Diagnostic Value of Rapid On-Site Evaluation for CT-Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions.

OBJECTIVE: Rapid on-site evaluation (ROSE) is an effective and efficient auxiliary examination, but its value for CT-guided percutaneous fine-needle aspiration (FNA) in the diagnosis of pulmonary occupying lesions is unclear. This study is aimed at evaluating the clinical utility of ROSE for CT-guided percutaneous FNA. METHODS: We reviewed 234 patients from September 2018 to April 2019. The result using ROSE was compared with the final pathological diagnosis of CT-guided percutaneous FNA, and we also compared the complications between the ROSE group and the NO-ROSE group. The final pathological diagnosis results served as the gold standard. We also analyzed the diagnostic rate of FNA and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of malignancy. The correlation between diverse pathological types of lung cancer was also taken into consideration. RESULTS: In total, 132 patients underwent CT-guided percutaneous FNA with ROSE (ROSE group), and 102 did not (NO-ROSE group). The diagnostic rate, sensitivity, specificity, PPV, and NPV of the ROSE group were 91.6%, 89.1%, 94.1%, 93.4%, and 90.1%, respectively. The complication rates of the ROSE group and the NO-ROSE group were 8.33% and 16.67%, respectively. This difference was not statistically significant (P > 0.05). In subsets of adenocarcinoma (AC) and small cell lung cancer (SCLC) patients, the ROSE result was highly consistent with the final pathological result. CONCLUSION: CT-guided percutaneous FNA combined with ROSE has a high diagnostic rate, sensitivity, and specificity for pulmonary occupying lesions and an acceptable rate of complications. This method is worthy of wide use given its high efficiency and safety.

Triptolide induces apoptosis through the calcium/calmodulin­dependent protein kinase kinaseß/AMP­activated protein kinase signaling pathway in non­small cell lung cancer cells.

Triptolide, a triterpene extracted from the Chinese herb Tripterygium wilfordii, has been reported to exert multiple bioactivities, including immunosuppressive, anti­inflammatory and anticancer effects. Although the anticancer effect of triptolide has attracted significant attention, the specific anticancer mechanism in non­small­cell lung cancer (NSCLC) remains unclear. The present study aimed to investigate the anticancer effect of triptolide in the H1395 NSCLC cell line and to determine its mechanism of action. The results revealed that triptolide significantly inhibited the cell viability of NSCLC cells in a dose­dependent manner, which was suggested to be through inducing apoptosis. In addition, triptolide was revealed to activate the calcium (Ca2+)/calmodulin­dependent protein kinase kinase ß (CaMKKß)/AMP­activated protein kinase (AMPK) signaling pathway by regulating the intracellular Ca2+ concentration levels, which increased the phosphorylation levels of AMPK and reduced the phosphorylation levels of AKT, ultimately leading to apoptosis. The CaMKKß blocker STO­609 and the AMPK blocker Compound C significantly inhibited the apoptosis­promoting effect of triptolide. In conclusion, the results of the present study suggested that triptolide may induce apoptosis through the CaMKKß­AMPK signaling pathway and may be a promising drug for the treatment of NSCLC.