Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs'effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.We compared outcomes and side effects between patients with and without prior TB.Of 116 patients(40 with TB history,76 without),prior TB didn't reduce treatment effectiveness but did increase severe side effects.Notably,older patients(≥65 years)faced a higher risk of severe side effects.Detailed cases of two patients with severe side effects underscored TB as a risk factor in lung cancer patients receiving ICIs,stressing the need for careful monitoring and personalized care.

Objective To retrospectively analyze the clinical data of 47 young NSCLC patients mutation style of EGFR and PD-L1 expression in tumor cells, to understand their clinicopathological and molecular characteristics. Methods We enrolled 47 young (≤40 years old) patients confirmed as NSCLC who underwent surgical resection, and 94 old patients (≥60 years old) were matched as 1:2 by R language. EGFR mutation status was detected by ARMS-PCR, and the expression of PD-L1 was detected by immunohistochemistry. Results The median age of 47 young patients with NSCLC was 37 years old. The disease was more common in women and the majority type was adenocarcinoma. In youth group, the 19del and 20ins were more frequent, but the exon 21 L858R point mutation proportion was higher in elder group. The expression of PD-L1 was significantly increased in the solid predominant histological subtype. The PD-L1 expression in 19del patients was higher than that in the patients with L858R mutation in youth group. Conclusion The majority of young NSCLC patients are female, nonsmokers and suffered from adenocarcinoma cancer. The proportion of EGFR alteration in 19del and 20ins in youth group is higher than that in elder group. The positive rate of PD-L1 expression in solid predominant histological subtype is higher than that with other subtypes. The expression of PD-L1 in young patients with EGFR 19del is higher than that with L858R.

BACKGROUND: Small cell lung cancer (SCLC) is a highly aggressive malignancy characterized by rapid growth, early metastasis and acquired therapeutic resistance, and the prognosis is extremely poor. Studies have proved that the stem cell marker CD44 is correlated with tumor recurrence and treatment resistance, however, there are limited reports yet concerning on the CD44 expression and its clinical prognostic significance in SCLC patients. The purpose of this study is to investigate the expression of CD44 in tumor tissues as well as serum of SCLC patients and explore its correlation with the clinical characteristics, therapeutic effect and prognosis. METHODS: The tumor tissues and serum samples of 47 newly diagnosed SCLC patients were collected. Immunohistochemistry and enzyme-linked immunosorbent assay were applied to detect CD44. The relationship between CD44 level and the clinical characteristics as well as prognosis of the patients was analyzed. RESULTS: The stem cell marker CD44 was detectable both in serum sample and tumor tissue of SCLC patients. The positive rate of CD44 in tumor tissue was significantly higher in patients with performance status (PS) 2 than that of patients with PS 0-1 (85.71% vs 30%, P=0.017). Patients were divided in to different groups according to the treatment efficacy. The CD44 immunohistochemical score and serum level in the disease progression group were significantly higher than those in the disease control group, and the differences were statistically significant (P=0.006, P=0.034), Univariate analysis depicted that the progression-free survival (PFS) of CD44 positive patients was significantly shorter than that of CD44 negative patients (5.23 mon vs 9.03 mon, P=0.036). CONCLUSIONS The positive expression of CD44 in tumor tissues of pre-treatment SCLC patients is correlated with poor PFS. The clinical significance of CD44 is worthy to be further studied.

BACKGROUND: In recent years, a number of clinical trials have shown that immunocheckpoint inhibitors (ICI) have brought survival benefits to patients with advanced non-small cell lung cancer (NSCLC), however, such clinical trials comprise cohorts selected based on strict and complex entry and exclusion criteria, and the results cannot fully reflect the real world situation. The purpose of this study was to investigate the clinical efficacy and safety of immunotherapy in the real world, as well as possible prognostic factors. METHODS: Patients with advanced NSCLC receiving immunotherapy in Beijing Chest Hospital from January 2017 to July 2019 were retrospectively collected, and the following information were collected: curative effect, progression-free surival (PFS) and adverse reactions. The occurrence of adverse reactions and clinical curative effect and prognosis factors that may be relevant were explored. RESULTS: 34 patients were enrolled in this study, median PFS was 5.66 months (95%CI: 4.48-6.84), grade 1-2 and 3-4 incidence of adverse events was 61.71% (22/34) and 14.71% (5/34), there were 3 patients (8.82%) experienced fatal immune related adverse events (irAE), 2 cases were immune associated pneumonia, 1 case was immune related myocarditis. Univariate analysis showed that tumor-node-metastasis (TNM) stage and metastatic site were correlated with median PFS (P<0.05), and multivariate analysis showed that patients with extrapulmonary metastasis (OR=6.42, P=0.029) and pleural metastasis (OR=14.14, P=0.006) had shorter median PFS. CONCLUSIONS In the real world, immunotherapy has good efficacy in patients with advanced NSCLC, but the incidence of severe irAE is also higher. Distant metastasis and pleural metastasis are poor prognostic factors for advanced NSCLC patients receiving immunotherapy.

Objective To explore the relationship between plasma adiponectin, visfatin, leptin, and resistin levels, and the onset of colonic polyps in prediabetes subjects. Methods A total of 468 prediabetes subjects, who received colonoscopy examination, were enrolled in this study, including 248 cases of colon polyps (polyps group with prediabetes) and 220 cases without colonic mucosal lesions ( polyps-free group with prediabetes). According to the clinical characteristics of colonic polyps, colonic polyps patients with prediabetes were subdivided into single polyp group, multiple polyps group, low-risk polyps group, and high-risk polyps group, respectively. In addition, 108 subjects with normal glucose tolerance, who were matched with prediabetes subjects on gender and age, were selected as control group, and 46 cases of them were refered to polyps group with normal glucose tolerance and 62 cases were refered to polyps-free group with normal glucose. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all subjects, and related risk factors of colonic polyps in prediabetes patients were analyzed. Results Not only in normal glucose tolerance subjects, but also in prediabetes subjects, plasma visfatin levels in polyps group were significantly higher than those in polyps-free group (P＜0.05), and plasma adiponectin levels were significantly lower than those in polyps-free group [normal glucose tolerance (9.8±4.8 vs 13.3±3.9)mg/L, P＜0.05; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4)mg/L, P＜0.01], respectively. However, no significant difference in the plasma leptin and resistin levels were observed between polyps-free group and polyps group ( both P＞0. 05), respectively. In addition, in prediabetes subjects, plasma visfatin levels increased (P＜0.05) and adiponectin levels decreased significantly [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P＜0.05] in multiple polyps group than in single polyp group. Nevertheless, there were no significant differences in plasma leptin and resistin levels between two groups (both P＞0.05). Moreover, plasma adiponectin levels decreased significantly in high-risk polyps group with prediabetes than in low-risk polyps group with prediabetes[(3.7±2.9vs7.4±3.5)mg/L,P＜0.05].Meanwhile,noneofplasmavisfatin,leptin,andresistinlevels had shown significant difference between two groups (all P＞0.05). The multivariate logistic regression analysis found that adiponectin was an independent protective factor for colon polyps, multiple colon polyps and high-risk colon polyps. Conclusion The changes of plasma adiponectin levels might be associated with onset of colonic polyps in prediabetes.

Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .

Humans ; Lung Neoplasms ; Pulmonary Blastoma

Background and objectiveEpidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the standard ifrst-line treatment regimen forEGFR mutated non-small cell lung cancer (NSCLC) patients. However, the ef-ifcacy of EGFR-TKIs widely varies. hTe aim of this study is to determine whether the pretreatment serum cytokeratin-19 frag-ments (CYFAR21-1) and carcinoembryonic antigen (CEA) are associated with the effcacy of EGFR-TKIs inEGFR-mutated NSCLC patients.MethodsWe retrospectively enrolled 194 NSCLC patients harboringEGFR mutations who received EGFR-TKIs. Clinical characteristics were collected, and the relation between the effcacy of EGFR-TKIs and pretreatment serum CYFAR21-1 and CEA was analyzed.Results In all cases, progression-free survival (PFS) in patients with high CYFAR21-1 level was signiifcantly shorter than PFS in patients with normal CYFAR21-1 (7.0vs 11.9 months,P<0.001). Overall survival (OS) in patients with high CYFAR21-1 was signiifcantly shorter than in the normal-CYFAR21-1 group (12.6vs28.0 months, P<0.001). In adenocarcinoma patients, PFS in the high-CYFAR21-1 level group was signiifcantly shorter than in patients with normal CYFAR21-1 (7.0vs 12.0 months,P<0.001). OS in patients with high CYFAR21-1 was signiifcantly shorter than that in the normal-CYFAR21-1 group (13.1vs 28.1 months,P<0.001). Among squamous carcinoma patients, CYFAR21-1 level did not affect survival. No signiifcant difference in PFS and OS was observed between patients with high CEA and patients with normal CEA.ConclusionEGFR-mutated patients with high CYFAR21-1 had signiifcantly shorter PFS and OS than patients with normal CYFAR21-1 atfer receiving EGFR-TKIs. Pretreatment serum CYFR21-1 level was a predictive marker of EGFR-TKI treatment inEGFR-mutated NSCLC patients.

Objective To investigate impact of nursing intervention on medication compliance in lung transplant patients.Methods A total of 46 lung transplant patients from April 2011 to December 2013 were divided into the experimental group(n =23) and the control group (n =23) by operation order.The control group received routine care,while on the basis of it,the experimental group received nursing intervention based on the result of blood concentration.Results The medication adherence after 6 months of the operation between the two groups had no significant differences (P ＞0.05).After 12 months of intervention,21 patients (91.30％) in the experimental group complied with the medication,18 patients (78.26％) in the control group complied with the medication.There was significant difference between the two groups (x2 =8.641,P ＜ 0.05).The blood concentrations after 6 months of the operation between the two groups had no significant differences (P ＞ 0.05).After 12 months,the blood concentrations of the experimental group was (13.15 ± 3.14) ng/L,which was significantly higher than that of the control group (t =7.658,P ＜ 0.05).Conclusions Nursing intervention can effectively improve medication compliance of lung transplant patients.Establishing a good nurse-patient relationship,strengthening health education,doing repeated training and condition changes of patients is the key point to improve medication compliance of lung transplant patients.

Objective To explore the impact of medication self-management module on medication compliance of patients after lung transplantation.Methods Totals of 48 patients were divided into experimental group ( n=24 ) and control group ( n =24 ) .The control group received conventional treatment and nursing care.The experimental group received medication self-management module on the basis of conventional treatment and nursing care.Results Compared the two groups after 12 months, medication compliance of experimental group was 87.50%, and that of control group was 79.17%, significant difference was found between two groups (χ2 =8.641,P<0.05).Blood drug concentration and 6MWT of experimental group was (10.78 ± 2.61)ng/L and (324.15 ±23.91) m,respectively, higher than that in control group (8.64 ±2.03) ng/L and (291.58 ±20.84) m, and the differences between the two groups were statistically significant ( t=8.143,7.852, respectively;P<0.05).Conclusions Medication self-management module can solve the patient’ s medication problem and improve the compliance of lung transplant patients,so it is suitable for clinical application.