistically significant ( P<0.05) . There were significant differences in forced vital capacity as a percentage of the predicted value (FVC) , forced expiratory volume in the first second as a percentage of the predicted value (FEV 1%) , one second rate (FEV 1/FVC) , partial pressure of oxygen (PaO 2) , partial pressure of carbon dioxide (PaCO 2) , and pH among pneumoconiosis patients at different stages ( P<0.05) . FVC%, FEV 1%, FEV 1/FVC, and PaO 2 decreased with the increase of the stage, the trend test was statistically significant (tau-b=-0.24, -0.34, -0.37, -0.17, P<0.05) , PaCO 2 and pH increased with the increase of the stage, and the trend test was statistically significant (tau-b=0.10, 0.08, P<0.05) . There were statistically significant differences in LYM, LMR, NLR, platelet lymphocyte ratio (PLR) in patients with pneumoconiosis at different stages ( P<0.05) , and LYM and LMR decreased with the increase of stage, trend test showed that there was statistically significant (tau-b=-0.11, -0.13, P<0.05) . There were significant differences in FVC%, FEV 1%, FEV 1/FVC, PaO 2, pH, LMR, NLR, PLR among patients with different types of pneumoconiosis ( P<0.05) . LMR in pneumoconiosis patients was significantly positively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=0.342, 0.324, 0.203, 0.207, P<0.05) , NLR was significantly negatively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=-0.193, -0.202, -0.164, -0.177, P<0.05) , PLR was significantly negatively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=-0.194, -0.193, -0.106, -0.113, P<0.05) . Multiple linear regression analysis showed that LMR in pneumoconiosis patients was positively related with FVC%, FEV 1% and PaO 2 ( P<0.05) . Conclusion:LMR in patients with pneumoconiosis has a certain correlation with lung function and blood gas analysis, LMR is expected to become a sensitive indicator for evaluating pneumoconiosis.

Objective:To analyze the correlation between blood routine-derived inflammation indicators and respiratory function in patients with pneumoconiosis.Methods:In January 2021, 492 male pneumoconiosis patients hospitalized in Hefei Institute of Occupational Disease Control and Prevention from 2012 to 2020 were randomly selected as the case group, 492 dust exposed non pneumoconiosis workers who underwent occupational health examination at the same time were taken as the control group. The occupational history and clinical examination data of the two groups of subjects were collected, the correlation between blood routine-derived inflammatory indexes and pulmonary function and blood gas analysis was analyzed retrospectively.Results:Compared with the control group, the lymphocyte monocyte ratio (LMR) in the case group was decreased, and the neutrophil lymphocyte ratio (NLR) was increased, and the difference was statistically significant ( P<0.05) . There were significant differences in forced vital capacity as a percentage of the predicted value (FVC) , forced expiratory volume in the first second as a percentage of the predicted value (FEV 1%) , one second rate (FEV 1/FVC) , partial pressure of oxygen (PaO 2) , partial pressure of carbon dioxide (PaCO 2) , and pH among pneumoconiosis patients at different stages ( P<0.05) . FVC%, FEV 1%, FEV 1/FVC, and PaO 2 decreased with the increase of the stage, the trend test was statistically significant (tau-b=-0.24, -0.34, -0.37, -0.17, P<0.05) , PaCO 2 and pH increased with the increase of the stage, and the trend test was statistically significant (tau-b=0.10, 0.08, P<0.05) . There were statistically significant differences in LYM, LMR, NLR, platelet lymphocyte ratio (PLR) in patients with pneumoconiosis at different stages ( P<0.05) , and LYM and LMR decreased with the increase of stage, trend test showed that there was statistically significant (tau-b=-0.11, -0.13, P<0.05) . There were significant differences in FVC%, FEV 1%, FEV 1/FVC, PaO 2, pH, LMR, NLR, PLR among patients with different types of pneumoconiosis ( P<0.05) . LMR in pneumoconiosis patients was significantly positively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=0.342, 0.324, 0.203, 0.207, P<0.05) , NLR was significantly negatively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=-0.193, -0.202, -0.164, -0.177, P<0.05) , PLR was significantly negatively correlated with FVC%, FEV 1%, FEV 1/FVC and PaO 2 ( rs=-0.194, -0.193, -0.106, -0.113, P<0.05) . Multiple linear regression analysis showed that LMR in pneumoconiosis patients was positively related with FVC%, FEV 1% and PaO 2 ( P<0.05) . Conclusion:LMR in patients with pneumoconiosis has a certain correlation with lung function and blood gas analysis, LMR is expected to become a sensitive indicator for evaluating pneumoconiosis.