ObjectiveTo detect the frequency of anaplastic lymphoma kinase (ALK), ROS1 and RET fusion genes in non-small cell lung cancer (NSCLC) patients in Sichuan, and analyze their correlation with clinical features of NSCLC. MethodsReverse transcription-polymerase chain reaction (RT-PCR) was performed to examine gene rearrangement of ALK, ROS1 and RET fusion genes in 310 NSCLC patients who were admitted in Department of Pulmonary Neoplasm of Sichuan Cancer Hospital from March 2009 to March 2012. There were 234 male and 76 female patients with their median age of 60 years (range, 29 to 77 years). There were 164 patients with a smoking history. Histological types included adeno-carcinoma (AC) in 142 patients, squamous cell carcinoma (SCC) in 138 patients, adenosquamous carcinoma in 10 patients, and other types in 20 patients. Patients, gender, age, smoking history, histological types and TNM staging were also collected. Correlations between fusion genes and clinical features were analyzed. ResultsAmong the 310 patient:15 patients with ALK fusion genes were identified (EML4-ALK) with a positive rate of 4.84%, including 14 patients with AC and 1 patient with SCC. ALK fusion genes were more common in patients under 60 years, without a smoking history, and with AC (P < 0.05). ALK fusion genes were not significantly correlated with gender or histodifferentiation. One patient with ROS1 fusion genes (CD74-ROS1) was identified with a positive rate of 0.32%, who was AC patients. Two patients with RET fusion genes (KIF5B-RET) were identified with a positive rate of 0.64%, both of whom were AC patients. ConclusionsGene rearran-gement rates of ALK, ROS1 and RET in NSCLC patients in Sichuan are 4.84%, 0.32% and 0.64% respectively. Patients with negative gene mutation of epithelial growth factor receptor (EGFR), AC, younger age, without a smoking history or with a light smoking history are more common to have ALK gene rearrangement. Gene rearrangement rates of ROS1 and RET are low, and their clinical significance needs more research.
目的 评估非小细胞肺癌患者中癌症相关性乏力的发生情况及其与患者临床病理特征和生存期之间的相互关系。 方法 应用简明疲劳量表中文版评估2008年12月－2009年12月间收治的72例初治肺癌患者，入组患者均完成根治性手术及术后生存随访。 结果 72例早期非小细胞肺癌患者中，无乏力9例（12.5%），轻度乏力48例（66.7%），中度乏力15例（20.8%），重度乏力0例（0%），乏力总体发生率为87.5%。乏力指数与患者的年龄、性别、吸烟史均无相关性，与患者的体力状况评分（ECOG PS）、TNM分期呈正相关，与中位生存期呈负相关，均有统计学意义（P＜0.05）。 结论 癌症相关性乏力作为非小细胞肺癌患者中普遍存在的一种症状，不仅能够反映患者当时的主观感受和生活状况，还可能是判断患者术后病理分期及最终总生存期的预测因素。
Objective To explore the learning curve and evaluate the safety of uniportal complete video-assisted thoracoscopic surgery (VATS) lobectomy. Methods We reviewed retrospectively the clinical data of 133 patients, who underwent uniportal VATS between March 2015 and October 2016 in Sichuan Provincial Cancer Hospital. There were 79 males and 54 females at age of 52.21±10.77 years. Results All the 127 patients completed uniportal VATS, 4.51% (6/133) converted to open surgery. There were 78 patients with lobectomy, 6 patients with segmentectomy, 37 patients with wedge resection, 6 patients with pleural, mediastinal lymph node biopsy or mediastinal tumor resection. In the lobectomy group, mean surgical time was 148.75±34.12 min, mean blood loss was 118.87±59.96 ml, mean number of lymph nodes was 11.25±6.15, the mean duration of chest-tube placement was 2.17±1.35 days, and mean length of stay was 7.58±2.59 days. Conclusion Based on skillful performance of the conventional thoracoscopic lobectomy, the learning curve for single port thoracoscopic lobectomy comprises at least 20 patients. The uniportal VATS lobectomy is a safe and operable method of minimally invasive technique, and it is worthy to be applied in thoracic surgery.
Objective To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recoveryafter surgery.
ObjectiveTo investigate the preoperative symptom burden and quality of life of patients undergoing lung cancer surgery.MethodsThis study was a cross-sectional study. We used the MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) and the single-item quality of life scale (UNISCALE) to collect the preoperative patient-reported outcomes of 265 patients with lung cancer from November 2017 to July 2019 in Sichuan Cancer Hospital.ResultsOf 265 patients, 90.9% had preoperative symptoms. The five most common symptoms were coughing (66.8%), dry mouth (53.6%), memory problems (52.8%), disturbed sleep (52.1%) and fatigue (44.2%). The five most common moderate to severe symptoms were disturbed sleep (23.0%), distress (18.5%), memory problems (16.6%), coughing (16.2%) and dry mouth (16.2%). Patients with early-stage lung cancer had less pain, fatigue, shortness of breath, lack of appetite, numbness and coughing, and their symptoms had less impact on work (including housework), relations with other people, walking and enjoyment of life as well as better quality of life before surgery (P<0.05). Patients with adenocarcinoma had milder coughing and a better quality of life before surgery (P<0.05). Symptom score was positively correlated with symptom interference with life score (r=0.66, P<0.01) and negatively correlated with quality of life score (r=-0.41, P<0.01).ConclusionMost patients undergoing lung cancer surgery have a mild symptom burden before surgery. The most common and severe symptoms are coughing, dry mouth, lung cancer and disturbed sleep. Patients with early-stage lung cancer have a milder symptom burden and a better quality of life.