ObjectiveTo assess the specific clinicopathological characteristics as well as prognostic value of prognostic significance of spread through air spaces (STAS) in lung adenocarcinoma.MethodsWe systematically searched the databases of PubMed, EMbase and Web of Science databases from their date of inception to March 2019. The quality of the included literature was assessed by the Newcastle-Ottawa scale (NOS). The NOS of the study higher than 6 points was considered as high quality. Software of Stata 12.0 was used for meta-analysis.ResultsTwenty retrospective cohort studies involved with totally 6 225 patients were included. Quality of included studies was high with NOS score equal or higher than 6 points. STAS was associated with male sex, ever smoking history, abnormal carcino-embryonic antigen (CEA) level, air bronchogram negative, anaplasticlymphoma kinase (ALK) arrangement positive, epidermal growth factor receptor (EGFR) mutation positive, advanced pathological tumor stage and more invasive pathological adenocarcinoma subtypes. The presence of STAS indicated significantly poor recurrence free survival (RFS) (HR=1.960, 95%CI 1.718-2.237, P<0.001) as well as poor overall survival (OS) (HR=1.891, 95%CI 1.389-2.574, P<0.001). Further subgroup analyses showed that exhibiting tumor size including diameter less than 2 cm (HR=2.344, 95%CI 1.703-3.225, P<0.001) and diameter over 2 cm (HR=2.571, 95%CI 1.559-4.238, P<0.001), resection type including lobectomy (HR=1.636, 95%CI 1.258-2.127, P<0.001) and sublobar resection (HR=3.549, 95%CI 2.092-6.021, P<0.001) in stageⅠ adenocarcinoma suggested that STAS had a bad effect on RFS.ConclusionPresence of STAS is associated with more aggressive clinicopathological features and independently associated with worse RFS and OS in lung adenocarcinoma. STAS positive has a negative effect on RFS whatever the tumor size (including the diameter<2 cm or >2 cm) and resection types in stageⅠ adenocarcinoma.
Objective To collect and store all interactions relating to medical information between our center and allied specialized hospitals by constructing a database system for thoracic surgery and pulmonary tuberculosis. Methods We collected all related medical records of patients who had been clinically diagnosed with pulmonary tuberculosis and tuberculous empyema using the CouchBase Database, including outpatient and inpatient system of the Department of Thoracic Surgery at the Public Health Clinical Center of Chengdu between January 2017 to June 2023. Then, we integrated all medical records derived from the radiology information system, hospital information system, image archiving and communication systems, and the laboratory information management system. Finally, we used artificial intelligence to generate a database system for the application of thoracic surgery on pulmonary tuberculosis, which stored structured medical data from different hospitals along with data collected from patients via WeChat users. The new database could share medical data between our center and allied hospitals by using a front-end processor. ResultsWe finally included 124 patients with 86 males and 38 females aged 43 (26, 56) years. A structured database for the application of thoracic surgery on patients with pulmonary tuberculosis was successfully constructed. A follow-up list created by the database can help outpatient doctors to complete follow-up tasks on time. All structured data can be downloaded in the form of Microsoft Excel files to meet the needs of different clinical researchers. Conclusion Our new database allows medical data to be structured, stored and shared between our center and allied hospitals. The database represents a powerful platform for interactions relating to regional information concerning pulmonary tuberculosis.