BACKGROUND: The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma. METHODS: A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024. RESULTS: A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%. CONCLUSIONS The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.
Humans ; ErbB Receptors/metabolism* ; Male ; Female ; Middle Aged ; Adenocarcinoma of Lung/surgery* ; Neoadjuvant Therapy ; Lung Neoplasms/surgery* ; Aged ; Retrospective Studies ; Mutation ; Adult

The increasing number of pulmonary nodules being detected by computed tomography scans significantly increase the workload of the radiologists for scan interpretation. Limitations of traditional methods for differential diagnosis of pulmonary nodules have been increasingly prominent. Artificial intelligence (AI) has the potential to increase the efficiency of discrimination and invasiveness classification for pulmonary nodules and lead to effective nodule management. Chinese Experts Consensus on Artificial Intelligence Assisted Management for Pulmonary Nodule (2022 Version) has been officially released recently. This article closely follows the context, significance, core implications, and the impact of future AI-assisted management on the diagnosis and treatment of pulmonary nodules. It is hoped that through our joint efforts, we can promote the standardization of management for pulmonary nodules and strive to improve the long-term survival and postoperative life quality of patients with lung cancer.

Objective:To explore the relationship between sleep duration and depressive symptoms in middle-aged and elderly people.Methods:A total of 11 931 middle-aged and elderly people aged ≥55 years who participated in the baseline survey of the "Community Cohort Study of Specialized Nervous System Diseases" in China from 2018 to 2019 were selected to obtain basic information about their lifestyle, food intake frequency, disease history, sleep duration. The body height and weight were measured, and body mass index (BMI) were calculated. The subjects with depressive symptoms were screened with the Geriatric Depression Scale (GDS-30). Restricted cubic spline model and multivariate logistic regression model were used to analyze the relationship between sleep duration and depressive symptoms.Results:Among the middle-aged and elderly people aged ≥55 years, 17.79% reported sleep duration less than 7 hours, 16.84% reported that their sleep duration ≥9 hours, and the detection rate of depression symptoms was 7.95%. After adjusting for factors such as region, age, gender, the restricted cubic spline results showed the U-shaped relationship between sleep duration and the risk for depressive symptoms, the results of multivariate logistic regression analysis showed that the risk for depressive symptom in middle-aged and elderly people aged ≥55 years with sleep duration ≤5 hours, 6 hours, and ≥9 hours were 1.749(95% CI:1.279-2.392), 1.284(95% CI:1.021-1.615) and 1.260(95% CI:1.033-1.538) times higher compared with the counterparts with sleep duration 7-8 hours, the risk for depressive symptom in women with sleep duration ≤5 hours, 6 hours and ≥9 hours were 2.115 (95% CI:1.473-3.038), 1.605(95% CI:1.213-2.123) and 1.313(95% CI:1.011-1.705) times higher, respectively, compared with counterparts with sleep duration 7-8 hours, the risk for depressive symptoms in 55-64-year-old middle-aged and elderly people with sleep duration ≤5 hours and ≥9 hours were 1.806 (95% CI:1.014-3.217) and 1.478 (95% CI:1.060-2.061) times higher compared with counterparts with sleep duration 7-8 hours, and the risk for depressive symptoms in elderly people aged 65-74 years with sleep duration ≤5 hours was 2.112 (95% CI:1.327-3.361)times higher compared with counterparts with sleep duration 7-8 hours, the differences were all significant ( P<0.05). There was no statistically significant association between sleep duration and depressive symptoms in men and in elderly people aged ≥75 years ( P>0.05). Conclusion:Insufficient or prolonged sleep was independently associated with depressive symptoms in middle-aged and elderly people, showing a U-shaped relationship, especially in women and in middle-aged and elderly people aged 55-64 years.

Objective:To search for potential protein biomarkers of papillary thyroid carcinoma (PTC) and thyroid borderline lesion. Dif-ferentially expressed proteins between the two were analyzed and identified. Methods:A total of 118 cases of thyroid resection sam-ples were obtained from patients who underwent surgery at the First People's Hospital of Yunnan Province from April 2013 to Febru-ary 2015. Experimental groups included 43 PTCs (40 classic and 3 follicular variants) and 33 thyroid borderline lesions (with equivocal PTC type nuclear features and papillary structure, but without metastasis, and lacking capsular or vascular invasion;8 cases with atypi-cal adenoma), respectively. The control group included 42 normal thyroid tissues adjacent to carcinoma. The total protein extracts from frozen thyroid samples of 10 cases in each group were profiled with 2D electrophoresis. The differential protein spots were then revealed by PDQUEST 7.3 software and identified by matrix-assisted laser desorption ionization time-of-fight/time-of-fight mass spec-trometry and Swiss-Prot database search. Six differentially expressed proteins of these spots were further validated using 118 samples through immunohistochemistry. Results:A set of 24 differentially expressed spots significant in discriminating between the sample groups were found, and 18 proteins were identified. Immunohistochemistry revealed the following six proteins located in the cyto-plasm:keratin, type II cytoskeletal 8 (CK8);keratin, type I cytoskeletal 18 (CK18);60 kDa heat shock protein (HSP60);actin, cytoplasmic 2 (γ-actin);14-3-3 protein beta/alpha (14-3-3β/α);and 14-3-3 protein epsilon (14-3-3ε). All six proteins were overexpressed in PTC compared with normal tissues (P<0.001). Meanwhile, CK8, CK18, HSP60, andγ-actin were overexpressed in PTC compared with bor-derline lesions (P<0.01). Except for CK8, the five other proteins were overexpressed in borderline lesions compared with normal tis-sues (P<0.001). Conclusion:Proteomic analysis is useful in searching for new biomarkers of PTC and thyroid borderline lesion. The ex-pression patterns of these differentially expressed proteins can be further validated using immunohistochemistry. The newly identified protein biomarkers can positively contribute to early PTC diagnosis.