Large Cell Carcinoma Research Articles

Estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time: a population-based study.

Lung cancer is the most common cancer worldwide, yet the current epidemiological profile of lung-cancer incidence by histological subtype is only partly understood. We aimed to assess geographical variation in incidence of lung cancer by subtype worldwide in 2022, geographical variation in adenocarcinoma incidence attributable to ambient particulate matter (PM) pollution worldwide in 2022, temporal trends in lung-cancer incidence by subtype from 1988 to 2017 in 19 countries, and generational changes. For this population-based study, we used data from the Global Cancer Observatory (GLOBOCAN) 2022, Cancer Incidence in Five Continents Volumes VII-XII, and members of the African Cancer Registry Network. To obtain national estimates of lung cancer in 2022 for the four main histological subtypes (ie, adenocarcinoma, squamous cell carcinoma [SCC], small-cell carcinoma, and large-cell carcinoma) by year, sex, and age group, we combined national estimates with representative, subsite-specific incidence proportions of lung cancer on the basis of recorded incidence data compiled in Cancer Incidence in Five Continents Volume XII and from members of the African Cancer Registry Network. We calculated country-specific, sex-specific, and age-specific proportions of and sex-specific and age-specific incidence rates per 100 000 people for all four histological subtypes. To account for differences in age composition between populations by country, we calculated age-standardised incidence rates (ASRs) per 100 000 people for lung cancer by subtype and sex at national and regional levels. We also quantified the burden of adenocarcinoma incidence attributable to ambient PM pollution for 179 countries in 2022. We conducted joinpoint regression and age-period-cohort analysis to assess temporal trends in ASRs in 19 countries by sex. In 2022, we estimated that there were 1 572 045 new cases of lung cancer worldwide among male individuals, of which 717 211 (45·6%) were adenocarcinoma, 461 171 (29·4%) were SCC, 180 063 (11·5%) were small-cell carcinoma, and 101 861 (6·5%) were large-cell carcinoma. In 2022, we estimated that there were 908 630 new cases of lung cancer worldwide among female individuals, of which 541 971 (59·7%) were adenocarcinoma, 155 598 (17·1%) were SCC, 87 902 (9·7%) were small-cell carcinoma, and 59 271 (6·5%) were large-cell carcinoma. Among male individuals, the highest ASRs were in east Asia for adenocarcinoma (27·12 [95% CI 27·04-27·21] per 100 000 people), east Europe for SCC (21·70 [21·51-21·89] per 100 000 people) and small-cell carcinoma (9·85 [9·72-9·98] per 100 000 people), and north Africa for large-cell carcinoma (4·33 [4·20-4·45] per 100 000 people). Among female individuals, the highest ASRs were in east Asia for adenocarcinoma (19·04 [18·97-19·11] per 100 000 people), north America for SCC (5·28 [5·21-5·35] per 100 000 people) and small-cell carcinoma (4·28 [4·21-4·35] per 100 000 people), and north Europe for large-cell carcinoma (2·87 [2·78-2·96] per 100 000 people). We estimated that 114 486 adenocarcinoma cases among male individuals and 80 378 adenocarcinoma cases among female individuals were attributable to ambient PM pollution worldwide in 2022, with ASRs of 2·35 (95% CI 2·33-2·36) per 100 000 male individuals and 1·46 (1·45-1·47) per 100 000 female individuals. Temporal trends in lung-cancer incidence by subtype and sex during 1988-2017 varied considerably across the 19 countries. Estimated geographical and temporal distribution of lung-cancer incidence varied across the four main subtypes worldwide. Our study highlights the need for future studies that identify possible causal factors that contribute to the changing risk patterns of lung cancer. Natural Science Foundation of China Young Scientist Fund, Medical Scientific Research Foundation of Guangdong Province in China, and Young Innovative Talents Project of General Universities in Guangdong Province in China.

Phase II study of mFOLFIRINOX efficacy as first and subsequent lines of advanced gastrointestinal neuroendocrine tumors G3 and neuroendocrine carcinomas therapy.

659 Background: Gastrointestinal (GI) neuroendocrine carcinomas (NEC) are rare tumors and account for 3% of all NECs. Despite the differences in genetic characteristics, treatment principles of GI NECs are extrapolated from lung NECs. The standard first-line therapy is platinum and etoposide-containing regimens, which allow to achieve a median PFS of 5-6 months. A small retrospective study demonstrated the potential effectiveness of the mFOLFIRINOX regimen with a median PFS of 5.4 months, despite that the majority of patients (pts) received this regimen as second or subsequent lines. The aim of this study is to evaluate mFOLFIRINOX +/- somatostatin analogues (SA) efficacy in GI NEC subgroup. Methods: This prospective, single center phase II study used a two-stage Simon design. The primary endpoint is disease control rate (DCR) ≥ 6 months. Statistical hypothesis: investigated therapy improves DCR compared with historical control from 50 to 70%. Secondary endpoints are progression-free survival (PFS), overall survival (OS), objective response. At the first stage, enrollment of 16 pts was planned (α=0.05, power 80%). If a disease control ≥ 6 months was achieved in at least 9 of the 16 pts, it was planned to continue enrollment up to 39 pts. Here we present results of the first stage of this study. Inclusion criteria: pts ≥18 y.o. with histologically confirmed advanced GI NEC or neuroendocrine tumor (NET) G3 ki67≥55%; ECOG 0-2. Recruitment of pts was carried from 2019 to February 2024. Results: The study included 16 pts, 12 male and 4 female. The most common sites of primary tumor are stomach (N=8, 50%) and pancreas (N=5, 31.3%). 10 (62.5%) pts had large cell carcinoma, 1 – small cell carcinoma (6.3%), 5 (31.3%) – NET G3. The median ki-67 was 70% (40-95%). 15 pts (93.7%) had IV stage, 1 (6.3%) – III. The most common site of metastases is liver – 11 (68.8%), more than half of pts have isolated metastases in liver (N=9, 56.3%). ECOG status was evaluated as 0-1 in 15 (93.7%) cases. Majority of pts (N=14, 87.5%) received mFOLFIRINOX as first line therapy. 7 pts (46.7%) had positive expression of SSTR-2A or -5 and received concurrent treatment with SA. ORR was 62.5% (N=10/16), stable disease – 37.5% (N=6/16). DCR ≥ 6 months was 93.7% (N=15). With a median follow-up of 13.2 months, median PFS was 10.8 months (95% CI 7.57-14.1). One pts had serious adverse event - myocardial infarction, no grade 5 toxicity was observed. Conclusions: Chemotherapy with mFOLFIRINOX showed promising results in GI NECs or NETs G3 ki67≥55% treatment. Primary endpoint was met, enrollment of patients in the study continues.

SVMVGGNet-16: A Novel Machine and Deep Learning Based Approaches for Lung Cancer Detection Using Combined SVM and VGGNet-16.

Lung cancer remains a leading cause of cancer-related mortality worldwide, necessitating early and accurate detection methods. Our study aims to enhance lung cancer detection by integrating VGGNet-16 form of Convolutional Neural Networks (CNNs) and Support Vector Machines (SVM) into a hybrid model (SVMVGGNet-16), leveraging the strengths of both models for high accuracy and reliability in classifying lung cancer types in different 4 classes such as adenocarcinoma (ADC), large cell carcinoma (LCC), Normal, and squamous cell carcinoma (SCC). Using the LIDC-IDRI dataset, we pre-processed images with a median filter and histogram equalization, segmented lung tumors through thresholding and edge detection, and extracted geometric features such as area, perimeter, eccentricity, compactness, and circularity. VGGNet-16 and SVM employed for feature extraction and classification, respectively. Performance matrices were evaluated using accuracy, AUC, recall, precision, and F1-score. Both VGGNet-16 and SVM underwent comparative analysis during the training, validation, and testing phases. The SVMVGGNet-16 model outperformed both, with a training accuracy (97.22%), AUC (99.42%), recall (94.22%), precision (95.28%), and F1- score (94.68%). In testing, our SVMVGGNet-16 model maintained high accuracy (96.72%), with an AUC (96.87%), recall (84.67%), precision (87.40%), and F1-score (85.73%). Our experimental results demonstrate the potential of SVMVGGNet-16 in improving diagnostic performance, leading to earlier detection and better treatment outcomes. Future work includes refining the model, expanding datasets, conducting clinical trials, and integrating the system into clinical practice to ensure practical usability.

Serum KL-6 levels reflect the severity of interstitial lung disease caused by immune checkpoint inhibitors.

Tumor immunotherapy, particularly immune checkpoint inhibitors (ICIs), has emerged as a powerful strategy in treating malignant tumors, exhibiting efficacy in both first-line and second-line treatments for advanced non-small cell lung cancer (NSCLC). Despite their success, ICIs can lead to adverse reactions, including interstitial lung disease (ILD), with an incidence ranging from 2.7% to 20.0%. The lack of clear correlations with dosage, duration, or drug efficacy, coupled with nonspecific clinical manifestations, poses challenges in timely diagnosis and effective management. This study examined the association between ICIs-related ILD and serum levels of KL-6 and inflammatory markers in NSCLC patients. A total of 382 NSCLC patients with squamous cell carcinoma (SQC, n=81), adenocarcinoma (ACA, n=132), and large cell carcinoma (LCC, n=169) were included, of whom 191 developed ILD following ICIs treatment. Serum KL-6, TNF-α, IL-8, and IL-6 were quantified using ELISA. Results showed significantly elevated serum KL-6 levels in ILD patients (759.35±214.14U/mL) compared to those without ILD (270.81±124.98U/mL). Cancer subtype analysis revealed increased KL-6 levels across SQC, ACA, and LCC ILD patients (SQC: 645.89±255.07, ACA: 797.39±192.30, LCC: 783.57±191.21; p<0.001). ROC analysis identified diagnostic thresholds for KL-6: 277.4U/mL for SQC (sensitivity 0.9756, specificity 0.8250), 346.9U/mL for ACA (sensitivity 0.9583, specificity 0.8333), and 281.3U/mL for LCC (sensitivity 0.9873, specificity 0.6111). Correlation analysis showed a significant relationship between KL-6 and TNF-α (r=0.4626, p=0.0023), IL-8 (r=0.5584, p=0.0001), and IL-6 (r=0.5336, p=0.0003) in SQC ILD patients. These findings suggest that elevated KL-6 levels and inflammatory markers are indicative of ILD in ICIs-treated NSCLC patients, with potential diagnostic implications across cancer subtypes.

UNDERSTANDING LUNG CARCINOMA: PATHOGENESIS, DIAGNOSTIC APPROACHES, AND THERAPEUTIC ADVANCES

Lung carcinoma, originating in the bronchi or lung parenchyma, remains a leading cause of cancer-related morbidity and mortality worldwide. It accounts for approximately 2 million new cases and 1.8 million deaths annually. Factors such as tobacco consumption, environmental pollutants, genetic predispositions, and occupational exposures contribute significantly to its increasing prevalence. Lung carcinoma is broadly classified into small and non-small cell carcinoma, with subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. The pathogenesis of lung carcinoma involves genetic mutations, including alterations in tumor suppressor genes and proto-oncogenes such as K-RAS, EGFR, and ALK, leading to unchecked cell proliferation. Advances in genomic profiling and biomarker discovery have enabled the development of targeted therapies, such as EGFR inhibitors and tyrosine kinase inhibitors, revolutionizing the treatment landscape. Diagnosis relies on imaging techniques like CT and PET scans, histopathological analysis, and molecular tests. Early detection and personalized medicine approaches have improved survival rates, though challenges such as drug resistance and limited access to advanced treatments persist. Preventive measures, including smoking cessation programs and public health initiatives, remain critical in reducing lung carcinoma incidence. Palliative care plays a vital role in managing symptoms and enhancing the quality of life for advanced-stage patients. Despite advancements in therapeutic strategies, the prognosis varies significantly depending on cancer type, stage, and metastasis. Integrating immunotherapy and precision medicine holds promise for further improving patient outcomes.

Demographics and Histopathological Characteristics of Lung Cancer Patients in Cirebon District, Indonesia (2021-2023)

Background: Based on the Global Burden of Cancer Study (GLOBOCAN) in 2020, In the world, lung cancer is the first cause of death. In Indonesia, lung cancer is the third highest. Lung cancer is classified into two cell types: Small Cell Lung Cancer and Non-Small Cell Lung Cancer. There are two types of Non-Small Cell Lung Cancer: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Aims: To determine the demographics and histopathological characteristics of lung cancer patients in Cirebon District (2021-2023). Methods: This research employed a descriptive observational method. The data were collected from general hospitals’ medical records of lung cancer patients at RSUD Waled Cirebon and RSUD Arjawinangun in 2021-2023 using the total sampling technique. There were 69 respondents met the inclusion criteria for this recent study. Results: In this study, there were 68.1% of patients aged from 46 to 70 years, and the majority were male (66.7%). The most common cancer cell type was adenocarcinoma (69.6%). Most patients did not have information regarding occupational data (68.1%), smoking history (98.6%), family history (98.6%), and staging (89.9%) included in their medical records. Conclusion: The analysis showed that most lung cancer patients are aged 46-70 years and male incidences in lung cancer patients were higher. The most common type of histopathological is adenocarcinoma. Related to occupational data, smoking history, family history, and staging could not be concluded because they were not included in the medical record. Received: 25 September 2024 | Reviewed: 19 October 2024 | Revised: 30 November 2024 | Accepted: 12 December 2024.

A Novel Approach to Diagnosis: Using Convolutional Neural Networks to Classify Non-Small Cell Lung Cancers on CT Scans

Background: Lung cancer is the leading cause of cancer-related deaths around the world, making early detection vital to treatment and survival. However, lung cancer has variable clinical presentations, so diagnosis, even by trained medical professionals, is challenging and time- consuming. Deep Learning (DL) has proven effective in training big data to generate accurate diagnoses through classification in a timely manner. Aim and Objective: This study uses data augmentation and hyperparameter optimization methods on convolutional neural networks (CNN) to understand the benefits of various architectures in addition to creating an accurate transfer-based tool for lung cancer diagnosis on CT scans. Materials and Methods: We found a dataset composed of chest CT images of patients with non-small cell lung cancers (NSCLC) categorized into adenocarcinoma, large cell carcinoma, and squamous cell carcinoma and a control group of normal chest CT scans. We tested the CNN architectures VGG16, InceptionV3, ResNet50, and EfficientNetB0 for feature extraction and observed each model on a variety of different metrics such as validation accuracy, statistical errors, and learning rate. Each model was trained on the prechosen data set 2 times at 6 and 12 epochs and several evaluation metrics were recorded. Observation and Results: EfficientNetB0, ResNet50, VGG16, InceptionV3 achieved test accuracies of 98.92%, 91.40%, 77.42%, 70.97% respectively when implemented with hyperparameter tuning and dropout layers. EfficientNetB0 also exceeded the other architectures in metrics such as precision, recall, and F1-score. Conclusion: Convolutional neural networks using EfficientNetB0 yielded a higher accuracy in diagnosis of non-small cell cancer on CT scan which encourages further research in developing robust diagnostic tools using DL to expedite diagnosis, especially in locations with inadequate healthcare resources.

Methylation status of selected genes in non-small cell lung carcinoma - current knowledge and future perspectives.

DNA methylation is recognized as an early event in cancer initiation and progression. This review aimed to compare the methylation status of promoter regions in selected genes across different histological subtypes of non-small cell lung cancer (NSCLC), including adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and the rare but highly aggressive large-cell neuroendocrine carcinoma (LCNEC). A comprehensive literature search was conducted in the PubMed database until August 17, 2024, using standardized keywords to identify reports on promoter methylation in NSCLC. Seventy-five studies were reviewed, focusing on the promoter methylation of key genes, such as APC, BRCA1, CDH1, CDH13, DAPK1, DLEC1, FHIT, GSTP1, hMLH1, MGMT, CDKN2A, RARβ, RASSF1, RUNX3, and TIMP3. These studies explored diagnostic, prognostic, epidemiological, and therapeutic aspects across NSCLC subtypes. Additionally, mutational profiles of TP53, RB1, KEAP1, and STK11 and expression patterns of ASCL1, DLL3, and NOTCH were analyzed. The findings suggest that LCNEC may serve as a biological bridge between non-small cell and small-cell lung carcinoma. Our analysis highlights that the methylation status of selected genes could enhance diagnosis, prognosis, and personalized treatment strategies in patients with NSCLC, particularly those with LCNEC.

Circulating tumor cells are associated with lung cancer subtypes: a large-scale retrospective study.

Circulating tumor cells (CTCs) provide a unique resource to decipher cell molecular properties of lung cancer. However, the clinicopathologic and radiological features associated with CTCs in different lung cancer subtypes remain poorly characterized. The aim of this study was to explore the clinicopathological and radiological features of CTCs in different lung cancer subtypes. The CTC data were obtained using the CellSearch Circulating Tumor Cell Kit. CTCs were detected in 5,128 surgical patients with lung adenocarcinoma (LUAD), 2,226 with lung squamous cell carcinoma (LUSC), 248 with small cell lung cancer (SCLC), 99 with large cell carcinoma, and 70 with metastatic carcinomas. A Pearson correlation analysis was conducted to analyze the patients' clinical information, radiological features, and molecular characteristics, and logistic regression was used to examine the correlations between these factors and CTCs. For LUAD, the presence of tumor lobation, air bronchogram, and the epidermal growth factor receptor (EGFR) mutation were significantly associated with CTC levels. While the multivariable logistic regression analysis indicated that CD68 and P40 expression were independent factors associated with CTCs. For LUSC, tumor size, tumor spiculation, pleural indentation, air bronchogram, the expression levels of CK8/18, GPA33, and leucocyte common antigen (LCA) were significantly associated with CTC levels. The multivariable logistic regression analysis indicated that tumor size, pleural indentation, and air bronchogram were independent factors affecting CTCs. For SCLC, no factors were found to be significantly associated with CTC levels. For large cell carcinoma, tumor lobation and spiculation were significantly associated with CTC levels. For metastatic lung cancers, the presence of the positive lymphoid node was the only factor significantly associated with CTC levels. We conducted a comprehensive analysis of the tumor properties, radiological features, and genomic characteristics that are significantly associated with CTCs in different lung cancer subtypes. This study helps elucidate the formation mechanism and relevant major regulation molecules of CTCs.

A large unilateral basal cell carcinoma treated with Hedgehog inhibitor sonidegib: a case report

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. BCCs are categorized into “easy-to-treat” and “difficult-to-treat” groups, with the latter including all BCCs that are challenging to manage due to technical, patient-related, or tumor-related factors, such as locally advanced BCCs. In this report, we describe an 84-year-old patient with an extensive, unilateral BCC. Following a decision by the multidisciplinary skin cancer board, the patient was successfully treated with a daily dose of 200 mg of sonidegib, an inhibitor of the Hedgehog pathway, for eight months, acquiring complete clinical and histopathological remission. No significant side effects were reported. The follow-up period of 24 months has shown no negative results.

Reconstruction of 2 Independent Facial Defects Using A Single Paramedian Forehead Flap.

The paramedian forehead flap (PMFF) has been well established for use in reconstruction limited to a single nasal outer layer defect and has recently gained recognition as an acceptable alternative to traditional methods of lower eyelid reconstruction. The use of a single, pedicled PMFF for the reconstruction of more than one defect has yet to be described. A 59-year-old male patient was originally diagnosed with large squamous cell carcinoma resulting in radical resection and ipsilateral neck dissection. Postoperative final pathology was read as basal cell carcinoma; due to close margins, the patient required adjuvant radiation therapy. Immediate reconstruction at index surgery included radial forearm free flap; however, the patient subsequently developed left eye symptoms due to lid retraction and nasal symptoms with a left alar defect. The authors report the use of a single pedicled PMFF to reconstruct 2 distinct ipsilateral defects in a radiated patient-nasal ala and lower eyelid. At 6 months post-secondary reconstruction, both recipient sites of the single PMFF appear viable and in adequate position without contraction. The patient has persistent but much improved symptoms related to his eye and nasal defects. A single PMFF can be safely and effectively used in the reconstruction of 2 distinct facial defects in the appropriate patient.

Effect of Smoking Duration and Pack-Year History on Histological Subtypes of Lung Cancer

Background: Lung cancer is the leading cause of cancer-related mortality worldwide, with smoking as the principal risk factor. The histological subtypes of lung cancer, including adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, vary according to smoking history and intensity. This study investigates the effect of smoking duration and pack-year history on the histological subtypes of lung cancer in Bangladesh. Methods: A cross-sectional study was conducted at the National Institute of Diseases of the Chest and Hospital (NIDCH) from July 2007 to June 2008. A total of 98 patients with confirmed primary lung cancer were included, comprising 81 smokers and 17 non-smokers. Results: Among the 98 patients, 45% had adenocarcinoma, 28.6% squamous cell carcinoma, 16.3% small cell carcinoma, 6.1% large cell carcinoma, and 3.1% other subtypes. Smokers exhibited a higher incidence of squamous cell carcinoma (33.3%) and small cell carcinoma (19.8%), while adenocarcinoma was more common in non-smokers (88.2%). Majority (94.1%) of the patients with lesions in the upper lobe was smokers compared to 56.7% of patients with lesions in the lower lobe (p &lt; 0.001) Ratio of upper and lower lobe tumour among smoker was roughly of 4:1. A significant association was found between smoking duration, pack-years, and the occurrence of squamous and small cell carcinoma (p &lt; 0.001). Conclusion: Smoking duration and pack-years have a significant impact on the histological subtypes of lung cancer. Squamous cell carcinoma and small cell carcinoma are more prevalent in smokers, while adenocarcinoma is more common in non-smokers.

Non-small cell lung carcinoma. Clinical case

In 2020, 2.2 million new cases of lung cancer were reported. The main form of lung cancer is non-small cell carcinoma (85%). Non-small cell lung cancer has 3 subtypes: adenocarcinoma, large cell and squamous cell carcinoma. Squamous cell lung cancer occurs in 20-40% of all lung cancers. Squamous cell lung cancer is associated with an unfavorable outcome. 5-year survival rate not exceeding 18%.

P2.10B.06 Improvements in Survival Outcomes of Large Cell Carcinoma Over Past Two Decades (2000-2020)

P2.10B.06 Improvements in Survival Outcomes of Large Cell Carcinoma Over Past Two Decades (2000-2020)

B-356 Siemens CYFRA 21-1: an assay for measurement of cytokeratin fragment 21-1

Abstract Background Cytokeratins are structural proteins forming the subunits of epithelial intermediary filaments. The soluble fragment of cytokeratin 19, cytokeratin fragment 21-1 (CYFRA 21-1), can be found in the blood of lung cancer patients, primarily those with non-small cell lung cancer (NSCLC). CYFRA 21-1 is the preferred biomarker in the management of NSCLC, particularly squamous cell and large cell carcinoma subtypes. An assay for CYFRA 21-1 on Siemens ADVIA Centaur® XPT and Siemens Atellica® IM (Siemens CYFRA) is being developed and analytical performance is being presented. Methods The Siemens CYFRA 21-1 assay (in development) is a one-step chemiluminescent microparticle immunoassay (CMIA) for the quantitative determination of CYFRA 21-1 in human serum and plasma. The specimen is incubated with paramagnetic microparticles coated with the monoclonal antibody (mAb) BM19.21 and acridinium-labeled mAb KS19.1 conjugate on the Siemens ADVIA Centaur XPT System and Siemens Atellica IM System. After incubation and washing, Acid and Base reagents are added. The resulting relative light units (RLUs) are directly proportional to the amount of CYFRA 21-1 in the sample allowing for the quantitative determination of CYFRA 21-1 in the specimen. Results The following performance were determined using 3 unique lots of reagents and calibrators with the calibration range for the assay being 0.00 to 100.00 ng/mL. For the ADVIA Centaur XPT and Atellica IM systems were shown to be equivalent within 4%. The limit of blank (LoB), limit of detection (LoD), and limit of quantitation at 20% CV (LoQ) were determined and met the goal of ≤ 1.00 ng/mL. Linearity according to CLSI EP06 Ed2 was demonstrated for a range of 0.66 through 100.00 ng/mL. A Precision study of 2 controls and 5 panels spanning the range of the assay demonstrated a total %CV ≤ 8% at all levels. In the sample tube type study, a matrix comparison of 61 matched serum and plasma samples were evaluated. Passing-Bablock slopes of &amp;lt; 5% and r &amp;gt; 0.99 were observed when evaluating samples within the measurement range for plasma (LiHep, LiHep separator, K2EDTA and K3EDTA) tubes and serum separator tubes (SST) compared to the Red Top serum samples. Six endogenous substances were evaluated for interference in the CYFRA 21-1 assay. The average percent difference between test and control samples for all endogenous interferents was &amp;lt; 10%. Percent difference in the presence of 20 potentially interfering drugs was ≤ 4.0%. Conclusions The Siemens CYFRA 21-1 assay currently in development is a sensitive and precise assay for the quantitative determination of CYFRA 21-1 in human serum and plasma.

Large cell carcinoma of the lung: LDCT features and survival in screen-detected cases.

To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials. Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3-5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12years since randomization. LCC was diagnosed in 30 (4%) of 750 subjects with screen-detected lung cancer (LC), including 15 prevalent and 15 incident cases. Three additional LCCs occurred as interval cancers during the screening period. LDCT images were available for 29 cases of screen-detected LCCs, and 28 showed a single, peripheral, and well-defined solid nodule or mass with regularly smooth (39%), lobulated (43%), or spiculated (18%) margins. One case presented as hilar mass. In 9 incident LCCs, smaller solid nodules were identified in prior LDCT examinations, allowing us to calculate a mean Volume Doubling Time (VDT) of 98.7±47.8 days. The overall five-year survival rate was 50%, with a significant (p=0.0001) difference between stages I-II (75% alive) and stages III-IV (10% alive). LCC is a fast-growing neoplasm that can escape detection by annual LDCT screening. LCC typically presents as a single solid peripheral nodule or mass, often with lobulated margins, and exhibits a short VDT. The 5-year survival reflects the stage at diagnosis.

Hybrid Approach of Multiclassification for Lung Cancer Types Identification

As a widespread health concern, lung cancer requires sophisticated detection techniques for a precise classification. This research proposes an integrated framework for improving how well lung cancer is detected by combining processing methods for images and machine learning. The dataset, which includes normal cases, large-cell carcinoma, squamous cell carcinoma, and adenocarcinoma, allows for a detailed investigation of various forms of lung cancer. K-means clustering is the initial stage of the approach of segmenting complex images. Utilizing the VGG16 model, features are extracted that are important for classification. Several classification models, such as SVM, Logistic Regression, and Feedforward Neural Network, are trained using the combined features from clustering and VGG16. This research goes beyond the dichotomy of benign and malignant cases, investigating in more detail the subtypes of large-cell carcinoma, squamous cell carcinoma, and adenocarcinoma. Including different classes of lung cancer increases the granularity of the classification process, improving diagnostic accuracy and clinical insights. The results highlight how well the suggested strategy works, which is a major advancement in the accurate identification of distinct kinds of lung cancer.

The study of plain CT combined with contrast-enhanced CT-based models in predicting malignancy of solitary solid pulmonary nodules

To compare the diagnostic performance between plain CT-based model and plain plus contrast CT-based modelin the classification of malignancy for solitary solid pulmonary nodules. Between January 2012 and July 2021, 527 patients with pathologically confirmed solitary solid pulmonary nodules were collected at dual centers with similar CT examinations and scanning parameters. Before surgery, all patients underwent both plain and contrast-enhanced chest CT scans. Two clinical characteristics, fifteen plain CT characteristics, and four enhanced characteristics were used to develop two logistic regression models: model 1 (plain CT only) and model 2 (plain + contrast CT). The diagnostic performance of the two models was assessed separately in the development and external validation cohorts using the AUC. 392 patients from Center A were included in the training cohort (median size, 20.0 [IQR, 15.0–24.0] mm; mean age, 55.8 [SD, 9.9] years; male, 53.3%). 135 patients from Center B were included in the external validation cohort (median size, 20.0 [IQR, 16.0–24.0] mm; mean age, 56.4 [SD, 9.6] years; male, 51.9%). Preoperative patients with 201 malignant (adenocarcinoma, 148 [73.6%]; squamous cell carcinoma, 35 [17.4%]; large cell carcinoma,18 [9.0%]) and 326 benign (pulmonary hamartoma, 118 [36.2%]; sclerosing pneumocytoma, 35 [10.7%]; tuberculosis, 104 [31.9%]; inflammatory pseudonodule, 69 [21.2%]) solitary solid pulmonary nodules were gathered from two independent centers. The mean sensitivity, specificity, accuracy, PPV, NPV, and AUC (95%CI) of model 1 (Plain CT only) were 0.79, 0.78, 0.79, 0.67, 0.87, and 0.88 (95%CI, 0.82–0.93), the model 2 (Plain + Contrast CT) were 0.88, 0.91, 0.90, 0.84, 0.93, 0.93 (95%CI, 0.88–0.98) in external validation cohort, respectively. A logistic regression model based on plain and contrast-enhanced CT characteristics showed exceptional performance in the evaluation of malignancy for solitary solid lung nodules. Utilizing this contrast-enhanced CT model would provide recommendations concerning follow-up or surgical intervention for preoperative patients presenting with solid lung nodules.

Patient-derived organoids and mini-PDX for predicting METN375S-mutated lung cancer patient clinical therapeutic response

Patient-derived organoids and mini-PDX for predicting METN375S-mutated lung cancer patient clinical therapeutic response

318. EFFICACY OF PROPHYLACTIC STEROID THERAPY OF INJECTION AND ADMINISTRATION AGAINST STRICTURE FOR SUBENTIRE CIRCUMFERENTIAL DEFECT AFTER ESOPHAGEAL ENDOSCOPIC SUBMUCOSAL DISSECTION

Abstract Background Esophageal stricture is a major problem after endoscopic submucosal dissection (ESD) for large superficial esophageal squamous cell carcinomas (SESCC). Local triamcinolone injection (LTI) has been reported as the standard prophylactic treatment against stricture, however, it showed that its efficacy was insufficient for subentire circumferential mucosal defect after ESD in the subgroup analysis of randomized controlled trial (JCOG1217). On the other hand, the usefulness of oral prednisolone administration (OPA) has also been reported. Thus, we aimed to compare the efficacy of LTI with combination of LTI and OPA in patients with subentire circumferential mucosal defect after esophageal ESD. Methods This retrospective study enrolled the patients with mucosal defect after ESD larger than 7/8th circumference and not spreading entire who treated with LTI or combination of LTI and OPA between July 2010 to January 2020. Triamcinolone acetonide (50-100 mg) was injected into ulcer bed immediately after ESD, and oral prednisolone (30 mg daily, tapered gradually for 8 weeks) was administrated. We defined as an esophageal stricture in case the endoscope could not pass through the stricture, and then endoscopic balloon dilation (EBD) was required. We evaluated stricture-free survival (SFS), and the number and duration of EBD. Results A total of 42 patients in the LTI group and 26 in the combination group were enrolled. The median longitudinal extension of the lesions was 4.5 cm (range; 2-7) in the LTI group and 4 cm (2-7) in the combination group. Finally, 18 patients (42.9%) in the LTI group and 7 (26.9%) in the combination group developed esophageal stricture, and 12-week SFS was 64.3% and 76.9%. The median number and duration of required ESD were 6 (2-10) in the LTI group and 4 (2-9) in the combination group, and 88 days (15-288) and 66 days (22-176). Conclusion The steroid combination therapy of local triamcinolone injection and oral prednisolone administration showed the effective outcomes comparing with local triamcinolone injection alone for subentire circumferential mucosal defect after esophageal ESD. Thus, this combination therapy can be the most promising treatment and should be compared in the randomized controlled trail with large sample size.