Objective To evaluate the association between the Thr241Met polymorphism in the XRCC3 gene and the risk of lung cancer in Chinese population by meta-analysis. Methods Databases including PubMed, EMbase, CNKI, VIP and WanFang Data were searched to identify domestic and foreign case-control studies concerning the association between Thr241Met polymorphism in XRCC3 gene and the risk of lung cancer in Chinese population from the inception to August 20th, 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and assessed quality. Then meta-analysis was performed using RevMan 5.0 software and Stata 10.0 software. Results A total of 5 case-control studies involved 2 999 lung cancer cases and 2 994 controls were included. The results of meta-analysis showed that, Chinese population who carry the variant genotype or allele had no increased risk of lung cancer: Met/Met vs. Thr/Thr: OR=1.00, 95%CI (0.38, 2.59), P=0.99; Met/Met vs. Thr/Met: OR=1.06, 95%CI (0.83, 1.36), P=0.63; Met/Met vs. Thr/Met+Thr/Thr: OR=0.99, 95%CI (0.38, 2.57), P=0.98; Thr/Met+Met/Met vs. Thr/Thr: OR=1.06, 95%CI (0.82, 1.37), P=0.65; Met vs. Thr: OR=1.05, 95%CI (0.82, 1.35), P=0.68. Conclusion Currently, Thr241Met polymorphism in the XRCC3 gene is not found to be associated with the risk of lung cancer in Chinese population. Considering the limited quality of the included case-control studies, more high quality studies with large sample size are needed to verify the above conclusion.
Objective To evaluate whether the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer” met the standards set in the STARD statement. Methods Based on each of the 25 items of STAndards for the Reporting of Diagnostic accuracy studies (STARD statement), the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer” was checked and evaluated. Results In the paper titled “Application of tumor type M2 pyruvate kinase in the diagnosis of lung cancer”, the reporting of 1 item of the STARD statement was adequately standardized, 7 items were relatively standardized, 5 items were inadequately standardized, 2 items were not standardized, and the other 10 were not reported. Conclusion Generally speaking, the reporting of diagnostic accuracy studies has not been standardized adequately in China. The methodological quality and applicability of diagnostic accuracy studies should be improved.
Objective An animal model of lung cancer was established to study whether wasabi could inhibit the expression of hnRNP A2/B1 in lung.Methods Thirty-six Wistar rats were randomly divided as model group and wasabi group.0.1 mL of arcinogenic iodized oil [50 mg 3-methylcholanthrene (MCA) in 1 mL carcinogenic iodized oil] were instilled intratracheally to induce lung cancer.A week before instillation of MCA，the wasabi group was orally administered wasabi extract solution until the animals were killed while the model group was given isometric saline at the same time.Six rats in each group were randomly killed on 30th day，60th day and 90th day.Immunohistochemisty and RT-PCR were used to measure the protein and mRNA expression of hnRNP A2/B1，respectively.Results Wasabi lowered the protein expression of hnRNP A2/B1 with a total inhibitory rate of 48.5%.At the 30th，60th and 90th day，the inhibitory rate was 51.0%，51.0% and 45.1% respectively.Meanwhile，wasabi lowered the mRNA expression of hnRNP A2/B1 with a total inhibitory rate of 60.5%.At the 60th and 90th day，the inhibitory rate was 79.5% and 58.0%，respectively.Conclusion Wasabi solution can down-regulate the expression of hnRNP A2/B1 which may be a molecular mechanisms by which wasabi inhibits lung cancer.
Objective To investigate the value of tumor type M2 pyruvate kinase ( M2-PK) in the differential diagnosis of pleural effusion. Methods A total of 146 patients with pleural effusion during January 2006 to December 2008 were recruited at the department of respiratory medicine of the Shantou Affiliated Hospital and the First Affiliated Hospital of Sun Yat-sen Medical College. Pleural effusion was malignant in 72 cases ( 52 cases with lung cancer and 20 cases with metastatic lung cancer) and benign in 74 cases ( 54 cases with infective pleural effusion and 20 with transudation effusion) . The patients were divided into a malignant pleural effusion group, an infective pleural effusion group, and a transudation group.Then the infective group was further divided into subgroups of tuberculosis pleural effusion group andparapneumonic effusion group. The concentration of tumor M2-PK in pleural fluid obtained during the first thoracocentesis was measured by enzyme-linked immunosorbent assay( ELISA) . Results The concentration of tumor M2-PK was significantly higher in the malignant pleural effusion group compared with the benignpleural effusion groups ( P lt; 0. 01) . Significant differences were also found in the concentration of tumor M2-PK between malignant pleural effusion caused by lung cancer and metastatic lung cancer( P lt; 0. 05) .When the cutoff value of tumor M2-PK was set at 18. 68 U/mL, the sensitivity, specificity, and accuracy for the diagnosis of malignant pleural effusion was 87. 6% , 86. 0% , and 87. 4%, respectively. Furthermore,the detection of tumor M2-PK in combination with CEA showed better diagnostic sensitivity( 96. 0% ) ,specificity ( 85. 0% ) , and accuracy ( 91. 1% ) . Conclusions The detection of tumor M2-PK in pleural effusion is of some clinical significance in the differential diagnosis of benign and malignant pleural effusion.The detection of tumor M2-PK in combination with CEA is a good diagnostic tool with high sensitivity andspecificity.
Objective Non-small cell lung cancer ( NSCLC) cells are relatively resistant to chemotherapy, and the outcomes are not always satisfactory. This study was designed to explore the relationship between the content of Ku80 protein of human lung cancer cells and their sensitivity to cisplatin.Methods The lung cancer cells isolated frommalignant pleural effusion samples frompatients with primary lung cancer were cultured in vitro. The sensitivity to cisplatin was tested with the method of CCK-8 expressed as half maximal inhibitory concentration ( IC50 ) . The relative content of Ku80 protein was determined by Western blot. The correlation between sensitivity to cisplatin of lung cancer cells and the relative content of Ku80 protein was analyzed. Results The IC50 of NSCLC group was significantly higher than that of SCLCgroup [ ( 4. 40 ±3. 39) mg/L vs. ( 1. 02 ±0. 54) mg/L, P lt; 0. 001] . The relative content of Ku80 protein of NSCLC group was statistically higher than that of SCLC group [ ( 0. 80 ±0. 45) vs. ( 0. 48 ±0. 25) , P lt;0. 05] . The correlation coefficient between content of Ku80 protein and IC50 was 0. 618 ( P lt; 0. 001) .Conclusions The content of Ku80 protein of NSCLC patients is higher than that of SCLC patients. Itmay be one of the mechanisms contributing to chemotherapeutic resistance of NSCLC. There is a negative relationship between Ku80 protein content of cancer cells and their sensitivity to cisplatin suggesting that the content of Ku80 protein may be served as a candidate index for predicting sensitivity of lung cancer cells to cisplatin.
Objective To analyze the imaging features of solitary pulmonary nodules ( SPNs) , and compare the two types of lung cancer prediction models in distinguishing malignancy of SPNs.Methods A retrospective study was performed on the patients admitted to Ruijin Hospital between 2002 and 2009 with newly discovered SPNs. The patients all received pathological diagnosis. The clinical and imaging characteristics were analyzed. Then the diagnostic accuracy of two lung cancer prediction models for distinguishing malignancy of SPNs was evaluated and compared.Results A total of 90 patients were enrolled, of which 32 cases were with benign SPNs, 58 cases were with malignant SPNs. The SPNs could be identified between benign and maligant by the SPN edge features of lobulation ( P lt;0. 05) . The area under ROC curve of VA model was 0. 712 ( 95% CI 0. 606 to 0. 821) . The area under ROC curve of Mayo Clinic model was 0. 753 ( 95% CI 0. 652 to 0. 843) , which was superior to VA model. Conclusions It is meaningful for the identification of benign and maligant SPNs by the obulation sign in CT scan. We can integrate the clinical features and the lung cancer predicting models to guide clinical work.
Objective To investigate the impact of complete video-assisted thoracoscopic lobectomy and open lobectomy on perioperative heart rate （HR） and blood oxygen saturation （SO2） of lung cancer patients，and explore whether minimally invasive surgery can enhance postoperative recovery of lung cancer patients. Methods A total of 138 lung cancer patients were chosen from 161 consecutive patients with pulmonary diseases who were admitted to West China Hospital of Sichuan University between September 2010 and December 2011. According to different surgical approach，all the 138 lung cancer patients were divided into routine thoracotomy group （thoracotomy group，70 patients including 53 males and 17 females with their average age of 56.1±9.7 years） and complete video-assisted thoracoscopic lobectomy group （VATS group，68 patients including 46 males and 22 females with their average age of 53.4±6.5 years）. There was no statistical difference in preoperative clinical characteristics between the 2 groups. Preoperative and postoperative （1st，3rd，7th and 30th day） numeric pain rating scale （NPRS），HR and SO2 were compared between the 2 groups. Results （1） There was no statistical difference in NPRS on the 1st and 3rd postoperative day between the 2 groups （3.83±0.79 vs. 3.93±0.67， 2.88±0.59 vs. 3.03±0.71，P＞0.05），but on the 7th and 30th postoperative day，NPRS of the thoracotomy group was signi- ficantly higher than that of VAST group （1.61±0.33 vs. 1.22±0.12，1.58±0.26 vs. 1.19±0.31，P＜0.05）. （2） Postop- erative sedentary HR of both VATS group and thoracotomy group were significantly higher than preoperative levels ［（84.13±17.21） / minute vs. （73.67±10.32）/minute， （86.13 ±19.67） / minute vs. （72.24±14.21） / minute， P＜0.05］. Postoperative HR of VATS group decreased to preoperative level on the 3rd postoperative day，while postoperative HR of the thoracotomy group decreased to preoperative level on the 7th postoperative day. （3） There was no statistical difference between preoperative and postoperative （all the time points） sedentary SO2 of both VATS group and thoracotomy group （96.34 %±2.11% vs. 97.12%±2.31%，95.33%±4.13% vs. 94.93% ±4.31%，P＞0.05）.（4） The changes of HR and SO2 before and after exercise of VATS group were significantly smaller than those of the thoracotomy group on the 3rd postoperative day ［（11.11±4.81）/minute vs. （18.23±6.17）/minute，3.1%±1.2% vs. 7.4 %±2.7%，P＜0.05］ . Conclusion The impact of complete video-assisted thoracoscopic lobectomy on cardiopulmonary function is comparatively smaller，which is helpful for postoperative fast-track recovery of lung cancer patients.
Abstract： Objective To evaluate the safety and efficacy of total thoracoscopic anatomic pulmonary segmentectomy for the treatment of early-stage peripheral lung carcinoma, pulmonary metastases and benign pulmonary diseases. Methods We retrospectively analyzed 20 patients who received total thoracoscopic anatomic pulmonary segmentectomy in Zhongshan Hospital of Fudan University from March 2008 to November 2011. There were ten male and ten female patients with a mean age of 58.0（14-86）years. Three ports were used. The pulmonary artery and vein of the segment were dealt with Hem-o-lok or stapler. The bronchi of the segment were dealt with staplers. Staplers were used in peripheral lung of intersegmental plane. Results All the twenty patients underwent total thoracoscopic anatomic segmentectomy successfully without any conversion to thoracoctomy or lobectomy. No perioperative morbidity or mortality occurred. Postoperative pathological examinations showed lung cancer in 10 patients, pulmonary metastases in 3 patients and benign pulmonary diseases in 7 patients. The mean operative time was 133.0（90-240）min. The mean blood loss was 85.0（50-200）ml. The chest tubes were maintained in position for 3.2 （2-7） d. The mean postoperative hospitalization time was 6.7 （4-11）d. Conclusion Total thoracoscopic anatomic pulmonary segmentectomy is a feasible and safe technique to be used selectively for Ⅰa stage lung cancer, pulmonary metastases and benign pulmonary diseases that are not appropriate for wedge resection.
Abstract：?Objective?To evaluate clinical outcomes of single utility port complete video-assisted thoracoscopic surgery （VATS） lobectomy for patients with early-stage lung cancer.?Methods?We retrospectively analyzed the clinical data of 162 consecutive patients with early-stage lung cancer who underwent single utility port complete VATS lobectomy from September 2009 to October 2011 in Chinese PLA General Hospital （single utility port group），and compared them with 221 patients with early-stage lung cancer who underwent video-assisted mini-thoracotomy （VAMT） lobectomy in the same period （VAMT group）. The clinical outcomes including operation time, intraoperative blood loss, lymph node dissection number, time to first activity out of bed, chest drainage duration and postoperative complications, were compared between the two groups.?Results?No perioperative death was observed in both groups. There were statistical differences in the intraoperative blood loss （162.8±75.6 ml vs. 231.4±62.8 ml）, time to first activity out of bed （2.2±0.3 d vs. 3.7±0.5 d） , and chest drainage duration （3.5±0.2 d vs. 4.6±0.4 d） between the two groups （P＜0.05）. There was no statistical difference in operation time （133.7±22.0 min vs. 124.9±25.7 min） , lymph node dissection number （11.7±1.9 vs. 12.5±2.7）， and incidence of serious postoperative complications （7.4% vs. 8.1%）between the two groups.?Conclusion?Single utility port complete VATS lobectomy and lymph node dissection are safe and reliable for patients with early-stage lung cancer with less injury and better postoperative recovery compared with VAMT.
Abstract： Sarcoidosis is a common systemic disease with noncaseating granulomatous epithelioid nodule and coexisting granulomatous inflammation. Although sarcoidosis can affect any organ of the body， more than 90% of the patients demonstrate thoracic involvement， which is often confusing with lung cancer and other diseases. Therefore, thoracic surgeons must have a clear understanding of sarcoidosis. Moreover， due to the special role of surgery in obtaining pathological specimens， thoracic surgeon plays an important role in the diagnosis and treatment of sarcoidosis. It is not difficult to make diagnosis for patients with typical clinical features of sarcoidosis. However， the majority of patients do not have specific manifestations of sarcoidosis. The cause of sarcoidosis remains unknown， and there is also no specific treatment strategy for it. But recent research has shown that annexin A11 gene may be involved in the pathogenesis of sarcoidosis， and tumor necrosis factor （TNF） inhibitor is effective in the treatwent of sarcoidosis.