Background: Mediastinal lymphadenopathy indicates an intrathoracic pathological process. Tuberculous mediastinal lymphadenopathy (TML) can be an early sign of tuberculosis infection, particularly in developing countries. Its incidence is often unclear due to underdiagnosis and limited access to diagnostic tools. Timely diagnosis is essential, as delayed treatment can result in severe complications. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a reliable method for obtaining samples and establishing a diagnosis, although its use is constrained by various factors. This study aims to clarify the role of EBUS features in assessing TML. Methods: This is a cross-sectional study that recruited ≥18 years old patients with suspected TML who underwent EBUS-TBNA. Mediastinal lymph nodes were systematically evaluated EBUS, with a focus on the largest nodes for further characteristic analysis. A TBNA was performed, and the retracted samples were assessed for pathology, acid-fast bacilli, Mycobacterium tuberculosis (MTB) culture, and Xpert Ultra examinations. Results: One hundred patients were recruited for the study. Fifty-three of these patients were ultimately diagnosed with TML. Significant associations were found between TML and several factors: short-axis size (p<0.001), oval-shaped lymph nodes (p=0.034), indistinct margins (p<0.001), central hilar presentation (p<0.001), internal echoes (p<0.049), thin layer echogenicity (p=0.033), and nodal matting (p<0.001). Among the diagnostic modalities, Xpert Ultra demonstrated the highest sensitivity for TML at 71.7%. Conclusion Endobronchial ultrasonographic features such as small size, round shape, indistinct margin, central hilar presentation, internal echo, thin layer echogenicity, and nodal matting are indicative of TML.

Insulin-like growth factor 1 receptor (IGF1R) has been intensively investigated in many preclinical studies using cell lines and animal models, and the results have provided important knowledge to help improve the understanding of cancer biology. IGF1R is highly expressed in patients with lung cancer, and high levels of circulating insulin-like growth factor 1 (IGF1), the main ligand for IGF1R, increases the risk of developing lung malignancy in the future. Several phase I clinical trials have supported the potential use of an IGF1R-targeted strategy for cancer, including lung cancer. However, the negative results from phase III studies need further attention, especially in selecting patients with specific molecular signatures, who will gain benefits from IGF1R inhibitors with minimal side effects. This review will discuss the basic concept of IGF1R in lung cancer biology, such as epithelial-mesenchymal transition (EMT) induction and cancer stem cell (CSC) maintenance, and also the clinical implications of IGF1R for lung cancer patients, such as prognostic value and cancer therapy resistance.

Circulating tumor cells (CTCs) are tumor cells that are separated from the primary site or metastatic lesion and disseminate in blood circulation. CTCs are considered to be part of the long process of cancer metastasis. As a 'liquid biopsy', CTC molecular examination and investigation of single cancer cells create an important opportunity for providing an understanding of cancer biology and the process of metastasis. In the last decade, we have seen dramatic development in defining the role of CTCs in lung cancer in terms of diagnosis, genomic alteration determination, treatment response and, finally, prognosis prediction. The aims of this review are to understand the basic biology and to review methods of detection of CTCs that apply to the various types of solid tumor. Furthermore, we explored clinical applications, including treatment monitoring to anticipate therapy resistance as well as biomarker analysis, in the context of lung cancer. We also explored the potential use of cell-free circulating tumor DNA (ctDNA) in the genomic alteration analysis of lung cancer.
Biology ; Blood Circulation ; Diagnosis ; DNA ; DNA, Neoplasm ; Lung Neoplasms ; Lung ; Methods ; Neoplasm Metastasis ; Neoplastic Cells, Circulating ; Prognosis