Objective To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. MethodsThe patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.
Objective To analyze the expression of H2A histone family, member X (H2AFX) gene in lung adenocarcinoma and its influence on prognosis. Methods We analyzed the expression level of H2AFX gene in the tumor tissues (497 cases) and normal adjacent tissues (54 cases) of lung adenocarcinoma patients via The Cancer Genome Atlas. The patients were divided into high expression group and low expression group according to the expression level of H2AFX gene in lung adenocarcinoma samples. The relationship between H2AFX and clinicopathological features of patients was analyzed through logistic regression. Kaplan-Meier survival curve and log-rank test were used to study the correlation between H2AFX expression and the prognosis of lung adenocarcinoma patients. Univariate and multiple Cox regression analyses were performed to determine the prognostic significance of H2AFX expression in lung adenocarcinoma patients. The research also covered H2AFX-related pathways of genes in the development of lung adenocarcinoma with gene set enrichment analysis (GSEA). Results The H2AFX expression was higher in lung adenocarcinoma tissues than that in normal adjacent tissues (P<0.001). Besides, it was significantly correlated with age (P<0.001), T staging (P=0.007), and N staging (P=0.010), but had little to do with M staging or gender (P>0.05). Kaplan-Meier survival curve and log-rank test showed that the survival rate of patients with high H2AFX expression was vastly lower than that of patients with low H2AFX expression (P<0.001). Multiple Cox regression analysis demonstrated that H2AFX could be an independent prognostic factor for lung adenocarcinoma [hazard ratio=1.41, 95% confidence interval (1.11, 1.78), P=0.004]. The results of GSEA displayed that H2AFX was involved in cell cycle, homologous recombination, DNA replication, base excision and repair, spliceosome, mismatch repair, p53 signaling pathway, nucleotide excision and repair, RNA degradation, RNA polymerase, and other pathways. Conclusions The expression of H2AFX gene is high in lung adenocarcinoma, and closely connected to the prognosis, occurrence, and evolution of lung adenocarcinoma. This gene can be one of the new molecular markers and therapeutic targets for lung adenocarcinoma.
ObjectiveTo evaluate the clinical manifestation, radiological, pathological features and treatment of organizing pneumonia (OP) induced by aerosolized recombinant super compound interferon (rSIFN-co).
MethodsClinical features and related laboratory examinations of a patient with OP developing after initiation of rSIFN-co for treatment of lung adenocarcinoma were analyzed, and the relevant literature was reviewed.
ResultsA 48-year-old man developed cough, fevers, shortness of breath and weight loss, shortly half a month after initiation of therapy with rSIFN-co for lung adenocarcinoma. Chest high resolution computerized tomography (HRCT) showed multiple lung infection diseases. However, the anti-infection treatment was invalid. Lung tissue biopsy by bronchofibroscope was consistent with OP. After discontinuation of rSIFN-co and receiving pulse corticosteroid therapy followed by oral methylprednisolone, the pneumonic symptoms and chest manifestations markedly improved. After eight-month follow-up, the patient's condition was stable. The relative literature screening from Pubmed and Wanfangdata was implemented, but there was no report about OP caused by aerosolized rSIFN-co for lung adenocarcinoma.
ConclusionThis report suggests that treatment with aerosolized rSIFN-co for lung adenocarcinoma may induce OP, a rare complication, and clinicians should have vigilance on it.
Lung adenocarcinoma has become the most common type of lung cancer. According to the 2015 World Health Organization histological classification of lung cancer, invasive lung adenocarcinoma can be divided into 5 subtypes: lepidic, acinar, papillary, solid, and micropapillary. Relevant studies have shown that the local lobectomy or sublobectomy is sufficient for early lepidic predominant adenocarcinoma, while lobectomy should be recommended for tumors containing micropapillary and solid ingredients (≥5%). Currently, the percentage of micropapillary and solid components diagnosed by frozen pathological examination is 65.7%, and the accuracy of diagnosis is limited. Therefore, to improve the accuracy of diagnosis, it is necessary to seek new methods and techniques. This paper summarized the characteristics and rapid diagnosis tools of early lung adenocarcinoma subtypes.
The diagnostic frequency of multiple pulmonary tumor nodules has increased significantly in clinical practice. Among patients with multiple pulmonary nodules, distinguishing between separate primary lung carcinomas and intrapulmonary metastases is critical for accurate tumor staging, therapeutic decision-making, and prognostic evaluation. The consensus document "Differentiating separate primary lung adenocarcinomas from intrapulmonary metastases with emphasis on pathological and molecular considerations: Recommendations from the International Association for the Study of Lung Cancer Pathology Committee" highlights the pivotal role of integrated pathological and molecular analyses in diagnosing and differentiating primary lung adenocarcinomas from intrapulmonary metastatic lesions. It further proposes a combined four-step histologic and molecular classification algorithm for addressing multiple pulmonary tumor nodules of adenocarcinoma histology, providing clinicians with enhanced diagnostic tools to refine staging accuracy, guide therapeutic strategies, and improve prognostic predictions for lung adenocarcinoma. Building on current advancements in global research, this article offers a comprehensive interpretation of the consensus recommendations.
ObjectiveTo assess the specific clinicopathological characteristics as well as prognostic value of prognostic significance of spread through air spaces (STAS) in lung adenocarcinoma.MethodsWe systematically searched the databases of PubMed, EMbase and Web of Science databases from their date of inception to March 2019. The quality of the included literature was assessed by the Newcastle-Ottawa scale (NOS). The NOS of the study higher than 6 points was considered as high quality. Software of Stata 12.0 was used for meta-analysis.ResultsTwenty retrospective cohort studies involved with totally 6 225 patients were included. Quality of included studies was high with NOS score equal or higher than 6 points. STAS was associated with male sex, ever smoking history, abnormal carcino-embryonic antigen (CEA) level, air bronchogram negative, anaplasticlymphoma kinase (ALK) arrangement positive, epidermal growth factor receptor (EGFR) mutation positive, advanced pathological tumor stage and more invasive pathological adenocarcinoma subtypes. The presence of STAS indicated significantly poor recurrence free survival (RFS) (HR=1.960, 95%CI 1.718-2.237, P<0.001) as well as poor overall survival (OS) (HR=1.891, 95%CI 1.389-2.574, P<0.001). Further subgroup analyses showed that exhibiting tumor size including diameter less than 2 cm (HR=2.344, 95%CI 1.703-3.225, P<0.001) and diameter over 2 cm (HR=2.571, 95%CI 1.559-4.238, P<0.001), resection type including lobectomy (HR=1.636, 95%CI 1.258-2.127, P<0.001) and sublobar resection (HR=3.549, 95%CI 2.092-6.021, P<0.001) in stageⅠ adenocarcinoma suggested that STAS had a bad effect on RFS.ConclusionPresence of STAS is associated with more aggressive clinicopathological features and independently associated with worse RFS and OS in lung adenocarcinoma. STAS positive has a negative effect on RFS whatever the tumor size (including the diameter<2 cm or >2 cm) and resection types in stageⅠ adenocarcinoma.
Diabetic retinopathy (DR) is a serious complication of diabetes mellitus that not only impairs vision and quality of life but has also emerged as a leading cause of blindness in working-age individuals. Long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (LncMALAT1) is a non-coding RNA molecule that regulates gene expression and has been implicated in the pathogenesis and progression of DR. It exerts its effects through the modulation of various pathological processes, including inflammation, oxidative stress, angiogenesis, and apoptosis. Notably, alterations in the expression levels of LncMALAT1 may serve as potential biomarkers for the early diagnosis of DR. Furthermore, interventions targeting LncMALAT1, employing antioxidants, anti-angiogenic agents, traditional Chinese medicine, and gene therapy, present promising avenues for its potential development as an effective therapeutic target for DR.
Lung adenocarcinoma is a prevalent histological subtype of non-small cell lung cancer with different morphologic and molecular features that are critical for prognosis and treatment planning. In recent years, with the development of artificial intelligence technology, its application in the study of pathological subtypes and gene expression of lung adenocarcinoma has gained widespread attention. This paper reviews the research progress of machine learning and deep learning in pathological subtypes classification and gene expression analysis of lung adenocarcinoma, and some problems and challenges at the present stage are summarized and the future directions of artificial intelligence in lung adenocarcinoma research are foreseen.
Objective To investigate the molecular mechanisms by which the long non-coding RNA (lncRNA) MIR223HG affects the proliferation, migration and apoptosis of lung adenocarcinoma cells. MethodsDNA damaging agent Zeocin was used to treat human embryo lung cell (MRC-5) and lung cancer cell (A549 and H1299), and the expression of MIR223HG was tested by quantitative real-time polymerase chain reaction (qRT-PCR) analysis. Moreover, the ataxia-telangiectasia mutated (ATM) protein and ATM pathway downstream factor Cell cycle checkpoint kinase 2 (Chk2), p53 tumor suppressor protein (p53) in the lung cancer cell (A549 and H1299) with Zeocin were also tested by qRT-PCR. Cell transfection and Transwell migration assay, colony formation assays, apoptosis assays were performed to verify the role of ATM in the expression of MIR223HG in lung adenocarcinoma. ResultsThe expression of MIR223HG was reduced markedly in the lung cancer cells (A549 and H1299) compared with human embryo lung cell (MRC-5) after treated with Zeocin. ATM protein and its downstream factors Chk2, p53 involved in the process, and ATM regulated the expression of MIR223HG in the lung cancer cells with Zeocin. Futhermore, ATM joined in the processes that MIR223HG regulated the lung cancer cells proliferation, migration and apoptosis. Conclusions The expression of MIR223HG is related to the DNA damage response in the lung cancer, and MIR223HG regulates lung cancer cells proliferation, migration and apoptosis by ATM/Chk2/p53 pathway. MIR223HG may be a potential therapeutic target for lung adenocarcinoma treatment.
Objective To evaluate the correlation between cyclin B1 (CCNB1) gene expression and the prognosis of lung adenocarcinoma. Methods Oncomine, STRING, Human Protein Atlas, The Cancer Genome Atlas and other databases as well as Kaplan-Meier method, Cox regression, receiver operating characteristic (ROC) curve and Spearman correlation analysis were used to verify the effect of CCNB1 on patients with lung adenocarcinoma. Results CCNB1 was highly expressed in lung adenocarcinoma, and the high expression was correlated with T stage (P=0.001), N stage (P<0.001), pathological stage (P<0.001) and gender (P=0.008). Univariate Cox regression analysis showed that the expression of CCNB1, T stage, N stage, M stage and pathological stage were the factors affecting the overall survival rate of patients with lung adenocarcinoma (P<0.05); multivariate Cox regression analysis showed that the expression of CCNB1 and T stage were independent risk factors for overall survival of patients with lung adenocarcinoma (P<0.05). Kaplan-Meier analysis showed that high expression of CCNB1 was associated with shorter overall survival [hazard ratio (HR)=1.60, 95% confidence interval (CI) (1.20, 2.14), P=0.002], disease-specific survival [HR=1.68, 95%CI (1.16, 2.44), P=0.006] and progression-free interval [HR=1.42, 95%CI (1.09, 1.85), P=0.009]. The ROC curve showed that CCNB1 might be a potential diagnostic molecule for lung adenocarcinoma [area under the curve=0.980, 95%CI (0.967, 0.993)]. Spearman correlation analysis showed that CCNB1 expression was positively correlated with the infiltration of T helper cells 2 (rs=0.805, P<0.001) and T helper cells (rs=0.103, P=0.017), and negatively correlated with the infiltration of natural killer cells (rs=?0.195, P<0.001), macrophages (rs=?0.134, P=0.002), and T cells (rs=?0.092, P=0.033). Conclusion CCNB1 is highly expressed in lung adenocarcinoma compared with normal tissues, which is related to poor prognosis and may provide a potential therapeutic target for patients with lung adenocarcinoma.
