High-risk Groups Of Lung Cancer Research Articles

Analysis of screening results and risk factors of high-risk populations of lung cancer in Nanchang city from 2018 to 2019

Objective: To collate and analyze the screening results of high-risk lung cancer populations in communities in Nanchang from 2018 to 2019, and to explore the lung-positive nodules and risk factors for lung cancer. Methods: Data of the screening subjects in 8 administrative districts and 15 street health service centers in Nanchang city, Jiangxi province from November 2018 to October 2019 were collected, people at high risk of lung cancer was assessed, clinical screening of high-risk groups of lung cancer was conducted by low-dose helical computed tomography (LDCT), and risk factors for suspected lung cancer and lung-positive nodules were analyzed. Results: Of the 25 871 people participated in screening, 5 220 were at high risk for lung cancer and 15 374 without other malignant tumors were at high risk. There were 2 417 cases participated in clinical LDCT screening, including 193 cases of lung-positive nodules, 67 cases of suspected lung cancer, 912 cases of other lung diseases, the positive rate of lung cancer or lung-positive nodules was 10.76% (260/2 417). Univariate analysis showed that age, coarse grain intake, oil intake, housing heating, passive smoking, alcohol consumption and mental trauma were associated with positive pulmonary nodules or lung cancer (all P<0.05). Multivariate analysis showed that gender, age, housing heating, smoking and drinking were related to the occurrence of lung nodules or lung cancer (all P<0.05). Conclusions: Men are more likely to develop lung cancer or lung-positive nodules than women. The age is an independent risk factor for lung-positive nodules or lung cancer. In a certain range, age will increase the incidence of lung cancer, housing heating may be the protective factor for lung cancer, while smoking and drinking are risk factors.

Application of logistic regression and convolutional neural network in prediction and diagnosis of high-risk populations of lung cancer.

The early detection, early diagnosis, and early treatment of lung cancer are the best strategies to improve the 5-year survival rate. Logistic regression analysis can be a helpful tool in the early detection of high-risk groups of lung cancer. Convolutional neural network (CNN) could distinguish benign from malignant pulmonary nodules, which is critical for early precise diagnosis and treatment. Here, we developed a risk assessment model of lung cancer and a high-precision classification diagnostic model using these technologies so as to provide a basis for early screening of lung cancer and for intelligent differential diagnosis. A total of 355 lung cancer patients, 444 patients with benign lung disease and 472 healthy people from The First Affiliated Hospital of Zhengzhou University were included in this study. Moreover, the dataset of 607 lung computed tomography images was collected from the above patients. The logistic regression method was employed to screen the high-risk groups of lung cancer, and the CNN model was designed to classify pulmonary nodules into benign or malignant nodules. The area under the curve of the lung cancer risk assessment model in the training set and the testing set were 0.823 and 0.710, respectively. After finely optimizing the settings of the CNN, the area under the curve could reach 0.984. This performance demonstrated that the lung cancer risk assessment model could be used to screen for high-risk individuals with lung cancer and the CNN framework was suitable for the differential diagnosis of pulmonary nodules.

A novel glycan biomarker, 10-7G value has a possibility to detect high risk-groups of lung cancer in medical checkup

A novel glycan biomarker, 10-7G value has a possibility to detect high risk-groups of lung cancer in medical checkup

Research Progress on Lung Cancer Screening

肺癌是世界上最常见的恶性肿瘤，其5年生存率仅为19.7%，严重威胁人类健康。肺癌筛查是降低肺癌死亡率的有效措施，已有的研究证明用低剂量螺旋计算机断层扫描（low-dose computed tomography, LDCT）进行筛查可降低20%的肺癌死亡，目前国际和国内均建议进行肺癌筛查。研究肺癌筛查的发展现状有助于我们明确肺癌的高危人群，探索合理的筛查方案，提高筛查的成本效益，减轻经济负担。因此本文就肺癌筛查现状、肺癌筛查的成本效益以及存在的问题综述如下。

Ground glass opacity on chest CT scans from screening to treatment: A literature review.

Lung cancer is the most common cause of cancer death in the world. However, recent studies have found that patients with pulmonary ground-glass opacity (GGO) have a better prognosis. Considering its low invasiveness, sublobar resection may be an appropriate treatment of choice. Low-dose computed tomography (CT) is recommended for the high-risk groups of lung cancer. Patients with nonsolid nodule are suggested to take annual low dose CT following-up. For part-solid or solid nodules, the solid component size less or more than 8 mm is the watershed of surgical treatment. Increasing tumor size is a hint of malignancy. Biopsy can be performed for clinically highly suspected malignant nodules. The endobronchial ultrasound biopsy, CT-guide biopsy, or surgical excision are the mainstream for the diagnosis of lung nodules. But for treatment, the sublobar resection is the mainstream of pulmonary GGO. A precise localization technique makes surgeons get enough resection margin and preserve more pulmonary function of the patients. The different localization technique is suitable for different kind nodular position. For patients with pure pulmonary GGO, annual low dose CT checkup is suitable. If the tumor size or solid part of the tumors increased gradually, adequate sublobar resection after tumor localization technique may provide good prognosis and preserve more pulmonary function of the patients.

Compliance of lung cancer screening with low-dose computed tomography and influencing factors in urban area of Henan province

Objective: To evaluate the compliance of low-dose computed tomography (LDCT) screening for high-risk groups of lung cancer and influencing factors in urban area of Henan province during 2013-2017. Methods: Cluster sampling method was used to select the residents of 40-74 years old in Henan for cancer risk factor investigation and lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT screening. The differences of LDCT receiving rates between groups were compared with χ(2) tests, and the time trend of rates were tested with the Cochran- Armitage trend test. The potential factors correlating to the compliance of LDCT screening were identified with multivariate logistic regression models. Results: Overall, 35 672 participants who met the inclusion criteria were included in this analysis, and 13 383 of them received LDCT screening, the receiving rate was 37.52%. The receiving rate varied greatly across cities, ranging from 38.47% to 26.73% (P<0.05). Moreover, the receiving rate varied greatly across periods, ranging from 29.22% during 2013-2014 to 43.30% during 2014-2015, and the receiving rate increases gradually as the screening year increases (P<0.001). The multivariate logistic regression analyses showed that: being female, age 45-69 years, with education level of junior high school/high school, previous smoking, drinking or previous drinking, infrequent physical exercise, history of tuberculosis, history of chronic bronchitis, history of emphysema, history of asthma bronchiectasis and family history of lung cancer were positive factors for receiving LDCT screening (All P<0.05). Conclusions: The overall compliance of LDCT screening in high-risk population of lung cancer was still not high in urban area of Henan. Implementation of effective interventions targeting the specific high-risk populations might improve the overall compliance of LDCT screening in the future.

Risk factors for lung cancer based on low-dose computed tomography screening

Objective: To analyze the risk factors related to lung cancer in participants with low-dose computed tomography (LDCT) screening, to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening. Methods: A total of 5 366 asymptomatic subjects (2 762 males and 2 604 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The result of LDCT and the risk factors of participants were analyzed. The LDCT positive results were defined as solid or part-solid nodules≥5 mm and non-solid nodule≥8 mm. A total of 12 factors were included and multivariate logistic regression was used to analyze the risk factors associated with lung cancer in the study. Results: Of the 5 366 asymptomatic subjects, 389 were positive and 4 977 were negative for LDCT screening. Among them, 26 of 389 positive cases were confirmed as lung cancers pathologically, and the detection rate of stage I lung cancer was 92.3% (24/26). Multivariate logistic regression showed that age, smoking, low level of education were the relevant risk factors for lung cancer and positive nodules. A stratified analysis of age showed that no risk factors were detected in the 40-49 years old group, while age, smoking, low level of education (primary school and below) were recognized as risk factors in the ≥50 years old group. No statistically significant risk factor was detected between the lung cancer group and the positive nodules group. Conclusions: Age, smoking, and low level of education (primary school and below) are related risk factors for lung cancer and positive nodules. People aged 50 years or older, smoking, and low level of education may be a high risk group for lung cancer. LDCT can effectively detect early lung cancer.

Measuring serum human epididymis secretory protein autoantibody as an early biomarker of lung cancer.

BackgroundLung cancer (LC) is one of the most common types of malignant tumors and is the most prominent cause of tumor-related death worldwide. LC is a heterogeneous disease caused by somatic cell mutations and dysregulation in several signaling pathways. Understanding these pathways provides the basis for detecting LC. LC screening and diagnosis in current clinic still rely on computed tomography (CT), but its high false positive rates and cost may prevent it from being a routine screening method. Therefore, the discovery of new non-invasive and more valuable biomarkers may present an improved diagnostic approach for LC, and potentially provide more useful information for the prognosis and treatment of LC in patients. This study investigated the potential of detecting serum autoantibodies produced against human epididymis secretory protein 4 (HE4) for LC diagnosis in high-risk groups.MethodsSerum samples from 61 patients with LC were included in this study, and another 53 serum samples from healthy donors or benign lung diseases (BLD) patients were collected as the control group. The samples were analyzed with enzyme-linked immunosorbent assays (ELISA).ResultsELISA results showed significantly higher levels of serum autoantibodies against HE4 in samples from LC patients compared to the control group (P<0.001). Analysis of HE4 autoantibodies showed a receiver operating characteristic (ROC) curve indicating 67.21% sensitivity, 96.23% specificity, and an area under the curve (AUC) of 0.848. Levels of HE4 autoantibodies can discriminate early-stage LC patients from the control group with a 54.76% sensitivity.ConclusionsDetecting serum HE4 autoantibody levels may be a potential biomarker in high-risk groups of LC. We present a new method for the diagnosis of LC in the clinic.

P2.11-37 Low-Dose CT Lung Screening: Analysis of Risk Factors Related to Lung Cancer

LDCT has been increasingly accepted as an efficient screening method for lung cancer detection and mortality reduction in high-risk populations. Screening data based lung cancer risk factors analysis is supposed to benefit identifying high-risk population of lung cancer. The aims of this study are to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening. Subjects consisted of 5366 asymptomatic and voluntary participants (includes 2762 males and 2604 females) aged 40-87 years old, who received LDCT in Cancer Hospital, Chinese Academy of Medical Sciences between Jan 1st, 2014 and Dec 31st, 2017. Participants finished questionnaires relevant to risk factors and were provided Low-dose CT scans. The LDCT Radiological results were interpreted according to the I-ELCAP lung Screening Protocol. Multivariate logistic regression examined associations of risk factors within Age, Sex, Smoking status, Second-hand smoking status, COPD, Asthma, Family history of lung cancer, History of tuberculosis, Occupational exposure and Diabetes. 389 of the 5366 participants had a positive (including lung cancer) screen with LDCT, 26 participants were pathologically confirmed lung cancer. Multivariate logistic regression showed that age and smoking (previous smoking and current smoking) were risk factors related to lung cancer and positive nodules. There was no risk factor in distinguishing between lung cancer and positive nodules (excluded lung cancer). Stratified by age, Multivariate logistic regression did not identify any risk factor related to lung cancer and positive nodules in 40-49 years old group, while 3 risk factors were identified in ≥50 years old group (age, smoking, and history of tuberculosis).View Large Image Figure ViewerDownload Hi-res image Download (PPT) • Age, smoking are risk factors related to lung cancer and positive nodules. • ≥50 years old with a history of smoking or tuberculosis may be a high risk group for lung cancer in China.

Differentiation of positive autofluorescence bronchoscopy findings by comparative genomic hybridization

Up to 50% of the results of autofluorescence bronchoscopy (AF) of histologically benign lesions are false-positive. For better differentiation of such lesions we have used comparative genomic hybridization (CGH). We studied biopsy material from 47 patients by CGH. For a comparison of findings, the patients were grouped as follows: Group 1, patients with manifest malignant lesions (n=10); group 2, patients with positive autofluorescence and negative (benign) histology (n=16); group 3, patients with negative autofluorescence and negative histology, who belong to a typical high-risk group for lung cancer (n=21). The biopsy specimens of 21/47 patients (45%) showed chromosome aberrations. In 8/10 cases (80%) in group 1, one or several chromosome lesions were detected. Chromosome aberrations were found in 13/16 specimens (81%) taken in group 2. None of the 21 biopsy specimens from the patients of group 3 showed any chromosome lesions. The chromosome aberrations detected in groups 1 and 2 show nearly identical distribution patterns. Lesions of chromosome 3 are the most frequent ones in both groups. The results of the CGH investigation show that regions of the bronchial mucosa with positive AF finding and benign histology frequently are seriously damaged and may develop into potentially malignant lesions.

Former poison gas workers and cancer: incidence and inhibition of tumor formation by treatment with biological response modifier N-CWS.

Mustard gas is known to have mutagenic and carcinogenic effects on animal and human cells. In this report, 1,632 male Japanese who worked in poison gas factories at some time between the years 1927 and 1945 were studied to determine comparative risk for development of cancer, the reference population being data on Japanese males overall. The standardized mortality ratio (SMR) for lung cancer in workers directly and indirectly involved in the production of mustard gas was significantly elevated. In addition, SMR for lung cancer in worker who had worked for more than 5 years was also significantly elevated. Thus, poison gas workers who had engaged in the production of mustard gas or related work for more than 5 years are a high-risk group for lung cancer. Under the cancer preventive program, Nocardia rubra cell-wall skeleton (N-CWS) was administered to 146 former poison gas workers. During a 4.5 year observation period, development of cancers was found in 7 treated workers and 17 untreated controls. After elimination of the influence of smoking level, a significant suppression of development of cancers was noted in the N-CWS-treated workers as compared to the untreated controls. Although the molecular mechanisms of carcinogenesis in former poison gas workers remains unclear, our study proposes the possible effect of biological response modifiers in the prevention of cancer development in high-risk human subjects.

CLINICAL AND PATHOLOGICAL STUDY OF ORAL LEUKOPLAKIA

Clinical and pathological observation has been carried out in 68 cases of oral leukoplakia examined in our department and results are as follows.1) The patients consisted of 42 males and 26 females, and a high prevalence was observed in males in their forties.2) Foci most frequently occured on the gingiva, then on the tongue, lips and buccal mucous membrane, and were found least frequently on the oral floor.On the gingiva, a great many white-spotted types and plateau types occurred but on the tongue erosive types were seen most frequently.On the lips and buccal mucous membrance, many white-spotted types were observed but on the oral floor only one white-spotted type and one erosive type were seen. Five cases were accompanied by cancer and four cases became malignant, all of these being derived from the erosive type.3) In relation to smoking, the incidence was 70% in males and 44% in females and was higher than the average percentage of adult smokers in our country. Score of Brinkman index (B.I.) was 562 on average and this was higher then B.I. 400 which is a standard value of the high-risk group for lung cancer, therefore smoking is considered to be the cause of this disease.4) Investigation of the relationship between metal restorations and dentures using patch testing revealed in 53% of a positive reaction cases. Many positive reactions were observed toward metals most commonly used in dental materials, and this suggested a great possibility of local stimululation by metal allergy. Cases associated with a local stimulus deriving from unfitted dentures, dental caries and metal allergies amounted to 56%.5) In the results of glucose tolerance testing, a significant difference was not shown in comparison with healthy persons in the same age bracket. Levels of serum immunoglobulins IgA, IgG, IgM, and vitamin A, vitamin B2 and cholesterol in blood were within normal values.The above results indicate that systemic factors were not influencing factors as much as were local factors.6) In histological studies, as to the first pattern (that without a differential pattern in epithelial cells, with a thin epithelial layer a great difference was not observed in comparison with other groups. However, as to the second pattern (that without a differential pattern in the epithelial cells, with a thickened epithelial layer) the epithelial layer was thickened and intercellular edema in the squamous cell layer and prolongation and acumination of the rete ridge were shown. As to the third pattern (one accompanied by a differential pattern in the epithelial cells) the tissues observed were similar to those in the second pattern, but cells with enlarged nuclei and increased chromatin content in the basement layer, and on increased mitosis rate were observed.In electron microscopic examination, in the basement cell layer, Langerhans cells (L.C.) were often observed.7) In the chemical examination of immunohistologic patterns clinically found, the degree of infiltration of sub-epithelial tissue, and S-100 protein-positive cells in the epithelium were analysed.Results showed that the number of S-100 protein-positive cells in the epithelia were increasing significantly in plateaupatterns, accompanied by erosion and cancer patterns.Pathologically, the relationship between degree of infiltration of sub-epithelial tissue and S-100 protein-positive cells was clearly observed to be correlative.The increase in L.C. in the case of plateaupattern and erosivepattern leukoplakia and in cases where lesions developed into cancer is considered to suggest functional acceleration of antigen recognition mechanism in the foci, together with the acceleration of cellular infiltration to sub-epithelial tissue in these patterns.