1.Invasiveness assessment by CT quantitative and qualitative features of lung cancers manifesting ground-glass nodules in 555 patients: A retrospective cohort study
Yantao YANG ; Wei WANG ; Yichen YANG ; Biying WANG ; Huilian HU ; Ziqi JIANG ; Dezhong CAI ; Yaowu DUAN ; Jiezhi JIANG ; Jia LUO ; Guangqiang ZHAO ; Yunchao HUANG ; Lianhua YE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(01):51-58
Objective To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.
2.Advances in the Study of Invasive Non-mucinous Adenocarcinoma with Different Pathological Subtypes.
Ruke TANG ; Lina BI ; Bingquan XIANG ; Lianhua YE ; Ying CHEN ; Guangjian LI ; Guangqiang ZHAO ; Yunchao HUANG
Chinese Journal of Lung Cancer 2023;26(1):22-30
Lung cancer is the leading cause of cancer death in the world today, and adenocarcinoma is the most common histopathological type of lung cancer. In May 2021, World Health Organization (WHO) released the 5th edition of the WHO classification of thoracic tumors, which classifies invasive non-mucinous adenocarcinoma (INMA) into lepidic adenocarcinoma, acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma, and micropapillary adenocarcinoma based on its histological characteristics. These five pathological subtypes differ in clinical features, treatment and prognosis. A complete understanding of the characteristics of these subtypes is essential for the clinical diagnosis, treatment options, and prognosis predictions of patients with lung adenocarcinoma, including recurrence and progression. This article will review the grading system, morphology, imaging prediction, lymph node metastasis, surgery, chemotherapy, targeted therapy and immunotherapy of different pathological subtypes of INMA.
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Humans
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Lung Neoplasms/pathology*
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Adenocarcinoma of Lung/pathology*
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Adenocarcinoma/pathology*
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Prognosis
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Lymphatic Metastasis
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Neoplasm Staging
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Retrospective Studies
3.Research progress on the correlation between imaging characteristics and pathological invasion degree of early lung adenocarcinoma
Yantao YANG ; Yunchao HUANG ; Guangqiang ZHAO ; Lianhua YE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(09):1337-1343
With the development of multi-slice spiral computed tomography (CT) technology and the popularization of low-dose spiral CT screening, more and more adenocarcinomas presenting ground-glass nodule (GGN) are found. Pathological invasiveness is one of the important factors affecting the choice of treatment strategy and prognosis of patients with early lung adenocarcinoma. Imaging features have attracted wide attention due to their unique advantages in predicting the pathologic invasiveness of early lung adenocarcinoma. The imaging characteristics of GGN can be used to predict the pathologic invasiveness of lung adenocarcinoma and provide evidence for clinical decisions. However, the imaging parameters and numerical values for predicting pathologic invasiveness are still controversial, which will be reviewed in this paper.
4.Recent Advances in Diagnosis and Treatment Strategies for Multiple Primary Lung Cancer.
Bangsheng LI ; Zhenghong YANG ; Yingding ZHAO ; Ying CHEN ; Yunchao HUANG
Chinese Journal of Lung Cancer 2023;26(11):863-873
As the utilization of computed tomography in lung cancer screening becomes more prevalent in the post-pandemic era, the incidence of multiple primary lung cancer (MPLC) has surged in various countries and regions. Despite the continued application of advanced histologic and sequencing technologies in this research field, the differentiation between MPLC and intrapulmonary metastasis (IM) remains challenging. In recent years, the specific mechanisms of genetic and environmental factors in MPLC have gradually come to light. Lobectomy still predominates in the treatment of MPLC, but the observation that tumor-specific sublobar resection has not detrimentally impacted survival appears to be a viable option. With the evolution of paradigms, the amalgamated treatment, primarily surgical, is an emerging trend. Among these, stereotactic ablative radiotherapy (SABR) and lung ablation techniques have emerged as efficacious treatments for early unresectable tumors and control of residual lesions. Furthermore, targeted therapies for driver-positive mutations and immunotherapy have demonstrated promising outcomes in the postoperative adjuvant phase. In this manuscript, we intend to provide an overview of the management of MPLC based on the latest discoveries.
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Humans
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Lung Neoplasms/therapy*
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Early Detection of Cancer
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Lung/surgery*
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Treatment Outcome
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Radiosurgery/methods*
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Neoplasms, Multiple Primary/pathology*
5.Research Progress of Indole in E.coli Biofilms on the Surface of Biomaterials
Danyan SU ; Wentian TANG ; Jinxu YANG ; Hua LIU ; Bangsheng LI ; Yingding ZHAO ; Yunchao HUANG
Journal of Kunming Medical University 2023;44(12):184-190
Escherichia coli is a highly adaptable opportunistic pathogen bacterium that can form biofilms on the surface of implants and generates persistent cells,leading to life-threatening infections that are difficult to treat with antibiotics alone.Therefore,there is a need for an effective E.coli biofilm inhibitor to combat this public health threat.Indole is a novel quorum-sensing signaling molecule of E.coli discovered in recent years,which is of great significance in regulating bacterial growth and biofilm formation,and is a potential target for future research on new anti-biofilm preparations.This article reviews the research progress on the formation of Escherichia coli biofilms,the microbial metabolism of indole and its regulation of Escherichia coli biofilm formation,in order to provide information for clinical treatment and drug development.
6.Interaction between obesity/central obesity and hypertension
Liangliang WANG ; Yu HUANG ; Wei GUO ; Xingmin WEI ; Ning FAN ; Guixue ZHAO ; Yahui XIE ; Dongjing MA ; Yunchao WANG ; Xinhua WANG ; Jianjun WU
Journal of Preventive Medicine 2022;34(2):129-134
Objective:
To examine the effects of obesity and central obesity on hypertension, so as to provide insights into the prevention and control measures of hypertension.
Methods:
From September to December 2018, residents at ages of 35 to 75 years were sampled using the multi-stage random sampling method in Baiyin District, Baiyin City, Gansu Province, and subjected to questionnaire surveys and physical examinations. The interaction between obesity/central obesity and hypertension was evaluated using logistic regression analysis. The synergy index ( SI ), relative excess risk due to interaction ( RERI ) and attributable proportion due to interaction ( AP ) were calculated using Excel compiled by Andersson et al.
Results:
A total of 6 246 questionnaires were allocated and 6 169 valid questionnaires were recovered, with an effective recovery rate of 98.77%. The respondents included 3 038 men ( 49.25% ) and 3 131 women (50.75%), with a mean age of ( 52.05±8.78 ) years. There were 832 respondents with obesity ( 13.49% ) and 2 278 with central obesity ( 36.93% ). The crude and standardized prevalence rates of hypertension were 35.89% and 33.05%, respectively. Multivariable logistic regression analysis showed that obesity ( OR=2.020, 95%CI: 1.705-2.393 ) and central obesity ( OR=1.622, 95%CI: 1.433-1.836 ) were statistically associated with hypertension. There was no multiplicative interaction between obesity or central obesity and hypertension ( OR=1.011, 95%CI: 0.655-1.560 ), and no additive interaction was detected between obesity or central obesityand hypertension ( SI=1.405, 95%CI: 0.815-2.424; RERI=0.658, 95%CI: -0.298 to 1.614; AP=0.201, 95%CI: -0.075 to 0.476 ).
Conclusions
Obesity and central obesity increase the risk of hypertension; however, no interaction is detected between obesity or central obesity and hypertension.
7.Research progress in diagnosis and treatment of multiple primary lung cancer
Qinling SUN ; Yunchao HUANG ; Guangqiang ZHAO ; Lianhua YE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(01):127-132
With the changes in the disease spectrum and the advancement of examination technology, the detection rate of multiple primary lung cancers (MPLC) is gradually increasing when multiple nodules and masses in the lung are examined clinically. MPLC has significant distinction with other types of lung diseases or lung cancers in the treatment and prognosis. In most cases, patients would be recommended to undergo the surgery as soon as possible which means that the accurate diagnosis should be made before surgery or during treatment. The newly developed molecular and genomic methods are more likely to better determine the relationship between multiple lesions. Artificial intelligence can be used as a related diagnostic aid to show more accurate and objective results in the diagnosis of multiple pulmonary nodules. This review summarizes the latest MPLC diagnostic research (including pathological analysis, imaging), analyzes surgical treatment methods, and looks forward to the future research direction of MPLC diagnosis and treatment, in order to provide reference for MPLC research.
8.Research progress of anatomical segmentectomy in the treatment of early non-small cell lung cancer
Zhuochen SUN ; Yunchao HUANG ; Guangqiang ZHAO ; Xuancheng LI ; Shouzhuo LI ; Yuandong SUO ; Di MENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(10):1384-1389
Lung cancer, as one of the malignant tumors with the fastest increasing morbidity and mortality in the world, has a serious impact on people's health. With the continuous advancement of medical technology, more and more medical methods are applied to lung cancer screening, which has gradually increased the detection rate of early lung cancer. At present, the standard operation for the treatment of early non-small cell lung cancer (NSCLC) is still lobectomy and mediastinal lymph node dissection. There is a growing trend to use segmentectomy for the treatment of early stage lung cancer. Anatomical segmentectomy not only removes the lesions to the maximum extent, but also preserves the lung function to the greatest extent, and its advantages are also obvious. This article reviews the progress of anatomical segmentectomy in the treatment of early NSCLC.
9.dbDEMC 3.0:Functional Exploration of Differentially Expressed miRNAs in Cancers of Human and Model Organisms
Xu FENG ; Wang YIFAN ; Ling YUNCHAO ; Zhou CHENFEN ; Wang HAIZHOU ; E.Teschendorff ANDREW ; Zhao YI ; Zhao HAITAO ; He YUNGANG ; Zhang GUOQING ; Yang ZHEN
Genomics, Proteomics & Bioinformatics 2022;20(3):446-454
MicroRNAs(miRNAs)are important regulators in gene expression.The dysregulation of miRNA expression is widely reported in the transformation from physiological to pathological states of cells.A large number of differentially expressed miRNAs(DEMs)have been identified in various human cancers by using high-throughput technologies,such as microarray and miRNA-seq.Through mining of published studies with high-throughput experiment information,the data-base of DEMs in human cancers(dbDEMC)was constructed with the aim of providing a systematic resource for the storage and query of the DEMs.Here we report an update of the dbDEMC to version 3.0,which contains two-fold more data entries than the second version and now includes also data from mice and rats.The dbDEMC 3.0 contains 3268 unique DEMs in 40 different cancer types.The current datasets for differential expression analysis have expanded to 9 generalized cat-egories.Moreover,the current release integrates functional annotations of DEMs obtained by using experimentally validated targets.The annotations can be of great benefit to the intensive analysis of the roles of DEMs in cancer.In summary,dbDEMC 3.0 provides a valuable resource for charac-terizing molecular functions and regulatory mechanisms of DEMs in human cancers.
10.Progress in Survival Prognosis of Segmentectomy for Early-stage Non-small Cell Lung Cancer.
Sunyin RAO ; Lianhua YE ; Xin CUI ; Qinling SUN ; Run CAO ; Shouyong XIAO ; Jichen YANG ; Wei WANG ; Guangqiang ZHAO ; Yunchao HUANG
Chinese Journal of Lung Cancer 2020;23(9):830-836
Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy.
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