Clinical Features Of Lung Cancer Research Articles

Analysis of the interlink between glucose-6-phosphate dehydrogenase (G6PD) and lung cancer through multi-omics databases

Glucose-6-Phosphate Dehydrogenase (G6PD) is a crucial enzyme that executes the pentose phosphate pathway. Due to its critical nodal position in the metabolic network, it is associated with different forms of cancer tumorigeneses and progression. Nonetheless, its functional role and molecular mechanism in lung cancer remain unknown. The present study provides intricate information associated with G6PD and Lung Cancer. Varieties of public datasets were retrieved by us, including UALCAN, TCGA, cBioPortal, and the UCSC Xena browser. The data obtained were used to assess the expression of G6PD, its clinical features, epigenetic regulation, relationship with tumour infiltration, tumour mutation burden, microsatellite instability, tumour microenvironment, immune checkpoint genes, genomic alteration, and patient's overall survival rate. The present study revealed that the G6PD expression was correlated with the clinical features of lung cancer including disease stage, race, sex, age, smoking habits, and lymph node metastasis. Moreover, the expression profile of G6PD also imparts epigenetic changes by modulating the DNA promoter methylation activity. Methylation of promoters changes the expression of various transcription factors, genes leading to an influence on the immune system. These events linked with G6PD-related mutational gene alterations (FAM3A, LAG3, p53, KRAS). The entire circumstance influences the patient's overall survival rate and poor prognosis. Functional investigation using STRING, GO, and KEGG found that G6PD primarily engages in hallmark functions (metabolism, immunological responses, proliferation, apoptosis, p53, HIF-1, FOXO, PI3K-AKT signaling). This work provides a wide knowledge of G6PD's function in lung cancer, as well as a theoretical foundation for possible prognostic therapeutic markers.

Impact of annual trend volume of low-dose computed tomography for lung cancer screening on overdiagnosis, overmanagement, and gender disparities

BackgroundWith the increasing prevalence of nonsmoking-related lung cancer in Asia, Asian countries have increasingly adopted low-dose computed tomography (LDCT) for lung cancer screening, particularly in private screening programs. This study examined how annual LDCT volume affects lung cancer stage distribution, overdiagnosis, and gender disparities using a hospital-based lung cancer database.MethodsThis study analyzed the annual utilized LDCT volume, clinical characteristics of lung cancer, stage shift distribution, and potential overdiagnosis. At the individual level, this study also investigated the relationship between stage 0 lung cancer (potential strict definition regarding overdiagnosis) and the clinical characteristics of lung cancer.ResultsThis study reviewed the annual trend of 4971 confirmed lung cancer cases from 2008 to 2021 and conducted a link analysis with an LDCT imaging examination database over these years. As the volume of lung cancer screenings has increased over the years, the number and proportion of stage 0 lung cancers have increased proportionally.Our study revealed that the incidence of stage 0 lung cancer increased with increasing LDCT scan volume, particularly during the peak growth period from 2017 to 2020. Conversely, stage 4 lung cancer cases remained consistent across different time intervals. Furthermore, the increase in the lung cancer screening volume had a more pronounced effect on the increase in stage 0 lung cancer cases among females than it had among males. The estimated potential for overdiagnosis brought about by the screening process, compared to non-participating individuals, ranged from an odds ratio of 7.617 to one of 17.114. Both strict and lenient definitions of overdiagnosis (evaluating cases of stage 0 lung cancer and stages 0 to 1 lung cancer) were employed.ConclusionsThese results provide population-level evidence of potential lung cancer overdiagnosis in the Taiwanese population due to the growing use of LDCT screening, particularly concerning the strict definition of stage 0 lung cancer. The impact was greater in the female population than in the male population, especially among females younger than 40 years.To improve lung cancer screening in Asian populations, creating risk-based prediction models for smokers and nonsmokers, along with gender-specific strategies, is vital for ensuring survival benefits and minimizing overdiagnosis.

Lung cancer after kidney transplantation: a 50-year experience at a single institution

PurposeTo investigate the clinical characteristics of lung cancer that develops after kidney transplantation.MethodsThe clinical data of patients with lung cancer diagnosed after kidney transplantation were collected retrospectively. The medical records were extracted from our database. All patients underwent routine chest examination after kidney transplantation.ResultsIn total, 17 lung tumors were detected in 15 (0.6%) of 2593 patients who underwent kidney transplantation at our institution. Eleven lung tumors were completely resected from a collective 10 patients (surgical group). The remaining five patients did not receive surgical treatment (nonsurgical group). The surgical group underwent wedge resection (n = 5), segmentectomy (n = 1), lobectomy (n = 3), and bilobectomy (n = 1). The pathological stages were 0 (n = 1), IA1 (n = 2), IA2 (n = 4), IA3 (n = 2), and IB (n = 1). The surgical group had a significantly better prognosis than the nonsurgical group. There were no perioperative complications related to kidney transplantation in either group.ConclusionsRoutine chest examination would be useful for the early diagnosis and treatment of lung cancer after kidney transplantation. Moreover, surgical resection for early-stage lung cancer was associated with a better prognosis for kidney transplantation patients.

Activation of astrocytes by ANXA2-derived extracellular vesicles from lung cancer cells affects aggressiveness, immunotherapy response and microenvironment of lung cancer

BackgroundANXA2 has been extensively documented in relation to cancer. Nevertheless, the involvement of ANXA2 in lung carcinoma remains uncertain. MethodsData from The Cancer Genome Atlas (TCGA) database was downloaded using open-access methods. The examination of publicly available data was conducted utilizing the R software. The mRNA level of specific molecules was detected using Real-time Quantitative PCR (qPCR). The protein level of specific molecules was detected using the Western blot assay. The cell proliferation ability of cancer cells was assessed using the CCK8 assay. The invasion and migration capability of cancer cells was assessed using the Transwell assay. Validation of exosomes extraction was conducted using electron microscopy and particle size analysis. ResultsIn this study, based on series experiments, we found that ANXA2 can promote the activation of neuroastrocytes cells CP-H122 through the exosome pathway. Also, we found that ANXA2 can be transmitted from A549 cells to CP-H122 through the exosomes pathway and further promote the activation of CP-H122. Activated CP-H122 cells further enhance the proliferation, invasion and metastasis of A549 cells. Meanwhile, we performed transcriptome sequencing to explore the downstream genes of ANXA2 to screen potential targets for follow-up studies. Analysis based on public data showed that ANXA2 was related to the worse survival performance and clinical features of lung cancer. Gene set enrichment analysis based on the Hallmark gene set indicated that the patient with high ANXA2 expression might have a higher activity of the apical surface, reactive oxygen species pathway, angiogenesis, TGF-β signaling, MYC target, but lower activity of pancreas-β cells. More important, our results showed that ANXA2 can affects immunotherapy response and reshape immune microenvironment of lung cancer. ConclusionsThis study demonstrates that ANXA2 activates CP-H122 cells, affects A549 cell behavior, and impacts lung cancer prognosis and immunotherapy response.

Epidemiological and clinical characteristics of lung cancer in Saudi Arabia: a retrospective study in single oncology center.

Lung cancer (LC) is one of the most common neoplastic diseases and a leading cause of death in Saudi Arabia. Its incidence in Saudi Arabia has increased by more than 3% within two decades. Our study aimed to describe the epidemiological and genetic landscapes of LC in Al-Madinah city in Saudi Arabia. A retrospective analysis was conducted on the medical records of 65 patients diagnosed with lung cancer between 2015 and 2021 at a single medical oncology center in Al-Madinah city of Saudi Arabia. The mean patients' age was 59.2 years, with 50 (76.9%) males and 15 (23.1%) females; 37 (57%) smokers, and 28 (43%) non-smokers. The number of cases per year has increased gradually over six years from 2015 (n = 3) to 2020 (n = 13). The most prevalent histopathological diagnosis was non-small cell lung cancer (NSCLC) (n = 58, 89%) followed by small cell lung cancer (SCLC) (n = 5, 7.8%). NSCLC was frequently more common in smokers while squamous cell carcinoma was more frequent in non-smokers. Around 89% (n = 58) of the cases were diagnosed in late stage IV and the most common metastatic sites were to pleura and lymph nodes (n = 32, 49.2%). Program Death Legend-1 (PDL-1) was fairly expressed in 7/10 (70%) patients. Epidermal Growth Factor Receptor (EGFR) was mutated in 5/17 (29%) patients. Other mutations detected include Anaplastic Lymphoma Kinase (ALK) and phosphatidylinositol 3-kinase (PIK3C) mutations in two patients. Our study revealed that lung cancer is a significant burden in Al-Madinah city of Saudi Arabia. If the risk factors are not controlled, the number of cases may increase considerably. Health education about the risk factors and cancer prevention helps in early lung cancer detection.

Lung cancer in Asian Indian females: Identification of disease-specific characteristics and outcome measures over a 12-year period.

Globally, the incidence of lung cancer amongst women appears to be increasing. We aimed to compare the socio-epidemiological and clinical characteristics of lung cancer amongst men and women from a large cohort at a tertiary care hospital in Northern India. Records of patients diagnosed with lung cancer between January 2008 and March 2020 were reviewed. Baseline epidemiological data, clinical characteristics, histologic profiles, treatment administered, and survival were compared between males and females. A total of 2054 male and 438 female patients were included in analysis. Compared to males, female patients were younger [median age, 56 vs. 60 years, P < 0.001)], less likely to be working, less educated beyond secondary level and less likely to be smokers (29.1% vs. 84.9%, P < 0.0001). No difference in baseline performance status was observed. Females were more frequently diagnosed with adenocarcinoma (54.2% vs. 30.2%, P = <0.0001), stage IV disease (70.8% vs. 63%, P = 0.001), and had higher rate of EGFR mutation (37.2% vs. 21.5%, P < 0.0001). There was no difference in the proportion of females receiving cancer-specific therapy. Multivariate Cox proportional hazards model revealed higher progression-free survival [median 9.17 vs. 7.23 months; P = 0.007] and overall survival [median 13.80 vs. 9.10 months respectively, P = 0.001] amongst females compared to males. Amongst a large cohort of lung cancer, females demonstrated several distinct and characteristic demographics as well as disease-related features, especially better survival outcomes.

Cryptogenic Organizing Pneumonia Mimicking a Mass Lesion: An Unusual Case

Cryptogenic organizing pneumonia (COP) is less common interstitial lung disease with varying clinical picture. It can be misdiagnosed as lung cancer as COP usually presents with malaise, fever, weight loss, and myalgia, which overlap with clinical features of lung cancer. Here, we present a rare case of a 68-year-old male smoker admitted with cough, hemoptysis, arthralgia, fever, and chest pain. On chest X-ray, unilateral homogenous opacity was seen. Blood culture and sputum for Ziehl–Neelsen stain were negative. High-resolution computed tomography chest revealed consolidation in middle and lower zone of the left lung with ground-glass opacity with centrilobular nodules. Bronchoalveolar lavage specimen was negative for bacteria, Mycobacterium tuberculosis, and atypical cells. Transbronchial lung biopsy showed evidence of OP. The patient responded well to steroids.

Looking for the Genes Related to Lung Cancer From Nasal Epithelial Cells by Network and Pathway Analysis.

Previous studies have indicated that the airway epithelia of lung cancer-associated injury can extend to the nose and it was associated with abnormal gene expression. The aim of this study was to find the possible lung cancer-related genes from the nasal epithelium as bio-markers for lung cancer detection. WGCNA was performed to calculate the module–trait correlations of lung cancer based on the public microarray dataset, and their data were processed by statistics of RMA and t-test. Four specific modules associated with clinical features of lung cancer were constructed, including blue, brown, yellow, and light blue. Of which blue or brown module showed strong connection to genetic connectivity. From the brown module, it was found that HCK, NCF1, TLR8, EMR3, CSF2RB, and DYSF are the hub genes, and from the blue module, it was found that SPEF2, ANKFN1, HYDIN, DNAH5, C12orf55, and CCDC113 are the pivotal genes corresponding to the grade. These genes can be taken as the bio-markers to develop a noninvasive method of diagnosing early lung cancer.

Does pulmonary fibrosis increase lung cancer risk?

Abstract Background The concepts in lung fibrosis and increased lung cancer risk have arisen from clinical observations of the concurrent findings during the autopsy of lung cancer and pulmonary fibrosis. Scar carcinoma attributes the origin of carcinomas to abutting areas of scarring. The association between fibrosis and lung cancer risk immediately raises a query: whether lung fibrosis induces lung cancer? Aim The study was done to elucidate the incidence, risk factors, and clinical characteristics of lung cancer in diffuse lung fibrosis. Patients and methods A cohort study was done based on a prospective group of 50 patients with diffuse lung fibrosis to evaluate the incidence of lung cancer, as well as a retrospective group of 50 patients with lung cancer to search for background of pulmonary fibrosis between 2019 and 2020. Demographic, radiographic, and histologic characteristics were reviewed for both groups. Results Among 50 patients with interstitial lung disease, lung cancer developed in 2/50 (4%) during the follow-up, whereas in the retrospective group, 8/50 (16%) were diagnosed as having lung cancer with diffused lung fibrosis between 2019 and 2020. Lung cancer risk factors were male sex, smoking, and occupational dust exposure. Squamous carcinoma followed by adenocarcinoma was the commonest histologic form. Conclusion Evidence shows an association between interstitial lung diseases and lung cancer emergence. Epidemiological evidence differs owing to the various study designs and populations.

Identification of Cigarette Smoking-Related Novel Biomarkers in Lung Adenocarcinoma.

Objective The aims of this study were to screen the gene mutations that are able to predict the risk of cigarette smoking-related lung adenocarcinoma (LUAD) and to evaluate its prognostic significance. Methods Clinical data and genetic information were retrieved from the TCGA database, and the patients with LUAD were divided into three groups including never smoking, light smoking, and heavy smoking according to cigarette smoking dose. Differentially mutated genes (DMGs) of each group were analyzed. At the same time, the function of DMGs in three smoking groups was evaluated by GO function and KEGG pathway analysis. The driver genes and protein variation effect of DMGs were performed to further screen key genes. The survival characteristics of the gene expression and mutation of those genes were analyzed and plotted to visualize by the Kaplan-Meier model. Result The DMGs for different smoking doses were identified. The driver and deleterious mutation in the DMGs were screened and gene interaction network was constructed. The DMGs with driver mutations and deleterious mutations that were associated with the overall survival in the heavy smoking patients were considered as the candidate genes for novel markers of smoking-related LUAD. The final novel risk factor gene was identified as MYH7 and the high express of MYH7 in LUAD correlation with patients' gender, lymph node metastasis, T stage, and clinical stage. Conclusions In summary, it can be concluded that MYH7 is a novel biomarker for heavy smoking-related LUAD and it is significantly correlated with the prognosis of lung cancer and is related to the clinical characteristics of lung cancer.

Impact of Coronavirus Disease 2019 on Clinical Characteristics in Patients With Lung Cancer: A Large Single-Centre Retrospective Study.

Lung cancer is the most common cancer malignancy worldwide. With the continuous spread of the coronavirus disease 2019 (COVID-19) globally, it is of great significance to explore the impact of this disease on the clinical characteristics of lung cancer. Thus, we aimed to investigate whether the COVID-19 pandemic had any influence on the clinical characteristics and diagnosis of patients with lung cancer. We collected clinical and demographic data of patients who were newly diagnosed with lung cancer at our hospital between February 2019 and July 2020. Overall, 387 patients with lung cancer were divided into two groups for analysis: epidemic group (from February to July 2020) and pre-epidemic group (from February to July 2019). The source of diagnosis and clinical characteristics of the two groups were analysed. T-test and Mann-Whitney U were used for continuous variables, and Chi-squared or Fisher’s exact test for categorical variable. We found that during the epidemic period, 110 cases of lung cancer were incidentally diagnosed during COVID-19 screening, accounting for 47.6% of all newly diagnosed lung cancer cases at our hospital. The proportions of patients who were diagnosed based on symptoms and physical examination in the epidemic group were 34.2 and 18.2%, respectively, while that in the pre-epidemic group were 41.7 and 58.3%, respectively. There was significant difference in the source of diagnosis between the two groups. In a subgroup analysis of the epidemic group, the average tumour volume of the patients diagnosed with COVID-19 screening was significantly smaller than that of the patients diagnosed with symptoms and physical examination. In conclusion, the continuation of the COVID-19 pandemic may impact the screening and clinical characteristics of lung cancer and require large-scale and longer-term observation.

Featuring Trends in the Epidemiology of Lung Cancer Following the Publication of the National Cancer Strategy in Qatar.

ObjectivesQatar has witnessed significant reforms in its health care system, including the care of cancer patients. In 2011, the National Cancer Strategy was released with the aim to deliver a high standard of care to cancer patients across the country. We sought to investigate the featuring trends in the epidemiological and clinical characteristics of lung cancer in Qatar following the publication of the National Cancer Strategy.MethodsWe conducted a retrospective cohort study documenting the epidemiological and clinical characteristics of primary lung cancer cases in Qatar diagnosed from 1 January 2011 to 31 December 2018.ResultsThe overall age-standardized incidence rate was 8.7 per 100 000 persons (11.6 per 100 000 and 5.4 per 100 000 persons for males and females, respectively). The one, three, and five-year overall survival rates were 67.0%, 48.0%, and 28.0%, respectively. The three-year overall survival rates for stages I, II, III, and IV were 97.0%, 78.0%, 52.0%, and 31.0%, respectively. The three-year survival rates for males and females were 43.0% and 64.0%, respectively (p = 0.029), for Qatari and non-Qatari nationals were 42.0% and 49.0%, respectively (p = 0.252), and for smokers and non-smokers were 39.0% and 69.0%, respectively (p ≤ 0.001). The overall age-standardized mortality rate was 5.5 per 100 000 persons. Adenocarcinoma was the most common histologic type.ConclusionsDespite the low overall lung cancer incidence rate in Qatar, there is a rise in the incidence among females when compared to previous studies. Qatar has favorable five-year lung cancer survival rates compared to many developed and neighboring countries. Policymakers in the country should consider the changing patterns in lung cancer incidence when planning future preventive strategies.

Impact of idiopathic pulmonary fibrosis on clinical outcomes of lung cancer patients

The clinical characteristics of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) differ from those of lung cancer in patients without IPF. Thus, we aimed to evaluate the impact of IPF on the clinical course of patients with lung cancer. Clinical data of IPF patients with lung cancer (n = 122) were compared with those of patients with lung cancer without IPF (n = 488) matched by age, sex, histopathology, stage, and date of diagnosis of lung cancer. The median follow-up period after diagnosis of lung cancer was 16 months. Among patients with IPF, the mean age was 68 years, 95.9% were male, 93.2% were ever-smokers, and squamous cell carcinoma was the most common cancer type (48.4%). The IPF group had poorer lung function and lower lobe predominance of lung cancer than the no-IPF group. The IPF group showed a poorer prognosis than the no-IPF group (5-year survival rate: 14.5% vs. 30.1%, respectively; P < 0.001), even after adjusting for lung function and regardless of the treatment method. Among patients with IPF, 16.8% experienced acute exacerbation within 1 month after treatment of lung cancer. The treatment outcome of patients with lung cancer and IPF was generally unfavorable, and acute exacerbation triggered by treatment frequently occurred.

Expression and Clinical Significance of Lipocalin-2 in the Serum of Lung Cancer Patients

背景与目的肺癌是全球发病率最高的癌症类型，严重威胁着人类健康。肺癌的早期诊断、早期治疗对于肺癌患者的生存尤为重要。血清中的肿瘤标志物作为肿瘤早期诊断的一种重要方法已被广泛应用。然而，肺癌的早期诊断标志物还很少。本研究旨在探讨Lipocalin-2在肺癌患者血清中的表达水平及其临床意义。方法采用酶联免疫吸附法（enzyme linked immunosorbent assay, ELISA）检测Lipocalin-2在60例肺癌患者与63例健康人群外周血血清中的浓度，并分析Lipocalin-2表达水平与肺癌临床特征之间的关系。结果Lipocalin-2在肺癌患者外周血血清中的表达水平明显高于健康人群，差异具有明显统计学意义（P < 0.001）。Lipocalin-2在肺癌患者中的表达与病理组织的分化、分期及淋巴结转移相关，差异具有明显统计学意义（P < 0.05）。Lipocalin-2在病理分化差的肺癌患者血清中的表达高于分化良好患者；在发生淋巴结转移的肺癌患者血清中的表达高于没有发生淋巴结转移患者；在临床Ⅲ期+Ⅳ期肺癌患者中的表达水平显著高于临床Ⅰ期Ⅱ期患者；差异均具有统计学意义（P < 0.05）。结论Lipocalin-2在肺癌患者血清水平中高表达，与病理组织的分化、分期及淋巴结转移相关，有望成为一种潜在的用于临床诊断的新型肺癌肿瘤标志物。

Overall survival for early and locally advanced non-small-cell lung cancer from one institution: 2000-2017.

Lung cancer is the leading cause of cancer death in Spain. The objective of our study was to evaluate the characteristics of patients diagnosed with stages I-III non-small-cell lung cancer, as well as the impact that epidemiological changes, diagnostic improvements and surgical therapeutic innovations have had on survival in the past 20years. Retrospective analysis of patients diagnosed with early and locally advanced non-small-cell lung cancer between years 2000 and 2017 in our institution. A total of 859 patients were included. An increase in the percentage of women diagnosed over time was observed. Statistically significant differences were observed in the mean age at diagnosis, with a progressive increase in the different periods. The percentage of current or former smokers was similar in all periods. Adenocarcinoma was the most frequent histologic type with a progressive increase in its frequency. The percentage of patients diagnosed in early stages has been increasing over the years. In stages I-II, there was a significant increase in the median survival (29.7months: 2000-2004, 68.73months: 2010-2014) that could be seen in stage III as well (14.7months: 2000-2004, 30.63months: 2015-2017). A variation of clinical characteristics of lung cancer in Spain has been observed in recent years, as well as an improvement in survival in early and locally advanced stages, due not only to the treatments, but also to a more accurate detection of these tumors. Little progress has been made in tobacco habit with high stable percentages over the years.

Analysis of Clinical Characteristics of Lung Cancer Combined with Multiple Primary Malignancies in Other Organs

背景和目的随着胸部计算机断层扫描（computed tomography, CT）肺癌早筛技术的普及，肺癌合并其他器官多原发癌（multiple primary malignancies, MPM）的检出比例不断提高。本研究就发病率、病理特征、诊疗特点和预后情况进行探讨分析，为完善此类疾病的临床诊疗提供研究依据。方法2011年9月-2015年9月江苏省肿瘤医院胸外科共收治5, 570例肺癌患者，回顾性分析其中61例肺癌合并其他器官MPM患者的临床病理特征。结果本研究中肺癌合并其他器官MPM的发病率为1.1%，其中同时多原发癌（synchronous MPM, SMPM）15例，异时多原发癌（metachronous MPM, MMPM）46例；结直肠癌、乳腺癌和甲状腺癌占肺癌合并其他器官MPM的前三位；患者总体5年生存率为39.3%，有71.4%的患者死于肺癌转移或复发，多因素分析发现肺癌患者的临床分期、肺癌与其他肿瘤发生的先后顺序、合并肿瘤的治疗状态以及是否存在表皮生长因子受体（epidermal growth factor receptor, EGFR）基因突变是影响患者生存期的重要因素。结论肺癌合并其他器官MPM的发病率并非罕见，相较于其他器官恶性肿瘤，肺癌是主要致死原因，中晚期肺癌、SMPM、肺癌先发、合并肿瘤仅获姑息治疗和无EGFR基因突变的患者预后较差。

Analysis of EGFR mutation and clinical features of lung cancer in Yunnan

Objective: To analyze the EGFR mutation profile of lung cancer patients in Yunnan, and to provide evidence for clinical personalized treatment. Methods: Demographic and clinical data of 2 967 lung cancer patients undergoing EGFR identification were collected and analyzed from January 2014 to August 2019 in Yunnan Cancer Hospital. Results: The proportion of EGFR mutation in 2 967 patients with lung cancer was 46.2%. Univariate analysis showed that the proportion of EGFR mutation in women was higher than that in men (P<0.001) and displayed a downward trend with age (P=0.03). The mutation rate of ethnic minorities was higher than Han (P=0.012). Mutation rate in patients without smoking history was higher than those with smoking history (P<0.001), and patients without drinking history was higher than patients with drinking history (P<0.001). Mutation rate in patients without family history of lung cancer was higher than those with family history (P=0.008). The mutation rate of adenocarcinoma was higher than other pathological types (P<0.001). The mutation rate was different among stages, and it was higher in early patients than that in advanced patients (P<0.001). The mutation rate of tissue specimens was higher than those of cytology and peripheral blood samples (P<0.001). The mutation rate of Xuanwei area was lower than that in non-Xuanwei area (P<0.001). Multivariate analysis showed that gender (P<0.001), age (P=0.036), smoking history (P<0.001), pathological type (P<0.001), specimen type (P<0.001), and whether or not Xuanwei area (P<0.001) were the independent factors of EGFR mutation.The EGFR mutation was more common in female, non-smokers, adenocarcinoma, non-Xuanwei area, tissue specimen and young lung cancer patients.The mutation types of EGFR in 1 370 cases mainly included 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area was L858R, while in non-Xuanwei area was 19-Del.The mutation rates of G719X, G719X+ L861Q, G719X+ S768I, and S768I in Xuanwei were higher while the mutation rates of 19-Del, L858R, and 20-ins were lower than non-Xuanwei area (P<0.05). The 19-Del mutation rate of ethnic minorities is higher than that of Han (P<0.001). The combined mutation rate of G719X, L861Q in Han was higher than that of ethnic minorities (P=0.005). Conclusions: The EGFR mutation rate in lung cancer patients in Yunnan is similar to Asian and Chinese, and higher in female, non-smokers, adenocarcinomas, young and non-Xuanwei area patients. The most common types of EGFR mutation in Yunnan are 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area is L858R, while in non-Xuanwei area is 19-Del. The mutation rates of G719X, G719X+ L861Q, G719X+ S768I and S768I are higher in Xuanwei patients than those in non-Xuanwei patients. The combined mutation rate of G719X and L861Q in Han nationality is higher than that of ethnic minorities.

Performance of Lung Cancer Screening With Low-Dose Computed Tomography in Gejiu, Yunnan: A Prospective, Population-Based, Screening Cohort Study

PURPOSE Low-dose computed tomography (LDCT) screening has been recommended for individuals with high lung cancer risk, but the performance of lung cancer screening with LDCT in China is uncertain. This study aims to evaluate the performance of LDCT lung cancer screening in the Chinese setting. METHODS From June 2014 through December 2014, a prospective cohort of patients to undergo lung cancer screening with LDCT was established in Gejiu, Yunnan Province, using one screening center of the Lung Cancer Screening Program in Rural China. Participants received baseline screening and 4 rounds of annual screening with LDCT until June 2019. The participation rate, detection rate, early detection rate, and clinical characteristics of lung cancer were reported. RESULTS Of participants, 2,006 had complete baseline screening results with a compliance rate of 98.4%. Of these, 1,411 were high-risk and 558 were non–high-risk individuals. During this period, 40 lung cancer cases were confirmed, and of them, 35 were screen detected, 4 were postscreening, and 1 was an interval case. The positive rate of baseline and annual screening was 9.7% and 9.0%, respectively, whereas the lung cancer detection rate was 0.4% and 0.6%, respectively. The proportion of early lung cancer increased from 37.5% in T0 to 75.0% in T4. Adenocarcinoma was the most common histologic subtype. Lung cancer incidence according to the criteria of the Lung Cancer Screening Program in Rural China and the National Lung Cancer Screening Trial was 513.31 per 100,000 person-years and 877.41 per 100,000 person-years, respectively CONCLUSION The lung cancer screening program with LDCT was a successful performance in Gejiu, Yunnan; however, additional studies are warranted to refine the high-risk population who will benefit most from LDCT screening and reduce the high false-positive results.

Expression and Clinical Significance of Galcetin-3 in the Serum of Non-small Cell Lung Cancer Patients

背景与目的肺癌是对人类健康威胁最大的疾病之一, 发病率高, 死亡率高。早期肺癌可以通过外科手术得到根治, 因此, 肺癌的早期发现及早期治疗尤其重要。血清肿瘤标志物是发现及诊断肺癌的一个重要手段。目前已知, 半乳糖凝集素3(Galectin-3)在多种恶性肿瘤中均有表达。该研究旨在探讨Galectin-3在非小细胞肺癌患者血清中的表达水平及其临床意义。方法采用酶联免疫吸附法检测并比较69例非小细胞肺癌患者与77例健康人群外周血血清Galectin-3浓度, 并分析其表达水平与肺癌临床特征之间的关系。结果Galectin-3在非小细胞肺癌患者外周血血清中的表达水平高于健康人群, 差异具有显著统计学意义(P < 0.01)；有淋巴结转移的非小细胞肺癌患者, Galectin-3表达水平显著高于无淋巴结转移患者, 差异有显著统计学意义(P < 0.01)；N2淋巴结转移的患者Galectin-3表达水平显著高于N1淋巴结转移的患者, 差异有显著统计学意义(P < 0.01)；临床Ⅲ期+Ⅳ期患者Galectin-3表达水平显著高于临床Ⅰ期+Ⅱ期患者, 差异有统计学意义(P < 0.05)。结论非小细胞肺癌患者血清Galectin-3水平呈现高表达, 与肺癌转移相关, 可能是一种潜在的肺癌肿瘤标志物。

Performance of lung cancer screening with low-dose CT in Gejiu, Yunnan: A population-based, screening cohort study.

BackgroundThe performance of lung cancer screening with low‐dose computed tomography (CT) (LDCT) in China is uncertain. This study aimed to evaluate the performance of LDCT lung cancer screening in the Chinese setting.MethodsIn 2014, a screening cohort of lung cancer with LDCT was established in Gejiu, Yunnan Province, a screening center of the Lung Cancer Screening Program in Rural China (LungSPRC). Participants received a baseline screening and four rounds of annual screening with LDCT in two local hospitals until June 2019. We analyzed the rates of participation, detection, early detection, and the clinical characteristics of lung cancer.ResultsA total of 2006 participants had complete baseline screening results with a compliance rate of 98.4%. Of these, 1411 were high‐risk and 558 were nonhigh‐risk participants. During this period, 40 lung cancer cases were confirmed, of these, 35 were screen‐detected, four were post‐screening and one was an interval case. The positive rate of baseline and annual screening was 9.7% and 9.0%, while the lung cancer detection rate was 0.4% and 0.6%, respectively. The proportion of early lung cancer increased from 37.5% in T0 to 75.0% in T4. Adenocarcinoma was the most common histological subtype. Lung cancer incidence according to the criteria of LungSPRC and National Lung Cancer Screening Trial (NLST) was 513.31 and 877.41 per 100 000 person‐years, respectively.ConclusionsThe program of lung cancer screening with LDCT showed a successful performance in Gejiu, Yunnan. However, further studies are warranted to refine a high‐risk population who will benefit most from LDCT screening and reduce the high false positive results.Key pointsThis study reports the results of lung cancer screening with LDCT in Gejiu, Yunnan, a high‐risk area of lung cancer, and it demonstrates that lung cancer screening with LDCT is effective in detecting early‐stage lung cancer. Our program provides an opportunity to explore the performance of LDCT lung cancer screening in the Chinese context.