非小细胞肺癌（NSCLC）的18F-FDG PET/CT显像原发灶代谢体积与转移的关系

目的 探讨非小细胞肺癌（NSCLC）的¹⁸F-FDG PET/CT显像原发灶代谢体积（MTV）与淋巴结和（或）远处转移的关系。方法 回顾性分析治疗前接受PET/CT全身扫描经病理检查证实的138例NSCLC患者,其中腺癌（腺癌组）92例、鳞癌（腺癌组）46例。分析两组间MTV的差异性,MTV与分化程度、年龄、病灶大小、密度及T分期等的相关性;采用二元Logistic回归分析预测转移的危险因素。结果 鳞癌组MTV明显高于腺癌组（F=28.390,P<0.001）,整体（r=0.785、0.577）、鳞癌组（r=0.791、0.509）及腺癌组（r=0.720、0.439）MTV均与病灶大小、T分期呈正相关（P均<0.01）,与年龄、病灶密度无明显相关性（P均>0.05）,整体及腺癌组MTV与分化程度呈负相关（r=-0.631、-0.751,P均<0.01）,鳞癌组MTV与分化程度无相关性（r=-0.351,P>0.05）;多因素Logistic回归分析仅MTV纳入回归方程（OR=1.096,P<0.001）;腺癌组与鳞癌组中,应用MTV评估转移的ROC曲线下面积分别为0.877、0.850（P<0.001）,阈值分别为 2.49 cm³、18.49 cm³时,灵敏度、特异度分别为89.13%（41/46）、78.26%（36/46）和81.25%（26/32）、78.57%（11/14）。结论 NSCLC的¹⁸F-FDG PET/CT显像原发灶MTV是转移独立的影响因子,MTV越高提示发生转移的可能性越大。     

非小细胞肺癌预后相关评价标志物的筛选

目的利用生物芯片技术和非小细胞肺癌（non-small cell lung cancer,NSCLC）患者血清及随访结果,筛选出新型NSCLC高敏感性和特异性的血清自身免疫抗体作为分子标志物用于NSCLC的预后评价。方法（1）提取NSCLC组织总mRNA构建T7噬菌体cDNA文库;（2）用NSCLC预后良好和不良患者血清对T7文库进行生物淘洗;（3）构建蛋白芯片,分别用预后良好和不良患者血清孵育芯片进行CyS／Cy3双荧光标记并分析芯片结果;（4）对挑选出的标志物进行测序及分析。结果筛选得到最佳评价组合含6个NSCLC预后相关标志物,其联合诊断准确率80．7％,敏感性85．3％,特异性73．9％,AUC为0．825;测序及BLAST分析显示,abl—interactor 1、pleiotrophin、surfactantprotein B 3个标志物是已知癌细胞转移和预后相关分子。结论成功筛选得到1个含有6个标志物的最佳评价组合,可对NSCLC预后进行较准确诊断。     

四种肿瘤标志检测非小细胞肺癌的临床应用研究

目的　研究与非小细胞肺癌 (NSCLC)相关的血清癌胚抗原 (CEA )、细胞角蛋白片断2 1 1(CYFRA2 1 1)、组织多肽特异性抗原 (TPS)和鳞状上皮细胞癌抗原 (SCC)等 4种肿瘤标志的临床应用价值。方法　采用电化学发光免疫分析仪 (Elecsys 2 0 10 ) ,快速微粒子酶免疫分析仪 (IMx) ,酶联免疫吸附法分别检测 76例NSCLC患者 ,13例肺良性疾病患者及 3 6名健康成人血清中的CEA、CYFRA2 1 1、TPS和SCC ,并对 2 7例NSCLC术后 1个月的患者进行随访检测。同时用SPSS10 0统计软件及接受器工作性能曲线 (ROC)分析 ,评价肿瘤标志物的临床应用价值。结果　血清CEA、CYFRA2 1 1和TPS水平随临床分期 (TNM )增加而升高 ,与正常人比较差异有显著性 (P <0 0 1) ,对于评价NSCLC具有一定的临床参考价值。各种组合检测中 ,以CEA +CYRA2 1 1+TPS组敏感性和有效性最高。手术治疗后 ,4种肿瘤标志均较术前明显下降。SCC仅对于肺鳞癌与腺癌的鉴别具有一定的参考价值。结论　 4种肿瘤标志物在NSCLC诊断治疗中 ,具有一定的临床应用价值。CEA +CYFRA2 1 1+TPS组合后可显著提高NSCLC诊断的敏感性和有效性     

Impact of symptom burden in post-surgical non-small cell lung cancer survivors

Purpose

Pain, fatigue, dyspnea, and distress are commonly reported cancer-related symptoms, but few studies have examined the effects of multiple concurrent symptoms in longer-term cancer survivors. We examined the impact of varying degrees of symptom burden on health-related quality of life (HRQOL) and performance status in surgically treated non-small cell lung cancer (NSCLC) survivors.

Methods

A sample of 183 NSCLC survivors 1–6 years post-surgical treatment completed questionnaires assessing five specific symptoms (pain, fatigue, dyspnea, depression, and anxiety), HRQOL, and performance status. The number of concurrent clinically significant symptoms was calculated as an indicator of symptom burden.

Results

Most survivors (79.8 %) had some degree of symptom burden, with 30.6 % reporting one clinically significant symptom, 27.9 % reporting two symptoms, and 21.3 % reporting three or more symptoms. Physical HRQOL significantly decreased as the degree of symptom burden increased, but mental HRQOL was only significantly decreased in those with three or more symptoms. Receiver-operating characteristic (ROC) curves showed that having multiple concurrent symptoms (two or more) was most likely associated with limitations in functioning (area under a ROC curve?=?0.75, sensitivity?=?0.81, specificity?=?0.54).

Conclusions

Two or more clinically significant symptoms are identified as the “tipping point” for showing adverse effects on HRQOL and functioning. This highlights the need for incorporating multiple-symptom assessment into routine clinical practice. Comprehensive symptom management remains an important target of intervention for improved post-treatment HRQOL and functioning among lung cancer survivors.     

体部伽玛刀治疗早期非小细胞肺癌初步临床研究

目的　研究体部伽玛刀治疗早期非小细胞肺癌的临床疗效。方法　对18 例I~II期非小细胞肺癌病例采用体部伽玛刀立体定向放射治疗,负压袋体模固定体位,螺旋CT增强扫描定位和三维适形治疗计划。处方剂量5Gy/次,5次/周,共10次,以50%等剂量曲线作为参考线。结果　原发灶完全缓解(CR) 12 例(66.7%),部分缓解(PR)6例(33.3%),无变化(NR)0例,总有效率(CR PR)100%。18 例治疗按计划完成,放射性肺炎多数较轻,I级占27.8%(5/18),II级占5.6%(1/18)。1、2年肿瘤局部控制率分别为94.4%、77.8%。结论　体部伽玛刀治疗早期非小细胞肺癌近期疗效好,放射反应轻微,分次立体定向适形放疗是较为理想的放疗模式,可提高肿瘤的局部控制率。     

血清LTA和CEA检测对非小细胞肺癌的诊断价值

目的探索肺癌相关抗原(LTA)与癌胚抗原(CEA)在非小细胞肺癌(NSCLC)辅助诊断中的价值。方法采用乳胶凝集试验和电化学发光分别检测87例NSCLC和46例小细胞肺癌(SCLC)病人血清的LTA与CEA。结果所有正常对照者血清的LTA与CEA均阴性;NSCLC血清的LTA阳性检出率明显高于SCLC与肺良性疾病(BLD)血清中的检出率(P均<0.005);NSCLC血清的CEA阳性检出率明显高于BLD血清中的检出率(P<0.005),但与SCLC血清中的阳性检出率无差别(P>0.005);NSCLC血清LTA结合CEA的阳性检出率明显高于SCLC及BLD血清中的检出率(P<0.005)。结论LTA结合CEA检测在NSCLC的辅助诊断中具有较高的灵敏度和特异性。     

血清LTA和CEA检测对非小细胞肺癌的诊断价值

目的 探索肺癌相关抗原(LTA)与癌胚抗原(CEA)在非小细胞肺癌(NSCLC)辅助诊断中的价值.方法 采用乳胶凝集试验和电化学发光分别检测87例NSCLC和46例小细胞肺癌(SCLC)病人血清的LTA与CEA.结果 所有正常对照者血清的LTA与CEA均阴性:NSCLC血清的LTA阳性检出率明显高于SCLC与肺良性疾病(BLD)血清中的检出率(P均&lt;0.005);NSCIJC血清的CEA阳性检出率明显高于BLD血清中的检出率(P&lt;0.005),但与SCLC血清中的阳性检出率无差别(P&gt;0.005);NSCLC血清LTA结合CEA的阳性检出率明显高于SCLC及BLD血清中的检出率(P&lt;0.005).结论 LTA结合CEA检测在NSCLC的辅助诊断中具有较高的灵敏度和特异性.     

用积分法评价7项血清肿瘤标志物对非小细胞肺癌的诊断价值

目的探讨用积分法评价血清细胞角蛋白片段21-1(CYFRA21-1)、癌胚抗原(CEA)、组织多肽特异性抗原(TPS)、糖类抗原CA125、CA153、CA199、和铁蛋白(FER)等7项肿瘤标志物对非小细胞肺癌(NSCLC)的诊断价值。方法采用免疫化学发光法、增强化学发光酶联免疫分析法和免疫放射分析法分别检测70例NSCLC患者、53例肺部良性疾病和72名正常对照者血清中的CYFRA21-1、CEA、TPS、CA125、CA153、CA199、FER,根据这些肿瘤标志物单项诊断NSCLC的有效性分别积分为4、3、32、、21、、1分,计算总积分。用总积分评价7项肿瘤标志物对NSCLC诊断的临床应用价值,并与NSCLC的TNM分期进行相关性分析和组织学分型比较。结果单项指标诊断NSCLC的灵敏度在32.9%-65.7%间,特异性在64.0%-96.8%,有效性在62.1%-85.1%间,积分法诊断NSCLC的灵敏度为82.8%,特异性为96.8%,诊断有效性91.8%。总积分水平与NSCLC患者的TNM分期呈显著正相关(r=0.68,P<0.001)。结论在对NSCLC患者用CYFRA21-1、CEA、TPS、CA125、CA153、CA153、和FER进行组合检查时,用积分法评价可显著提高对NSCLC的诊断价值。     

非小细胞肺癌胸水原代肿瘤细胞系建立及其药敏试验的临床应用价值

目的通过非小细胞肺癌(NSCLC)患者恶性胸腔积液肿瘤细胞的体外原代培养,检测其对常规化疗药物的敏感性,为临床筛选个体化治疗方案提供参考。方法收集20例经病理组织学确诊为NSCLC患者的恶性胸腔积液,通过密度梯度离心法分选后体外短暂培养以去除非肿瘤细胞成分,建立原代细胞系;使用MTT法检测肺癌常规化疗药物作用于肿瘤细胞的半数抑制浓度(IC50),与理论计算获得的血药浓度值(IC50 m)进行比较获得IC50绝对预测值(R),并将其与患者的临床实际疗效进行比对分析。结果 20例恶性胸腔积液样本经预处理及培养4代后均能获得在体外稳定传代的原代肿瘤细胞系,巴氏染色证实其具有癌细胞特征,且显微镜下观察癌细胞纯度近乎100%。MTT法检测结果显示,使用R值时,能将超出测试浓度上限的无效IC50值进一步纳入疗效评估的有效范围;与其中具有完整化疗史的6例患者的实际疗效比对结果显示,当用R值在0.5～2.0和大于2.0分别预测实际疗效为疾病稳定和疾病进展时,其疗效预测的总体一致性为77%(10/13)。结论癌性胸水原代肿瘤细胞培养及其药敏检测在预测NSCLC患者的实际化疗疗效中具有参考价值。     

Cetuximab in non-small cell lung cancer

Advanced non-small cell lung carcinoma (NSCLC) remains a challenge to treat due to its high local and systemic recurrence. The overall survival remains poor despite the approval of several new chemotherapeutic agents in the management of advanced NSCLC. Overexpression or mutations in the EGFR have been shown to be associated with a significant percentage of NSCLC. The development of targeted agents, such as cetuximab, against the EGFR is therefore a rational objective. Several preclinical and clinical studies suggest that cetuximab is active against NSCLC. This paper reviews the application of cetuximab in NSCLC.     

Updates in non-small cell lung cancer

Lung cancer is the leading cause of cancer death in both men and women. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, representing more than 80% of lung cancer diagnoses. Five-year survival remains at 15%, but new strategies for prevention, early detection, and treatment may improve survival rates. This article provides an overview of updates in NSCLC, with an emphasis on advances in treatment strategies. Newer targeted therapies, as well as advances in genetic blueprinting, will be discussed. Nurses play a pivotal role in the assessment and management of patients with NSCLC and, therefore, must remain abreast of the most current prevention, screening, and treatment options.     

Influence of tumor burden on red blood cell deformability in small cell lung cancer patients

Red blood cell deformability was measured in 54 newly diagnosed patients with small cell bronchogenic carcinoma and in 22 normal hospital employees. Twenty-one small cell cancer patients had disease confined to one hemithorax plus draining lymph nodes (one organ system), 15 had involvement of one additional metastatic site (two organ systems), 12 had two metastatic sites (three organ systems) and 6 patients had 4 organ systems involved. Patients with one or two organ system involvement had red cell deformability results comparable to the normal control group. Patients with tumor extension to 3 or 4 organ systems had significantly decreased deformability relative to patients with lesser tumor burdens. Based on the lowest deformability results in the control population small cell cancer patients were divided into those with normal or impaired red blood cell deformability. The latter patients were significantly more anemic and had higher red cell mean corpuscular volumes than their normal counterparts. Patients with impaired deformability also had significantly elevated blood glucose levels and significantly lower serum inorganic phosphorus and iron binding capacity. Since red cell deformability is the principal determinant of capillary blood flow abnormal deformability may result in decreased tumor oxygenation and decreased, and non-uniform, delivery of chemotherapeutic agents to tumor tissue.     

骨扫描在术前评估非小细胞肺癌患者分期中的价值

骨转移是非小细胞肺癌(NSCLC)容易出现胸外转移的部位之一。骨扫描的诊断对指导临床治疗有重要意义。目前认为全身骨扫描是能较早发现骨转移的手段。本院常规对NSCLC患行全身骨扫描，以明确分期，指导治疗。但国外对于术前无骨痛症状的可手术非小细胞肺癌患行全身骨扫描的指征存在争议。本回顾性分析了105例非小细胞     

LINC00978在非小细胞肺癌中的临床价值和生物学作用

目的探究长链非编码RNA(long non-coding RNA, lncRNA)LINC00978在非小细胞肺癌(non-small cell lung cancer, NSCLC)中的表达变化及生物学功能,并初步探讨其作用机制。方法采用qRT-PCR检测NSCLC患者肿瘤组织与血清中LINC00978的表达水平。通过CCK-8、平板克隆、Transwell迁移和侵袭实验观察LINC00978敲减和过表达对A549细胞生物学功能的影响。采用流式细胞术、qRT-PCR和western blot探究LINC00978的作用机制。结果 LINC00978在NSCLC患者肿瘤组织(t=2.465,P0.05)和血清(t=8.781,P0.01)中呈高表达。LINC00978敲减抑制A549细胞增殖、迁移和侵袭能力(P均0.01),诱导G_1期阻滞以及细胞凋亡(P均0.01)。LINC00978敲减下调Cyclin D1和Bcl-2的表达而上调Bax的表达(P均0.05)。此外,LINC00978敲减抑制N-cadherin、Vimentin、Snail、Slug和Twist的表达而促进E-cadherin的表达(P均0.05)。LINC00978过表达则具有相反作用。结论 LINC00978在NSCLC中高表达,并促进NSCLC发生、发展,具有成为NSCLC诊断及治疗新靶点的潜能。     

基于CT测量的肿瘤体积对非小细胞肺癌患者新辅助化疗疗效的评估价值

目的  分析基于CT测量的肿瘤体积对非小细胞肺癌患者新辅助化疗疗效的评估价值。方法  选取2019年5月~2020年5月在我院接受新辅助化疗的74例非小细胞肺癌患者,化疗后以病理结果为标准其分为有效组（n=51）和无效组（n=23）,通过CT测量所有患者的肿瘤体积,并采用单因素和Logistic多因素回归分析其影响因素。结果  化疗后,两组患者肿瘤体积小于化疗前（P < 0.05）,有效组患者肿瘤体积小于无效前（P < 0.05）。两组患者化疗后6月生存率的差异无统计学意义（P > 0.05）;化疗后1年,有效组患者生存率高于无效组（P < 0.05）。单因素分析结果显示：临床分期、分化程度以及化疗周期可能是肿瘤体积的影响因素（P < 0.05）。Logistic回归分析结果显示：临床分期、分化程度及化疗周期是非小细胞肺癌患者肿瘤体积的影响因素（P < 0.05）。ROC曲线分析结果表明肿瘤体积对非小细胞肺癌患者新辅助化疗疗效的预测价值,敏感度为0.732,特异性为0.800。结论  基于CT测量的肿瘤体积对非小细胞肺癌患者新辅助化疗的疗效有一定的评估价值。     

解整合素-金属蛋白酶8对非小细胞肺癌的诊断价值

目的 探讨解整合素-金属蛋白酶8(ADAM8)对非小细胞肺癌患者(NSCLC)的诊断价值.方法 应用ELISA方法 检测62例NSCLC患者、27例良性肺病患者和32例健康体检者血清中的ADAM8蛋白表达水平.结果 NSCLC组血清ADAM8水平[(456.88±143.87)ng/L]高于良性肺病组[(271.63±74.20)ng/L]和正常对照组[(253.09±72.15)ng/L],差异均有统计学意义(P均<0.01),良性肺病组AD-AM8表达水平比正常对照组略高,但差异无统计学意义(P0.05);ADAM8在腺癌患者中表达水平与鳞癌相比差异无统计学意义[(462.54±161.387)ng/L与(449.04±118.03)ng/L,P0.05],Ⅲ、Ⅳ期NSCLC患者血清中ADAM8的水平[(498.80±151.80)ng/L]高于Ⅰ、Ⅱ期患者[(385.80±95.85)ng/L],差异有统计学意义(P<0.01);检测ADAM8对NSCLC的诊断敏感性为77.4%,特异性为90.6%.结论 ADAM8在NSCLC患者血清中过度表达,表明其与肺癌的发生和转移有着密切的关系,检测ADAM8对NSCLC的诊断有一定的辅助价值.     

The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study

Purpose

Disease symptom management in patients with advanced non-small cell lung cancer (NSCLC) is a critical aspect of therapy. The main objective of our study was to assess patient-reported outcomes and the degree of concordance between physician and patient perceptions of symptom severity in advanced NSCLC in the USA.

Methods

Patients with advanced (stage IIIB/IV) NSCLC (N?=?450) were recruited in a nationwide (USA) lung cancer study. Patients and their oncologists completed patient and physician versions of the Lung Cancer Symptom Scale (LCSS). Patient-reported lung cancer-specific quality of life was assessed with the Functional Assessment of Cancer Therapy—Lung (FACT-L). Concordance was assessed using the kappa-statistic. Regression analysis was performed with FACT-L total score as the dependent variable and patient-reported LCSS symptom scores as predictors.

Results

A high proportion of patients experienced lung cancer symptoms: fatigue (100 %), loss of appetite (97 %), shortness of breath (95 %), cough (93 %), pain (92 %), and blood in sputum (63 %). Concordance between physician and patients was lowest for loss of appetite (kappa 0.1701) and greatest for hemoptysis (kappa 0.4586). Loss of appetite (β?=??0.204; p?<?0.001), cough (β?=??0.145; p?<?0.01), pain (β?=??0.265; p?<?0.001), and shortness of breath (β?=??0.145; p?<?0.01) were found to be significant predictors of the quality of life.

Conclusions

Symptom burden in patients with advanced NSCLC is high and has a negative impact on the quality of life. Patient-reported outcomes data could help optimize disease outcomes and therapy management in NSCLC.     

非小细胞肺癌中甲基转移酶的研究

目的:探讨非小细胞肺癌中DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶基因的过甲基化状况及表达的关系.方法:采用甲基化特异性PCR及免疫组织化学法检测96例经病理确诊的非小细胞肺癌中DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶基因及蛋白表达.结果:96例非小细胞肺癌组织DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶基因过甲基化率36.5%,DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶蛋白的阳性表达率为33.3%,DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶基因过甲基化与蛋白的表达呈负相关(Rs=-0.536,P＜0.05).结论:在非小细胞肺癌中,DNA修复酶O6-甲基鸟嘌呤-DNA甲基转移酶基因过甲基化导致蛋白表达的降低,可能与肺癌的发生、发展相关.