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find Keyword "Nonsmall cell lung cancer" 7 results
  • Effect Analysis on Singledirection Lobectomy for Primary Nonsmall Cell Lung Cancer in the Early Stage by Videoassisted Thoracic Surgery

    Abstract: Objective To investigate the effect of singledirection lobectomy plus systematic lymphnode dissection for primary nonsmall cell lung cancer (NSCLC) in the early stage by videoassisted thoracic surgery (VATS). Methods We retrospectively analyzed the clinical data of 89 patients who received VATS lobectomy plus systematic lymphnode dissection for earlystage primary NSCLC in the Second People’s Hospital of Chengdu between June 2006 and December 2009. Based on the operative approach, the patients were divided into two groups: VATSminithoracotomy group and singledirection lobectomy VATS group. In the former group, there were 46 patients, including 36 males and 10 females, with an age of 58.76±14.78 years. For patients in this group, minithoracotomy was carried out assisted by VATS. In the latter group, there were 43 patients, including 37 males and 6 females, with an age of 61.34±12.56 years, and singledirection lobectomy VATS was performed for patients in this group. Moreover, 42 patients undergoing routine posterior lateral open thoracotomy were chosen to form the control group (thoracotomy group, included 37 males and 5 females with an age of 56.30±15.59 years). The clinical features, such as operative time, operative blood loss, the number of systematic dissected lymph nodes, postoperative drainage quantity, postoperative complications and visual analogue scale (VAS) of chest pain were retrospectively analyzed to evaluate the early outcomes. Results No operative death occurred in all three groups. There were significant differences among the three groups in the postoperative drainage time (P=0.024), postoperative drainage quantity (P=0.019), operative blood loss (P=0.009), early outofbed activity time (P=0.031), and the incidence of cardiopulmonary complications (P=0.048). Compared with the VATSminithoracotomy group, the singledirection lobectomy VATS group was significantly lower or shorter (Plt;0.05) in postoperative drainage quantity (208.33±50.39 ml vs. 245.98±45.32 ml), operative blood loss (78.79±24.23 ml vs. 112.63±64.32 ml), and the early outofbed activity time (2.31±0.27 d vs. 3.56±0.31 d). The rate of using Dolantin in the control group was significantly higher than the other two groups (P=0.046, 0.007). The change of VAS score among the three groups after operation was also statistically significant (F=5.796, P=0.002). A total of 109 patients (37 in the VATSminithoracotomy group, 37 in the singledirection lobectomy VATS group, and 35 in the control group) were followed up after operation with a period of 2 to 48 months. Twentytwo patients were lost in the followup. There were 10, 9, and 8 deaths during the followup in the three groups respectively, and the median survival time was 40 months, 37 months, and 37 months respectively. There was no significant difference among the three groups in survival time (P=0.848). Conclusion VATS, especially VATS assisted single direction lobectomy and systematic lymphnode dissection for primary NSCLC in the early stage has the same surgical efficacy as the traditional open thoracotomy, and is minimally invasive, which contributes to a quick recovery. Consequently, it is a reliable approach for lung cancer in the early stage. 

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • The Correlation of Integrinlinked Kinase and Matrix Metalloproteinases9 Expression with Prognosis of Nonsmall Cell Lung Cancer

     Abstract: Objective To observe the expression of integrinlinked kinase (ILK) and matrix metalloproteinases9 (MMP9) in human nonsmall cell lung cancer (NSCLC) and investigate the correlation of ILK and MMP9 expression with the prognosis of NSCLC. Methods The expression of ILK and MMP9 in 75 specimens of NSCLC resected from January 2002 to January 2004 were detected by immunohistochemistry. According to the median of integral optical density (IOD), all patients were divided into the high or low ILK expression group and the high or low MMP-9 expression group. The relativity of ILK and MMP9 was determined, and the relationship of survival time with clinical features including expression of ILK and MMP-9 was compared by Logrank test. Results Both ILK and MMP-9 were expressed in NSCLC specimens. The expression between ILK and MMP-9 was positively correlated in 75 patients of our group (r=0.79, Plt;0.05). Patients with lower expression of ILK and MMP9 had a significantly longer survival time than those with higher expression of ILK and MMP-9 in the postoperative followup (χ2=15.067,14301,Plt;0.05). The survival time was not correlated with sex,age,smoking history or pathological type(χ2=0450,0078, 1.460, 1.623,Pgt;0.05), while tumor diameter, lymph node metastasis, TNM stage, the expression of ILK and MMP-9 significantly influenced the survival time (χ2=3.963, 15.169,20.529, 15.067,14.301,Plt;0.05). Conclusion  The expression of ILK and MMP9 affects the prognosis of NSCLC. MMP-9 may advance infiltration and metastasis of tumor cells through ILK pathway. In summary, the expression of ILK and MMP9 may play an important role in the evaluation of prognosis for patients with NSCLC.

    Release date:2016-08-30 06:03 Export PDF Favorites Scan
  • Influence of Tumor Associated Macrophages Distribution on Prognosis of Nonsmall Cell Lung Cancer

    Objectives To investigate the effects of the distribution of tumor associated macrophages (TAMs) on prognosis in the patients with non-small cell lung cancer. Methods The number of CD68+ macrophages in 136 lung cancer nest and stroma was counted simultaneously by labelled streptavidin biotin method(LSAB),and its correlation with patient postoperation prognosis was analyzed. Results CD68 macrophas were observed in both inside and around the cancer tissue,The mean TAMs in cancer stroma (36.00/HFP) was higher than that in cancer nest (23.80/HFP,Plt;0.05). Mean TAMs in nest of stage Ⅰ+Ⅱ cancer was significantly higher than that of stageⅢ+Ⅳ cancer(32.60/HFP vs. 14.80/HFP,Plt;0.05),and mean TAMs in stroma of stage Ⅰ+Ⅱ cancer was significantly lower than that of stage Ⅲ+Ⅳ cancer(24.30/HFP vs. 47.60/HFP,Plt;0.05).The number of TAMs in cancer nest and the ratio of nest TAMs /stoma TAMs were both positively correlated with the patient survival time (rs=0.510, 0.633, respectively). Otherwise the number of TAMs in cancer stroma was negatively correlated with the patient survival time (rs=-0.187). Five-year survival rate in patients with high density TAMs in cancer nest was significantly higher than that in patients with low density TAMs (51.4% vs. 11.1%, Plt;0.05), while reverse correlation between TAMs in cancer stroma and patient 5-year survival rate was observed (18.9% vs. 44.4%,Plt;0.05). And 5 year suvival rate in patients with high ratio of nest/stroma TAMs was higher than that with low ratio (58.1% vs.4.2%,Plt;0.01). Conclusion Cox regressive prognostic analysis showed that the higher the nest/stroma TAMs ratio, the higher probability of the patients survival time. While the higher number of TAMs in the cancer stroma, the lower probability of the patients survival time. Our results showed that distribution pattern of TAMs in cancer nest and cancer stroma could possibly be used to estimate the prognosis of patients with non-small cell lung cancer.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • The Surgical Treatment and Prognosis in Elderly with Nonsmall Cell Lung Cancer

    Objective To determine whether the basal characteristics and survival of young patients undergoing surgical resection of nonsmall cell lung cancer (NSCLC) differ from those of elderly patients. And, we would discuss the special perioperative management in elderly patients with NSCLC. Methods 178 NSCLC patients who underwent surgery in our hospital between Jan. to Dec. in 2002 were divided into two groups according to age. Young group comprised 89 patients aged 50 years or younger and elderly group comprised 89 patients aged 70 years or older. The patients’ clinical data, operative style,postoperative complications and survival results were reviewed and analysed. Results The proportion of the elderly group squamous cell carcinoma patients was higher than that of the younger group (χ2=9.281,P=0.000.),but there was no significant difference between the gender, smoking, histology, TNM stage, type of resection, post operation chemotherapy or radiotherapy(χ2≤5.569,Pgt;0.05). The incidence of the preoperative cardiovascular disease, chronic bronchitis in the elderly group patients were higher than those of younger group(χ2=14.053,P=0.000;χ2=13.044,P=0.000).The incidence of postoperative complications was significantly higher in elderly group than those of younger group(χ2=12842,P=0.000). The 1, 3 and 5year survival rates were 71.43%,33.53% and 27.83% in elderly group, and 77.78%,46.67% and 44.07% in young group, respectively. However, the 1, 3 and 5year survival rates for patients in two groups showed no difference between two groups(Pgt;0.05). Conclusion The elderly patients have higher operative risk than that of young patients. We should pay more attention to the perioperative management of elderly patients. The elderly patients could get acceptable long term survival rates through surgical treatment. Operation is still the first choice for elderly patients with NSCLC.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • Videoassisted Thoracoscopic Lobectomy and Conventional Thoracotomy to Primary Nonsmall Cell Lung Cancer

    Objective To investigate the clinical value of using videoassisted thoracoscopic lobectomy(VATS lobectomy) to treat primary nonsmall cell lung cancer(NSCLC) so that the videoassisted thoracoscopic surgery(VATS) can be better used in clinic. Methods From September 2007 to December 2008, seventysix NSCLC patients were collected. Thirtyseven patients underwent VATS lobectomy(VATS group), 21 male and 16 female with an average age of 60.4 years. Among them 20 underwent videoassisted minithoracotomy lobectomy, and 17 underwent total thoracoscopic lobectomy. Thirtynine patients underwent conventional thoractomy(conventional thoracotomy group), 32 male and 7 female with an average age of 58.7 years. Perioperative clinical and laboratory parameters of the two groups were compared. Results There was no severe complication and perioperative mortality in both groups. There were statistical significances between VATS group and conventional thoracotomy group in incision length (7.6±1.9 cm vs. 28.5±3.6 cm, t=-31.390,P=0.000), postoperative dosage of dolantin(160±125 mg vs.232±101 mg,t=-2.789,P=0.007), postoperative chest tube time(chest tube output>100ml,4.8±2.5 d vs. 8.1±3.2 d,t=-4.944,P=0.000) and postoperative hospitalization time(12.1±3.0 d vs. 15.7±4.7 d,t=-3.945,P=0.000). There was no statistical significance between two groups in operation time(t=1.732,P=0.087), intraoperative blood loss(t=-1.645,P=0.105) and the number of lymph node dissection(t=-0.088,P=0.930). The total hospitalization expenses in VATS group were higher than that in conventional thoracotomy group, but there was no statistical significance(t=1.303,P=0.197). The serum levels of glucose at 1st day after operation(7.2±1.2 mmol/L vs. 8.4±2.2 mmol/L, t=5.603,P=0.000)and the total count of white blood cell (12.7±3.8×10.9/L vs. 15.1±5.9×10.9/L,t=5.082,P=0.004) in VATS group were significantly lower than that in conventional thoracotomy group. The prealbumin(PA) level in VATS group was significantly higher than that in conventional thoracotomy group(215.0±45.5 mg/L vs.147.3+50.8 mg/L,t=-7.931,P=0.000). Conclusion VATS lobectomy could clean lymph node completely. Its advantages include less postoperative trauma, lower acute phase response, mild pain, rapid recovery, shorter hospitalization time and less economic burden. It could be an operation approach for early NSCLC patients who have been strictly selected.

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • Analysis of Prognostic Factors for Patients with Stage Ib Nonsmall Cell Lung Cancer after Operation

    Objective To study the clinicopathologic features which influence the prognosis of patients with stage Ib nonsmall cell lung cancer (NSCLC) after operation, and discuss the indication of postoperative chemotherapy. Methods From January 2002 to December 2002, the clinical materials of 152 patients who underwent complete pulmonary lobectomy and were confirmed to have stage Ib NSCLC by postoperative histopathological examination were collected from Shanghai Chest Hospital. There were 82 male and 70 female cases aged from 33-80 years. The mean age was 63.0 years. KaplanMeier method was used to compare and analyze the age, gender, tumor diameter, tumor location, lymphatic or vascular carcinoma embolus, differentiation, pleural invasion and chemotherapy of patients. Cox regression model was used to do prognostic multivariate analysis to above factors. Results The 5year survival rate was 71.1%. The median survival time was 44.20 months. The results of single factor analysis showed that the tumor diameter was longer than 5 cm(χ2=4.020,P=0.042), lymphatic or vascular carcinoma embolus existed(χ2=14670,P=0.001), poorly differentiated tumor(χ2=8.395,P=0.004), and those whose tumors were located on middlelower lobars had a poor prognosis(χ2=3.980,P=0.045). The age(χ2=0.478,P=0.740), gender(χ2=0.571,P=0.450), pathological type(χ2=0.406,P=0.816), pleural invasion(χ2=0.022,P=0.882) and postoperative chemotherapy of patients (χ2=1.067,P=0.302)had no relationship with postoperative survival. The results of multivariate analysis showed that lymphatic or vascular carcinoma embolus(P=0.006,95%CI:1.491,10.524) and poorly differentiated tumor(P= 0.001,95%CI:0.116,0.578) were the main factors which influenced the survival rate of patients. Conclusion The tumor differentiation and lymphatic or vessel carcinoma embolus of patients with stage Ib NSCLC are important factors which influence prognosis and survival rate. The poorly differentiated tumor and lymphatic or vessel carcinoma embolus could be regarded as one of the indications of postoperative chemotherapy.

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • The Expression of S100A4 Protein in Tumorstroma of Human Nonsmall Cell Lung Cancer and Its Clinical Significance

    Objective To investigate the expression and clinical significance of S100A4 protein in tumorstroma of nonsmall cell lung cancer(NSCLC) to study its correlation with invasion, metastasis and prognosis. Methods Immunohistochemical staining(SP method)for S100A4 protein expression was performed in tissue sections from 130 patients with NSCLC operated and to analyze association of S100A4 protein with clinicopathological parameters in lung cancer and prognosis. Results The total positive expression rates of S100A4 protein in stroma of NSCLC was 72.3%. The positive expression rates of S100A4 protein in stroma of squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma and large cell lung cancer were 84.3%,59.6%,70.0% and 75% respectively.The expression of S100A4 protein was significantly associated with lymph node metastasis (χ2=18.91, P=0.000), distant metastasis(χ2=5.51, P=0.019) and TNM stage (χ2=21.54, P=0.000). The 3 years survival rates of patients whose tumourstroma stained positive for S100A4 was lower than that of patients whose tumourstroma stained negative (36.2% vs. 63.9%, P=0.003). Cox’ risk ratio model analysis indicated that age ≤50 years (OR=1.866), lymph node metastasis(OR=1.826), distant metastasis(OR=6.224), lower histology differentiation and undifferentiation (OR=1.793), TNM stage Ⅲ-Ⅳ (OR=2.573) and positive expression of S100A4 protein in stroma of NSCLC(OR=1.776) were significantly independent prognostic factors which affected survival. Conclusion Expression of S100A4 protein in stroma of NSCLC is significantly associated with invasion, metastasis, TNM stage and prognosis. S100A4 protein might become a marker for prediction of tumor progression of disease and clinical therapy.

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
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