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.

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.

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 ; Lung Neoplasms/pathology* ; Adenocarcinoma of Lung/pathology* ; Adenocarcinoma/pathology* ; Prognosis ; Lymphatic Metastasis ; Neoplasm Staging ; Retrospective Studies

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.

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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Objective To investigate the correlation between patients clinical characteristics and the number and subtype of circulating tumor cells (CTCs) from peripheral blood of perioperative hepatocellular carcinoma (HCC)patients by SE-iFISH.Methods 20 HCC patients undergoing radical resection were enrolled from June 2015 to June 2016.The SE-iFISH technique was used to separate and identify circulating tumor cells.The pathology and clinical data were used to evaluate patients survival in combination with CTCs characteristics.Results A total of 347 CTCs were detected,of which 114 were triploid,64 were tetraploid,and 165 were pentaploid.The number of preoperative CTCs and the number of preoperative triploids was significantly correlated with the presence of vascular tumor emboli (Z1 =-2.080,P =0.037,Z3 =-2.321,P =0.020) and TNM staging(Z2 =-2.148,P =0.032,Z4 =-2.526,P =0.012).Postoperative patients disease-free survival in high CTCs detection group was significantly shorter than that of CTCs low expression group (x2 1 =7.486,P =0.006,x22 =12.056,P =0.001).Conclusion Detection of the number and the specific subtypes of CTCs with SE-iFISH strategy in patients with HCC help predict treatment efficacy and prognosis.

Objective To evaluate the relationship between quartz's deposit and expression of NF-κB in non-small cell lung cancer (NSCLC) lung tissues in Xuanwei, Yunnan Province, and to clarify the role of quartz in Xuanwei NSCLC's carcinogenic mechanism. Methods As research objects, the lung tissues of NSCLC and lung benign lesions after surgical resection were collected from July 2009 to September 2015 at the Third Affiliated Hospital of Kunming Medical University. Firstly, the transmission electron microscopic (TEM) with energy dispersive X-ray analyzer (EDS) was used for observation of crystalline deposit and local pathological changes. Secondly, expression level of NF-κB had been analysed and a correlation analysis with particle size of SiO2 crystal in the same lung sample was made. Results The occurrence rates of quartz in Xuanwei NSCLC lung tissues were above non-Xuanwei NSCLC and benign lung tissues (P<0.01);the average particle size of SiO2 crystal was (226 ± 120) nm × (237 ± 163) nm in Xuanwei NSCLC group and it was smaller than the other two groups; In Xuanwei NSCLC group, the expression level of NF-κB was significantly higher than non-Xuanwei and benign lung tissues (P< 0.01), but there was no significant difference between cancer tissues and normal lung tissues in the group (P>0.05). The expression level of NF-κB was generally increasing when quartz 's size became smaller. Conclusion Quartz 's deposit may play a certain role in carcinogenic mechanism of lung cancer in Xuanwei, the smaller the particle size, the greater the cytotoxicity.

Xuanwei district in Yunnan Province of China has pretty high incidence of lung cancer in China, even a- round the world. Studies have shown that there exists a close relationship between lung cancer and local indoor air pollution caused by Bituminous coal. Considering that the indoor air pollution in Xuanwei District is caused by "open fireplace", an indoor air pollution simulation system was designed, and an F344 rats lung damage model was estab- lished for this indoor air pollution fireplace. The model is based on indoor air pollution simulation system with signal multiplexer control and multi-channel acquisition, and mining PID algorithm was used for polynomial fitting to each test point, and a relatively constant PM2. 5 air pollution status was simulated. The results showed that the system could simulate a variety of states of air pollution, provide a new test method for evaluation of human injury caused by indoor air pollution and a new idea for the study of the incidence of lung cancer in Xuanwei district and other places.
Air Pollution, Indoor ; analysis ; Animals ; China ; Coal ; adverse effects ; Humans ; Incidence ; Lung ; drug effects ; pathology ; Lung Neoplasms ; epidemiology ; Models, Biological ; Particulate Matter ; analysis ; Rats ; Rats, Inbred F344

Objective To establish a HPLC method for determination of naringenin and apigenin in Premna fulva. Methods The SHISEIDO￣SPOLAR C18(250 mm×4.6 mm,5μm) was used as analytical column.The mobile phase consisted of methanol￣0.2% phosphoric acid (42:58) with isocratic elution at a flow rate of 1.0 mL.min-1 .The detection wavelength of naringenin and apigenin was 288 nm and 340 nm, respectively.Column temperature was set at 35 ℃ , the injection Volume was 10 μL. Results Naringenin and apigenin had a good linear relationship in the concentration range of 0.180 ~ 3.60 μg (r =0.999 9) and 0. 0052 ~ 0. 1040 μg ( r = 0. 999 9), respectively. Conclusion The method is accurate and reliable. It is appropriate for the quantitative determination of naringenin and apigenin in Premna fulva and its preparations.

Background and objectivehTe high incidence of lung cancer in Xuanwei, China, has become an im-portant restricting factor for livelihood development, thus exerting local social and economic impacts. Coal is the main fuel of the local community and also the main source of indoor pollution. hTis study aims to explore the coal combustion inhalable ifne particulate matter (PM2.5) and its component output differences in different areas of Xuanwei, Yunnan. Moreover, the aim of this study is to investigate the relationship between inhalation of ifne particles and high incidence of local lung cancer.Meth-odsFor combustion test, coal mines designated as C1, K7 and M30 were collected from LaoLin Colliery of Laibing Town, Huchang Colliery of Baoshan Town, and Taiping Colliery of Wenxing Town in Xuanwei, respectively. PM2.5 of indoor air was weighed, analyzed for elemental composition, and morphologically compared. hTe pathological specimen of lung cancer pa-tients in Xuanwei who underwent operation was observed through electron microscope.Results hTe PM2.5 concentrations in indoor air were (8.244 ±1.460) mg/m3 (C1), (5.066±0.984) mg/m3 (K7), and (5.071±1.460) mg/m3 (M30). hTe differences among pairwise comparisons were statistically signiifcant (P=0.029). hTe iflter impurities of C1 coal seam primarily includeSi- and O-enriched compounds. Moreover, three membranes that comprised other elements, including C, S, and Si, were ob-served. hTese membranes were evident from the aggregation of silica and a Ca-Al membrane. Compared with that of other coal seams, C1 coal generated a mass of impurities, in which several particles have irregular shape. We found nanoscale ifne particles in some specimens of Xuanwei lung cancer patients.ConclusionhTe produced combustion of C1 coal was different from that of K7 and M30 coal. PM2.5 composition may be associated with the high local incidence of lung cancer.