Objective To evaluate the security and clinical value of the combination of three-dimensional computed tomography-bronchography and angiography (3D-CTBA) and indocyanine green (ICG) staining in video-assisted thoracic surgery (VATS) segmentectomy. Methods The clinical data of 125 patients who received VATS segmentectomy from January 2020 to January 2021 in our hospital were retrospectively analyzed. There were 40 (32.0%) males and 85 (68.0%) females with an average age of 54.8±11.1 years. Results The procedure was almost identical to the preoperative simulation. All intersegment planes were displayed successfully by ICG reverse staining method. There was no allergic patient. A total of 130 pathological specimens were obtained from the 125 patients. The mean operation time was 126.8±41.9 min, the time of first appearance of fluorescence was 22.7±4.9 s, the mean mark time was 65.6±20.3 s, the median blood loss was 20.0 (10.0-400.0) mL, the postoperative hospital stay was 5.6 (4.0-28.0) d, and the postoperative retention of chest tube time was 3.2 (2.0-25.0) d. Pathological results showed that microinvasive adenocarcinoma was the most common type (38.5%, 50/130), followed by invasive adenocarcinoma (36.9%, 48/130); there were 3 metastatic tumors (3/130, 2.3%).Conclusion The combination of 3D-CTBA and ICG reverse staining is proved to be a safe, necessary and feasible method. It solves the difficult work encountered in the procedure of segmentectomy, and it is worth popularizing and applying in clinic.
Lobectomy and systematic nodules resection has been the standard surgical procedure for non-small cell lung cancer (NSCLC). However, increased small-size lung cancer has been identified with the widespread implementation of low-dose computed tomography (LDCT) screening, and it is controversial whether it is proper to choose lobar resection for the pulmonary nodules. Numerous retrospective researches and randomized clinical trials, such as JCOG0201, JCOG0804/WJOG4507L, JCOG0802 and CALGB/Alliance 140503, revealed that the sublobar resection was safe and effective for NSCLC with maximum tumor diameter≤2 cm and with consolidation tumor ratio (CTR)≤0.25, and that segmentectomy was superior to lobectomy with significant differences in 5-year overall survival rate and respiratory function for patients with small-size (≤2 cm, CTR>0.5) NSCLC and should be the standard surgical procedure. It is the principle for multiple primary lung cancer that priority should be given to primary lesions with secondary lesions considered, and it is feasible to handle the multiple lung nodules based on the patients' individual characteristics.
Objectvie To explore the role of DNAJC5B in immunotherapy for esophageal cancer. MethodsThis study utilized the ESCC dataset from the TCGA database, and selected genes associated with DNAJC5B expression through Pearson correlation analysis, followed by Gene Ontology (GO) functional enrichment analysis and KEGG pathway analysis. Additionally, single-cell RNA sequencing data was used to analyze DNAJC5B expression in different T cell subgroups. The prognostic value of DNAJC5B was evaluated using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and Cox proportional hazards model analysis. ResultsDNAJC5B is highly expressed in advanced esophageal cancer patients, especially in males. GO and KEGG analyses revealed a significant correlation between DNAJC5B expression and immune-related processes, such as adaptive immune response and cell surface receptor signaling pathways. Single-cell analysis indicated that DNAJC5B expression is positively correlated with immune function and primarily accumulates in CD8+ T cells. Kaplan-Meier survival curves showed that the median survival time of patients with high DNAJC5B expression was 681 days, significantly lower than the 1361 days in patients with low expression. Independent prognostic analysis revealed hazard ratios of 3.577 and 4.114 for DNAJC5B, both with P-values less than 0.05. Conclusion DNAJC5B may play a significant immunomodulatory role in esophageal cancer, particularly in regulating CD8+ T cell function and tumor immune escape. These findings support the potential of DNAJC5B as a biomarker for treatment and prognosis evaluation in esophageal cancer