Thymoma is a malignant tumor originating from thymus epithelial cells, with an incidence of 1.3-2.6 per million. Due to its low incidence, lack of cells and animal models, there are relatively few studies on thymoma, and its diagnosis and treatment progress is relatively slow. The update of 5th edition of WHO Classification of Thoracic Tumors in 2021 and the NCCN( National Comprehensive Cancer Network) Clinical Practice Guidelines in Oncology: Thymoma and Thymoma Cancer in 2024 put forward many new views and suggestions on the diagnosis and treatment strategy of thymoma. This article reviews the research and treatment of thymoma based on the latest research progress in recent years, aiming to improve the clinician's understanding of thymoma, provide reference for treatment, and promote the research of thymoma.

Background and purpose:Relapsed or refractory diffuse large B-cell lymphoma(DLBCL)can be treated with chimeric antigen receptor T-cell(CAR-T)therapy.Imaging-based biomarkers may help identify patients likely to achieve clinical response to this immunotherapy.In this study,an 18-f1uoro-2-deoxy-D-glucose positron emission tomography-computed tomography(18F-FDG PET/CT)based model was developed to assess the progression-free survival(PFS)and overall survival(OS)of patients with relapsed or refractory(R/R)DLBCL who received CAR-T therapy.Methods:We retrospectively analyzed clinical and imaging data from patients with DLBCL who underwent CAR-T therapy at the First Affiliated Hospital of Soochow University between March 2017 and January 2022.Inclusion criteria:① age≥18 years old;② pathologically confirmed R/R DLBCL;③ 18F-FDG PET/CT performed before CAR-T cell therapy;④ complete clinicopathologic data;⑤ patients must have measurable lesions.Exclusion criteria:① patients with incomplete clinical or imaging data;② patients with other types of malignant tumors;③ patients who have received granulocyte colony-stimulating factor treatment within 1 month prior to PET/CT scan.This study was reviewed by the Ethics Committee of the First Affiliated Hospital of Soochow University(ID:2025256).Receiver operating characteristic(ROC)curves were used to determine the optimal thresholds for maximum standardized uptake value(SUVmax),tumor metabolic volume(MTV),and total glycolysis(TLG),and the patients were classified into high-risk and low-risk groups.Univariate and multivariate Cox regression analyses were used to identify potential prognostic factors and construct predictive models,which were visualized by drawing nomogram.Area under the ROC curve was used to assess the performance of each model.Results:A total of 61 patients(37 male patients and 24 female patients,aged 26-75 years)with DLBCL who underwent 18F-FDG PET/CT prior to CAR-T infusion were included.The median follow-up was 14 months;36 patients(59.02%)had disease progression and 25 patients(40.98%)died.Multivariate analysis showed that grade of cytokine release syndrome(CRS)[Hazard ratio(HR)=3.671;P=0.003]and MTV(HR=0.171,P=0.004)were independent prognostic factors for OS;Eastern Cooperative Oncology Group(ECOG)score(HR=2.411,P=0.019),grade of CRS(HR=2.499;P=0.027),and MTV(HR=0.338,P=0.007)were independent prognostic factors for PFS.The combined model(MTV,ECOG score,grade of CRS)was better than the clinical model(ECOG score,grade of CRS),and metabolic parameter model(MTV)in predicting PFS and OS.Conclusion:18F-FDG PET/CT metabolic parameter MTV in combination with traditional clinical risk factors(ECOG score,Grade of CRS)could identify patients with ultra-high risk of DLBCL.

Background and purpose:Relapsed or refractory diffuse large B-cell lymphoma(DLBCL)can be treated with chimeric antigen receptor T-cell(CAR-T)therapy.Imaging-based biomarkers may help identify patients likely to achieve clinical response to this immunotherapy.In this study,an 18-f1uoro-2-deoxy-D-glucose positron emission tomography-computed tomography(18F-FDG PET/CT)based model was developed to assess the progression-free survival(PFS)and overall survival(OS)of patients with relapsed or refractory(R/R)DLBCL who received CAR-T therapy.Methods:We retrospectively analyzed clinical and imaging data from patients with DLBCL who underwent CAR-T therapy at the First Affiliated Hospital of Soochow University between March 2017 and January 2022.Inclusion criteria:① age≥18 years old;② pathologically confirmed R/R DLBCL;③ 18F-FDG PET/CT performed before CAR-T cell therapy;④ complete clinicopathologic data;⑤ patients must have measurable lesions.Exclusion criteria:① patients with incomplete clinical or imaging data;② patients with other types of malignant tumors;③ patients who have received granulocyte colony-stimulating factor treatment within 1 month prior to PET/CT scan.This study was reviewed by the Ethics Committee of the First Affiliated Hospital of Soochow University(ID:2025256).Receiver operating characteristic(ROC)curves were used to determine the optimal thresholds for maximum standardized uptake value(SUVmax),tumor metabolic volume(MTV),and total glycolysis(TLG),and the patients were classified into high-risk and low-risk groups.Univariate and multivariate Cox regression analyses were used to identify potential prognostic factors and construct predictive models,which were visualized by drawing nomogram.Area under the ROC curve was used to assess the performance of each model.Results:A total of 61 patients(37 male patients and 24 female patients,aged 26-75 years)with DLBCL who underwent 18F-FDG PET/CT prior to CAR-T infusion were included.The median follow-up was 14 months;36 patients(59.02%)had disease progression and 25 patients(40.98%)died.Multivariate analysis showed that grade of cytokine release syndrome(CRS)[Hazard ratio(HR)=3.671;P=0.003]and MTV(HR=0.171,P=0.004)were independent prognostic factors for OS;Eastern Cooperative Oncology Group(ECOG)score(HR=2.411,P=0.019),grade of CRS(HR=2.499;P=0.027),and MTV(HR=0.338,P=0.007)were independent prognostic factors for PFS.The combined model(MTV,ECOG score,grade of CRS)was better than the clinical model(ECOG score,grade of CRS),and metabolic parameter model(MTV)in predicting PFS and OS.Conclusion:18F-FDG PET/CT metabolic parameter MTV in combination with traditional clinical risk factors(ECOG score,Grade of CRS)could identify patients with ultra-high risk of DLBCL.

Thymoma is a malignant tumor originating from thymus epithelial cells, with an incidence of 1.3-2.6 per million. Due to its low incidence, lack of cells and animal models, there are relatively few studies on thymoma, and its diagnosis and treatment progress is relatively slow. The update of 5th edition of WHO Classification of Thoracic Tumors in 2021 and the NCCN( National Comprehensive Cancer Network) Clinical Practice Guidelines in Oncology: Thymoma and Thymoma Cancer in 2024 put forward many new views and suggestions on the diagnosis and treatment strategy of thymoma. This article reviews the research and treatment of thymoma based on the latest research progress in recent years, aiming to improve the clinician's understanding of thymoma, provide reference for treatment, and promote the research of thymoma.

Melanoma is the most aggressive cutaneous tumor. Neuropilin and tolloid-like 2 (NETO2) is closely related to tumorigenesis. However, the functional significance of NETO2 in melanoma progression remains unclear. Herein, we found that NETO2 expression was augmented in melanoma clinical tissues and associated with poor prognosis in melanoma patients. Disrupting NETO2 expression markedly inhibited melanoma proliferation, malignant growth, migration, and invasion by downregulating the levels of calcium ions (Ca²⁺) and the expression of key genes involved in the calcium signaling pathway. By contrast, NETO2 overexpression had the opposite effects. Importantly, pharmacological inhibition of CaMKII/CREB activity with the CaMKII inhibitor KN93 suppressed NETO2-induced proliferation and melanoma metastasis. Overall, this study uncovered the crucial role of NETO2-mediated regulation in melanoma progression, indicating that targeting NETO2 may effectively improve melanoma treatment.
Humans ; Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism* ; Cell Line, Tumor ; Cell Proliferation ; Melanoma/genetics* ; Membrane Proteins/genetics* ; Phosphorylation ; Signal Transduction

Objective    To analyze the research hotspots and progress of surgical treatment of myasthenia gravis. Methods    The top 100 most cited articles on surgical treatment of myasthenia gravis were identified by searching the Web of Science database, and a bibliometric analysis was conducted. Results    The publication year of the top 100 most cited articles ranged from 1939 to 2021, and the number of citations ranged from 55 to 850 per article. Most of the included articles were original research articles (75/100), which were mainly retrospective studies (64/75). The United States was the country with the most published articles and most citations, and Annals of Thoracic Surgery was the most sourced journal (n=20). Through VOSviewer analysis, high-density keywords were thymectomy, maximal thymectomy, extended thymectomy, transcervical thymectomy, thymoma, and autoantibodies. Conclusion    The scope of surgical resection, surgical approach and pathogenesis are the current hotspots in the field of surgical treatment of myasthenia gravis. It is hoped that this paper can provide references for future researches in this field.

Objective    To investigate the clinical characteristics and treatment of primary mediastinal yolk sac tumor (PMYST). Methods    We collected the clinical data of PMYST patients who were admitted to the Department of Thoracic Surgery of Peking Union Medical College Hospital from September 2000 to September 2020. The clinical and pathological characteristics, treatment and prognosis of PMYST patients were retrospectively analyzed. Results     Finally 18 patients were enrolled, including 17 males and 1 female with a median age of 22.0 (16.6, 26.2) years. Patients had increased level of alpha fetoprotein (AFP). The pathological type can be single yolk sac tumor or combined with other mediastinal germ cell tumors. Chemotherapy and radical surgery were the main treatment methods. Extensive resection was feasible for patients with tumor invasion of other organs. Seven patients developed lung or pleural metastasis after operation, and 3 of them had extrapleural metastasis. One patient recurred within 1 year after surgery. All patients were followed up by telephone or outpatient department. At the last follow-up, 5 patients survived, 9 died, and 4 were lost to follow up, with a median survival of 16.8 months. The median disease-free survival was 14.9 months. The survival rates at 1, 3 and 5 years were 73.3%, 28.6% and 11.8%, respectively. Conclusion    PMYST often occurs in young-middle aged male patients. Preoperative puncture can provide an effective diagnostic basis. R0 resection, AFP returning to normal after treatment and no metastasis may be potential indicators of good prognosis. The overall prognosis of PMYST is poor, and some patients can achieve long-term survival after treatment.

Lung cancer ranks the first cancer-related morbidity and mortality in China. With the development and penetration of imaging technology, increasing small pulmonary peripheral Nodules (SPPNs) have been detected. However, precise location and diagnosis of SPPNs is still a tough problem for clinical diagnosis and treatment in department of thoracic surgery. With the development of electromagnetic navigation bronchoscopy (ENB), it provides a novel minimally invasive method for the diagnosis and treatment of SPPNs. In this review, we summarized the application and progress of ENB in preoperative positioning, diagnosis, and local treatment, then, discussed the clinical application of ENB in the hybrid operating room.
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Bronchoscopy/methods* ; Electromagnetic Phenomena ; Humans ; Lung Neoplasms/surgery* ; Multiple Pulmonary Nodules/diagnosis* ; Thoracic Surgery

Thymic neuroendocrine tumors (TNETs) are a series of rare diseases with aggressive biology and poor prognosis. Clinical manifestations of TNETs are atypical, and ectopic secretion of adrenocorticotropic hormone can be found in some cases, resulting in associated endocrine symptoms. Due to the low morbidity and strong heterogeneity, it’s difficult to diagnose, treat and obtain new treatment regimen. Early complete surgical resection is an effective treatment. For advanced cancer, clinical trials of new drugs are expected to improve the survival of patients.

Small cell lung cancer carries the worst prognosis among lung cancer. The current guidelines only recommend surgical treatment for patients in the Ⅰ-ⅡA stage, but surgical treatment is often in a neglected position in clinical practice. More and more recent studies have focused on this aspect. This article reviews the recent research literatures and reviews the progress of surgery in the multidisciplinary treatment of small cell lung cancer.