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1.
Transl Lung Cancer Res ; 13(4): 749-762, 2024 Apr 29.
Article En | MEDLINE | ID: mdl-38736497

Background: The efficacy of perioperative chemotherapy (PC) in pulmonary sarcomatoid carcinoma (PSC) is controversial. We conducted this study to investigate the effect of different histological subtypes on the efficacy of PC in PSC patients. Methods: Clinicopathological data of 811 PSC patients of different histological subtypes were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier method and log-rank test were used to evaluate the effects of PC on the overall survival (OS) and cancer-specific survival (CSS) in different subtypes of PSC patients. Propensity score matching (PSM) was used to reduce potential confounding effects. Subgroup analyses were conducted to further investigate the efficacy of PC in patients with different characteristics. Results: A total of 210 (25.89%) enrolled PSC patients received PC. PC was not associated with OS or CSS benefit in pleomorphic carcinoma, giant cell carcinoma, or spindle cell carcinoma patients, neither before nor after matching. But survival benefit of PC was observed in carcinosarcoma patients both before (5-year OS: 48.79% vs. 38.75%, P=0.01) and after (5-year OS: 51.29% vs. 17.54%, P=0.003) matching. Subgroup analyses showed that in patients whose tumor larger than 4 cm, PC was still associated with improved survival in carcinosarcoma, but not in the other histological subtypes of PSC. Conclusions: The efficacy of PC varies between different subtypes of PSC. Survival benefit of PC was only observed in carcinosarcoma patients, but not in pleomorphic carcinoma, giant cell carcinoma, or spindle cell carcinoma patients. Histological subtype should be considered when treating PSC patients with PC.

2.
J Thorac Dis ; 16(4): 2285-2295, 2024 Apr 30.
Article En | MEDLINE | ID: mdl-38738235

Background: The postoperative outcomes of suction drainage versus non-suction drainage after uniportal video-assisted thoracoscopic surgery (UniVATS) come with little consensus. This study aimed to prospectively compare the postoperative outcomes of suction drainage versus non-suction drainage in patients who underwent UniVATS. Methods: Between October 2022 and January 2023, patients undergoing UniVATS were prospectively enrolled. The choice of drainage strategy (suction or non-suction) was at the surgeon's discretion. The primary outcome was chest tube duration, with secondary outcomes including postoperative drainage volume, pain scores, postoperative complications, length of hospital stay, and hospitalization cost. Baseline characteristics and postoperative outcomes were compared. Univariable and multivariable analyses were used to identify risk factors for postoperative outcomes. Results: A total of 206 patients were enrolled in this study, with 103 patients in each group. Baseline characteristics were well-balanced. The chest tube duration did not significantly differ between the two groups. However, suction drainage exhibited a significantly lower total drainage volume compared to non-suction drainage (280.00 vs. 400.00 mL, P=0.03). Suction drainage was associated with a significantly shorter postoperative hospital stay (3.00 vs. 4.00 days, P<0.001) and lower pain score on the second postoperative day (POD). Multivariable analyses also confirmed that suction drainage was significantly correlated with a lower total drainage volume and a shorter postoperative hospital stay. Conclusions: These findings suggested that the suction drainage was superior to non-suction drainage in terms of postoperative drainage volume and length of hospital stay in patients undergoing UniVATS.

3.
BMC Anesthesiol ; 24(1): 179, 2024 May 20.
Article En | MEDLINE | ID: mdl-38769487

BACKGROUND: Video double-lumen tube (VDLT) intubation in lateral position is a potential alternative to intubation in supine position in patients undergoing thoracic surgery. This non-inferiority trial assessed the efficacy and safety of VDLT intubation in lateral position. METHODS: Patients (18-70 yr) undergoing right thoracoscopic lung surgery were randomized to either the left lateral position group (group L) or the supine position group (group S). The VDLT was placed under video larygoscopy. The primary endpoint was the intubation time. Secondary endpoints included VDLT displacement rate, intubation failure rate, the satisfaction of surgeon and nurse, and intubation-related adverse events. RESULTS: The analysis covered 80 patients. The total intubation time was 52.0 [20.4]s in group L and 34.3 [13.2]s in group S, with a mean difference of 17.6 s [95% confidence interval (CI): 9.9 s to 25.3 s; P = 0.050], failing to demonstrate non-inferiority with a non-inferiority margin of 10 s. Group L, compared with group S, had significantly lower VDLT displacement rate (P = 0.017) and higher nurse satisfaction (P = 0.026). No intubation failure occurred in any group. Intubation complications (P = 0.802) and surgeon satisfaction (P = 0.415) were comparable between two groups. CONCLUSIONS: The lateral VDLT intubation took longer time than in the supine position, and non-inferiority was not achieved. The incidence of displacement as the secondary endpoint was lower in the L group, possibly due to changing body positions beforehand. The indication of lateral VDLT intubation should be based on a balance between the safety of airway management and the lower incidence of displacement. TRIAL REGISTRATION: The study was registered at Chictr.org.cn with the number ChiCTR2200064831 on 19/10/2022.


Intubation, Intratracheal , Patient Positioning , Humans , Intubation, Intratracheal/methods , Middle Aged , Female , Male , Adult , Aged , Patient Positioning/methods , Young Adult , Thoracic Surgical Procedures/methods , Adolescent , Thoracic Surgery, Video-Assisted/methods
4.
Sci Total Environ ; 930: 172832, 2024 Jun 20.
Article En | MEDLINE | ID: mdl-38688367

Inorganic mercury (HgII) can be transformed into neurotoxic methylmercury (MeHg) by microorganisms in paddy soils, and the subsequent accumulation in rice grains poses an exposure risk for human health. Warming as an important manifestation of climate change, changes the composition and structure of microbial communities, and regulates the biogeochemical cycles of Hg in natural environments. However, the response of specific HgII methylation/demethylation to the changes in microbial communities caused by warming remain unclear. Here, nationwide sampling of rice paddy soils and a temperature-adjusted incubation experiment coupled with isotope labeling technique (202HgII and Me198Hg) were conducted to investigate the effects of temperature on HgII methylation, MeHg demethylation, and microbial mechanisms in paddy soils along Hg gradients. We showed that increasing temperature significantly inhibited HgII methylation but promoted MeHg demethylation. The reduction in the relative abundance of Hg-methylating microorganisms and increase in the relative abundance of MeHg-demethylating microorganisms are the likely reasons. Consequently, the net Hg methylation production potential in rice paddy soils was largely inhibited under the increasing temperature. Collectively, our findings offer insights into the decrease in net MeHg production potential associated with increasing temperature and highlight the need for further evaluation of climate change for its potential effect on Hg transformation in Hg-sensitive ecosystems.


Mercury , Methylmercury Compounds , Oryza , Soil Pollutants , Soil , Soil Pollutants/metabolism , Soil Pollutants/analysis , Mercury/metabolism , Mercury/analysis , Methylation , Soil/chemistry , Soil Microbiology , Climate Change , Demethylation , Environmental Monitoring
5.
Signal Transduct Target Ther ; 9(1): 65, 2024 Mar 09.
Article En | MEDLINE | ID: mdl-38461173

Despite epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) have shown remarkable efficacy in patients with EGFR-mutant non-small cell lung cancer (NSCLC), acquired resistance inevitably develops, limiting clinical efficacy. We found that TET2 was poly-ubiquitinated by E3 ligase CUL7FBXW11 and degraded in EGFR-TKI resistant NSCLC cells. Genetic perturbation of TET2 rendered parental cells more tolerant to TKI treatment. TET2 was stabilized by MEK1 phosphorylation at Ser 1107, while MEK1 inactivation promoted its proteasome degradation by enhancing the recruitment of CUL7FBXW11. Loss of TET2 resulted in the upregulation of TNF/NF-κB signaling that confers the EGFR-TKI resistance. Genetic or pharmacological inhibition of NF-κB attenuate the TKI resistance both in vitro and in vivo. Our findings exemplified how a cell growth controlling kinase MEK1 leveraged the epigenetic homeostasis by regulating TET2, and demonstrated an alternative path of non-mutational acquired EGFR-TKI resistance modulated by TET2 deficiency. Therefore, combined strategy exploiting EGFR-TKI and inhibitors of TET2/NF-κB axis holds therapeutic potential for treating NSCLC patients who suffered from this resistance.


Carcinoma, Non-Small-Cell Lung , Dioxygenases , Drug Resistance, Neoplasm , Lung Neoplasms , Humans , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/metabolism , Dioxygenases/genetics , DNA-Binding Proteins/genetics , ErbB Receptors , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Lung Neoplasms/metabolism , Mutation , NF-kappa B/genetics , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , /therapeutic use , Drug Resistance, Neoplasm/genetics
6.
Int J Surg ; 2024 Mar 21.
Article En | MEDLINE | ID: mdl-38518080

BACKGROUND: Whether wedge resection is oncological suitable for ground glass opacity (GGO)-dominant non-small cell lung cancer (NSCLC) ≤2 cm is still debatable. The aim of this study is to investigate the short-term and long-term outcomes of intentional wedge resection and segmentectomy for those patients. MATERIALS AND METHODS: This was a real-world study from one of the largest thoracic surgery centers in XX. Patients who underwent intentional wedge resection or segmentectomy for ≤2 cm CTR(consolidation-to-tumor)≤0.5 NSCLC were consecutively included between December 2009 and December 2018. Data were prospectively collected and retrospectively reviewed. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. Long-term outcomes, including overall survival (OS), recurrence-free survival (RFS) and lung cancer-specific survival (LCSS), were analyzed using Cox proportional model. RESULTS: A total of 1209 patients were included (497 in the wedge resection group, 712 in the segmentectomy group). Compared to segmentectomy, wedge resection had a significantly lower rate of complications (3.8% vs. 7.7%, P=0.008), a shorter operating time (65min vs. 114min, P<0.001), and a shorter postoperative stay (3d vs. 4d, P<0.001). The median follow-up was 70.1 months. The multivariate Cox model indicated that wedge resection had survival outcomes that were similar to segmentectomy in terms of 5-year OS (98.8% vs. 99.6%, HR=1.98, 95%CI: 0.59-6.68, P=0.270), 5-year RFS (98.8% vs. 99.5%, HR=1.88, 95%CI: 0.56-6.31, P=0.307) and 5-year LCSS (99.9% vs. 99.6%, HR=1.76, 95%CI: 0.24-13.15, P=0.581). CONCLUSION: Intentional wedge resection is an appropriate choice for ≤2 cm GGO-dominant NSCLC.

7.
Cell Rep Med ; 5(4): 101489, 2024 Apr 16.
Article En | MEDLINE | ID: mdl-38554705

Lung adenocarcinoma is a type of cancer that exhibits a wide range of clinical radiological manifestations, from ground-glass opacity (GGO) to pure solid nodules, which vary greatly in terms of their biological characteristics. Our current understanding of this heterogeneity is limited. To address this gap, we analyze 58 lung adenocarcinoma patients via machine learning, single-cell RNA sequencing (scRNA-seq), and whole-exome sequencing, and we identify six lung multicellular ecotypes (LMEs) correlating with distinct radiological patterns and cancer cell states. Notably, GGO-associated neoantigens in early-stage cancers are recognized by CD8+ T cells, indicating an immune-active environment, while solid nodules feature an immune-suppressive LME with exhausted CD8+ T cells, driven by specific stromal cells such as CTHCR1+ fibroblasts. This study also highlights EGFR(L858R) neoantigens in GGO samples, suggesting potential CD8+ T cell activation. Our findings offer valuable insights into lung adenocarcinoma heterogeneity, suggesting avenues for targeted therapies in early-stage disease.


Adenocarcinoma of Lung , Adenocarcinoma , Lung Neoplasms , Humans , Lung Neoplasms/genetics , Adenocarcinoma/genetics , Adenocarcinoma/pathology , CD8-Positive T-Lymphocytes/pathology , Ecotype , Retrospective Studies
8.
Redox Biol ; 70: 103038, 2024 Apr.
Article En | MEDLINE | ID: mdl-38266576

Dysfunction of the vascular angiocrine system is critically involved in regenerative defects and fibrosis of injured organs. Previous studies have identified various angiocrine factors and found that risk factors such as aging and metabolic disorders can disturb the vascular angiocrine system in fibrotic organs. One existing key gap is what sense the fibrotic risk to modulate the vascular angiocrine system in organ fibrosis. Here, using human and mouse data, we discovered that the metabolic pathway hydrogen sulfide (H2S)-AMP-activated protein kinase (AMPK) is a sensor of fibrotic stress and serves as a key mechanism upregulating the angiocrine factor plasminogen activator inhibitor-1 (PAI-1) in endothelial cells to participate in lung fibrosis. Activation of the metabolic sensor AMPK was inhibited in endothelial cells of fibrotic lungs, and AMPK inactivation was correlated with enriched fibrotic signature and reduced lung functions in humans. The inactivation of endothelial AMPK accelerated lung fibrosis in mice, while the activation of endothelial AMPK with metformin alleviated lung fibrosis. In fibrotic lungs, endothelial AMPK inactivation led to YAP activation and overexpression of the angiocrine factor PAI-1, which was positively correlated with the fibrotic signature in human fibrotic lungs and inhibition of PAI-1 with Tiplaxtinin mitigated lung fibrosis. Further study identified that the deficiency of the antioxidative gas metabolite H2S accounted for the inactivation of AMPK and activation of YAP-PAI-1 signaling in endothelial cells of fibrotic lungs. H2S deficiency was involved in human lung fibrosis and H2S supplement reversed mouse lung fibrosis in an endothelial AMPK-dependent manner. These findings provide new insight into the mechanism underlying the deregulation of the vascular angiocrine system in fibrotic organs.


AMP-Activated Protein Kinases , Plasminogen Activator Inhibitor 1 , Pulmonary Fibrosis , Animals , Humans , Mice , AMP-Activated Protein Kinases/genetics , AMP-Activated Protein Kinases/metabolism , Endothelial Cells/metabolism , Fibrosis , Lung/metabolism , Plasminogen Activator Inhibitor 1/genetics , Plasminogen Activator Inhibitor 1/metabolism , Pulmonary Fibrosis/genetics , Pulmonary Fibrosis/metabolism
9.
BMC Surg ; 24(1): 32, 2024 Jan 23.
Article En | MEDLINE | ID: mdl-38263042

BACKGROUND: Increasing attention has been raised on the surgical option for lung cancer patients aged ≥75 years, however, few studies have focused on whether uniportal video-assisted thoracoscopic surgery (VATS) is safe and feasible for these patients. This study aimed to evaluate short-term results of uniportal versus three-port VATS for the treatment of lung cancer patients aged ≥75 years. METHODS: We retrospectively evaluated 582 lung cancer patients (≥75 years) who underwent uniportal or three-port VATS from August 2007 to August 2021 based on the Western China Lung Cancer Database. The baseline and perioperative outcomes between uniportal and three-port VATS were compared in the whole cohort (WC) and the patients undergoing lobectomy (lobectomy cohort, LC) respectively. Propensity score matching (PSM) was used to minimize confounding bias between the uniportal and three-port cohorts in WC and LC. RESULTS: Intraoperative blood loss was significantly less in the uniportal than three-port LC (50 mL vs. 83 mL, P = 0.007) before PSM and relatively less in the uniportal than three-port LC (50 mL vs. 83 mL, P = 0.05) after PSM. Significantly more lymph nodes harvested (13 vs. 9, P = 0.007) were found in the uniportal than three-port LC after PSM. In addition, in WC and LC, there were no significant differences between uniportal and three-port cohorts in terms of operation time, the rate of conversion to thoracotomy during surgery, nodal treatments (dissection or sampling or not), the overall number of lymph node stations dissected, postoperative complications, volume and duration of postoperative thoracic drainage, hospital stay after operation and hospitalization expenses before and after PSM (P > 0.05). CONCLUSIONS: There were no significant differences in short-term outcomes between uniportal and three-port VATS for lung cancer patients (≥75 years), except relatively less intraoperative blood loss (P < 0.05 before PSM and P = 0.05 after PSM) and significantly more lymph nodes harvested (P < 0.05 after PSM) were found in uniportal LC. It is reasonable to indicate that uniportal VATS is a safe, feasible and effective operation procedure for lung cancer patients aged ≥75 years.


Lung Neoplasms , Humans , Aged , Cohort Studies , Blood Loss, Surgical , Retrospective Studies , Thoracic Surgery, Video-Assisted
11.
Lung Cancer ; 189: 107476, 2024 03.
Article En | MEDLINE | ID: mdl-38280290

Pulmonary blastomas (PB) are an extremely rare type of lung cancer. Currently, no standard treatment exists for PB. Immunotherapy with checkpoint inhibitors and anti-angiogenesis treatments has been an effective method for lung cancer; however, studies on PB treatment are lacking. Herein, we present a case report of successful conversion therapy with immunotherapy and targeted therapy for PB. After receiving treatment with a PD-1 inhibitor (penpulimab) and a multi-target tyrosine kinase inhibitor (anlotinib) treatment, the patient showed an impressive response and underwent a successful operation. We also summarized and reviewed literature reports on PubMed from January 1, 2000, to December 31, 2022, using the keyword "pulmonary blastoma", discussing the efficacy and specifics of chemotherapy and radiotherapy. Immunotherapy, in combination with targeted therapy, should be considered a potential therapeutic strategy for PB.


Lung Neoplasms , Pulmonary Blastoma , Humans , Pulmonary Blastoma/therapy , Lung Neoplasms/therapy , Immunotherapy , Immune Checkpoint Inhibitors , Protein Kinase Inhibitors/therapeutic use
12.
J Hazard Mater ; 465: 133298, 2024 Mar 05.
Article En | MEDLINE | ID: mdl-38141310

Methylmercury (MeHg) production in aquatic ecosystems is a global concern because of its neurotoxic effect. Dissolved organic matter (DOM) plays a crucial role in biogeochemical cycling of Hg. However, owing to its complex composition, the effects of DOM on net MeHg production have not been fully understood. Here, the Hg isotope tracer technique combined with different DOM treatments was employed to explore the influences of DOM with divergent compositions on Hg methylation/demethylation and its microbial mechanisms in eutrophic lake waters. Our results showed that algae-derived DOM treatments enhanced MeHg concentrations by 1.42-1.53 times compared with terrestrial-derived DOM. Algae-derived DOM had largely increased the methylation rate constants by approximately 1-2 orders of magnitude compared to terrestrial-derived DOM, but its effects on demethylation rate constants were less pronounced, resulting in the enhancement of net MeHg formation. The abundance of hgcA and merB genes suggested that Hg-methylating and MeHg-demethylating microbiomes responded differently to DOM treatments. Specific DOM components (e.g., aromatic proteins and soluble microbial byproducts) were positively correlated with both methylation rate constants and the abundance of Hg-methylating microbiomes. Our results highlight that the DOM composition influences the Hg methylation and MeHg demethylation differently and should be incorporated into future Hg risk assessments in aquatic ecosystems.


Mercury , Methylmercury Compounds , Water Pollutants, Chemical , Methylmercury Compounds/metabolism , Dissolved Organic Matter , Lakes/chemistry , Ecosystem , Mercury/analysis , Water , Water Pollutants, Chemical/chemistry
13.
Environ Sci Technol ; 57(48): 19990-19998, 2023 Dec 05.
Article En | MEDLINE | ID: mdl-37943716

As wildland fires become more frequent and intense, fire smoke has significantly worsened the ambient air quality, posing greater health risks. To better understand the impact of wildfire smoke on air quality, we developed a modeling system to estimate daily PM2.5 concentrations attributed to both fire smoke and nonsmoke sources across the contiguous U.S. We found that wildfire smoke has the most significant impact on air quality in the West Coast, followed by the Southeastern U.S. Between 2007 and 2018, fire smoke contributed over 25% of daily PM2.5 concentrations at ∼40% of all regulatory air monitors in the EPA's air quality system (AQS) for more than one month per year. People residing outside the vicinity of an EPA AQS monitor (defined by a 5 km radius) were subject to 36% more smoke impact days compared with those residing nearby. Lowering the national ambient air quality standard (NAAQS) for annual mean PM2.5 concentrations to between 9 and 10 µg/m3 would result in approximately 35-49% of the AQS monitors falling in nonattainment areas, taking into account the impact of fire smoke. If fire smoke contribution is excluded, this percentage would be reduced by 6 and 9%, demonstrating the significant negative impact of wildland fires on air quality.


Air Pollutants , Air Pollution , Fires , Wildfires , United States , Humans , Air Pollutants/analysis , Smoke/analysis , Air Pollution/analysis , Southeastern United States , Particulate Matter
14.
Res Sq ; 2023 Sep 12.
Article En | MEDLINE | ID: mdl-37790383

As wildfires become more frequent and intense, fire smoke has significantly worsened ambient air quality, posing greater health risks. To better understand the impact of wildfire smoke on air quality, we developed a modeling system to estimate daily PM2.5 concentrations attributed to both fire smoke and non-smoke sources across the Continental U.S. We found that wildfire smoke has the most significant impact on air quality in the West Coast, followed by the Southeastern U.S. Between 2007 and 2018, fire smoke affected daily PM2.5 concentrations at 40% of all regulatory air monitors in EPA's Air Quality System (AQS) for more than one month each year. People residing outside the vicinity of an EPA AQS monitor were subject to 36% more smoke impact days compared to those residing nearby. Lowering the national ambient air quality standard (NAAQS) for annual mean PM2.5 concentrations to between 9 and 10 µg/m3 would result in approximately 29% to 40% of the AQS monitors falling in nonattainment areas without taking into account the contribution from fire smoke. When fire smoke impact is considered, this percentage would rise to 35% to 49%, demonstrating the significant negative impact of wildfires on air quality.

15.
J Hazard Mater ; 460: 132457, 2023 10 15.
Article En | MEDLINE | ID: mdl-37669605

The production of methylmercury (MeHg) in flooded paddy fields determines its accumulation in rice grains; this, in turn, results in MeHg exposure risks for not only rice-eating humans but also wildlife. Nitrogen (N) fertilizers have been widely applied in rice cultivation fields to supply essential nutrients. However, the effects of N fertilizer addition on mercury (Hg) transformations are not unclear. This limits our understanding of MeHg formation in rice paddy ecosystems. In this study, we spiked three Hg tracers (200HgII, Me198Hg, and 202Hg0) in paddy slurries fertilized with urea, ammonium, and nitrate. The influences of N fertilization on Hg methylation, demethylation, and reduction and the underlying mechanisms were elucidated. The results revealed that dissimilatory nitrate reduction was the dominant process in the incubated paddy slurries. Nitrate addition inhibited HgII reduction, HgII methylation, and MeHg demethylation. Competition between nitrates and other electron acceptors (e.g., HgII, sulfate, or carbon dioxide) under dark conditions was the mechanism underlying nitrate-regulated Hg transformation. Ammonium and urea additions promoted HgII reduction, and anaerobic ammonium oxidation coupled with HgII reduction (Hgammox) was likely the reason. This work highlighted that nitrate addition not only inhibited HgII methylation but also reduced the demethylation of MeHg and therefore may generate more accumulation of MeHg in the incubated paddy slurries. Findings from this study link the biogeochemical cycling of N and Hg and provide crucial knowledge for assessing Hg risks in intermittently flooded wetland ecosystems.


Mercury , Methylmercury Compounds , Oryza , Humans , Nitrates , Methylation , Ecosystem , Urea , Fertilizers , Demethylation
16.
Int J Surg ; 109(12): 3752-3759, 2023 Dec 01.
Article En | MEDLINE | ID: mdl-37707522
17.
J Thorac Dis ; 15(8): 4216-4228, 2023 Aug 31.
Article En | MEDLINE | ID: mdl-37691649

Background: Single or combined basal segmentectomy (CBS), excluding common basal segmentectomy, is the most difficult of all types of segmentectomies. The purpose of this study was to compare the perioperative outcomes and oncological prognosis between uniport thoracoscopic basal segmentectomy (UTBS) and triport thoracoscopic basal segmentectomy (TTBS). Methods: This study retrospectively collected 300 patients who underwent thoracoscopic single or CBS at the West China Hospital of Sichuan University from April 2015 to May 2022, including 67 and 233 patients in the UTBS and TTBS groups, respectively. Propensity score matching (PSM) was used to reduce confounding bias between the two groups. The primary outcome was recurrence-free survival (RFS). The secondary outcomes were overall survival (OS) and perioperative outcomes. Results: After PSM, the UTBS group (n=64) had significantly less intraoperative blood loss than the TTBS group (n=64) (20 vs. 30 mL, P=0.001). Other perioperative outcomes, including the operation time, number of lymph nodes and lymph node stations harvested, duration of chest tube drainage, postoperative hospital stay, and postoperative complications, were comparable. Subgroup analysis demonstrated that the operative time in the group underwent single basal segmentectomy (SBS) was significantly shorter compared to the group underwent CBS (110 vs. 120 min, P=0.002). There were 5 cases of recurrence in the overall cohort and no recurrence in the matched cohort. No deaths were observed in the overall cohort. Therefore, a survival analysis was conducted only for RFS in the overall cohort. The RFS rate and OS rate of the overall cohort were 98.3% and 100%, respectively. The surgical approach (UTBS vs. TTBS) was not an independent risk factor for RFS (HR: 1.120, 95% CI: 0.342-13.051, P=0.879). Conclusions: UTBS provided similar perioperative outcomes and oncological prognoses compared to TTBS.

18.
J Thorac Dis ; 15(8): 4292-4305, 2023 Aug 31.
Article En | MEDLINE | ID: mdl-37691674

Background: Whether segmentectomy is appropriate for stage IA non-small cell lung cancer (NSCLC), especially for stage IA NSCLC with a tumor size of 2-3 cm, remains controversial. Thus, we conducted this meta-analysis to compare segmentectomy and lobectomy for stage IA NSCLC with a tumor size of 2-3 cm and IA ≤2 cm NSCLC. Methods: A systematic screening of online databases (PubMed, Embase, Web of Science, and Cochrane Library) was conducted regarding the terms of perioperative outcomes, overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS). The inverse-variance and Mantel-Haenszel approaches were used to pool effect sizes for survival outcomes and perioperative outcomes. Results: A total of 10 articles were included in the analysis. The perioperative morbidity [risk ratio (RR): 0.90, P=0.10], mortality (RR: 0.94, P=0.84), intraoperative blood loss [mean difference (MD): 3.07, P=0.86] and operative time (MD: 18.99, P=0.13) were comparable between the segmentectomy and lobectomy groups. The number of lymph nodes harvested was statistically less in segmentectomy than in lobectomy (MD: -5.71, P=0.02). In stage IA patients with a tumor size of 2-3 cm, lobectomy showed superior survival outcomes compared to segmentectomy, with a pooled hazard ratio (HR) of 1.39 (P=0.01) for OS and 1.38 (P=0.06) for RFS or DFS. In stage IA ≤2 cm, lobectomy and segmentectomy had comparable survival outcomes with pooled HRs of 1.18 (P=0.29) for OS and 1.18 (P=0.12) for RFS or DFS. Conclusions: When a patient is in stage IA and the tumor size is less than 2 cm, segmentectomy should be performed. If the tumor size is between 2 and 3 cm, lobectomy is recommended.

19.
Cancer Med ; 12(16): 17149-17170, 2023 08.
Article En | MEDLINE | ID: mdl-37606338

BACKGROUND: Selenium is an essential trace element in the human body. In epidemiological and clinical studies, Se supplementation significantly reduced the incidence of lung cancer in individuals with low baseline Se levels. The significant action of selenium is based on the selenium-containing protein as a mediator. Of note, the previous studies reported that the expression of selenium-binding protein 1 (SELENBP1) was obviously decreased in many human cancer tissues including non-small cell lung cancer (NSCLC). However, its roles in the origin and development of NSCLC are still unclear. METHODS: The expression of SELENBP1 was measured by qRT-PCR, Western blotting and IHC in our collected clinical NSCLC tissues and cell lines. Next, the CCK-8, colony formation, wound-haeling, Millicell, Transwell, FCM assay, and in vivo xenograft model were performed to explore the function of SELENBP1 in NSCLC. The molecular mechanisms of SELENBP1 were investigated by Western blotting or IF assay. RESULTS: We further identified that the expression of SELENBP1 was significantly decreased in NSCLC tissues in TCGA database and 45 out of 59 collected clinical NSCLC tissues compared with adjacent nontumor tissues, as well as in four NSCLC cell lines compared with normal lung cells. Particularly, we unexpectedly discovered that SELENBP1 was obviously expressed in alveolar type 2 (AT-II) cells for the first time. Then, a series of in vitro experiments uncovered that overexpression of SELENBP1 inhibited the proliferation, migration, and invasion of NSCLC cells, and induced cell apoptosis. Moreover, overexpression of SELENBP1 also inhibited growth and induced apoptosis of NSCLC cells in vivo. Mechanistically, we demonstrated that overexpression of SELENBP1 inhibited the malignant characteristics of NSCLC cells in part via inactivating the PI3K/AKT/mTOR signal pathway. Meanwhile, we found that overexpression of SELENBP1 inducing the apoptosis of NSCLC cells was associated with the activation of caspase-3 signaling pathway under nonhigh level of oxidative stress, but overexpression of SELENBP1 facilitating the cell apoptosis might be related to its combining with GPX1 and colocalizing in the nucleus under high level of oxidative stress. CONCLUSIONS: Our findings highlighted that SELENBP1 was an important tumor suppressor during the origin and development of NSCLC. It may help to discover novel biomarkers or drug therapy targets for NSCLC.


Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Selenium , Humans , Apoptosis , Carcinoma, Non-Small-Cell Lung/genetics , Lung Neoplasms/genetics , Phosphatidylinositol 3-Kinases , Selenium/pharmacology , Selenium-Binding Proteins/genetics
20.
Respir Res ; 24(1): 192, 2023 Jul 29.
Article En | MEDLINE | ID: mdl-37516880

BACKGROUND: Chronic lung allograft dysfunction (CLAD) directly causes an abysmal long-term prognosis after lung transplantation (LTx), but effective and safe drugs are not available. Metformin exhibits high therapeutic potential due to its antifibrotic and immunomodulatory effects; however, it is unclear whether metformin exerts a therapeutic effect in CLAD. We sought to investigate the effect of metformin on CLAD based on rat models. METHODS: Allogeneic LTx rats were treated with Cyclosporin A (CsA) in the first week, followed by metformin, CsA, or vehicle treatment. Syngeneic LTx rats received only vehicles. All rats were sacrificed on post-transplant week 4. Pathology of lung graft, spleen, and thymus, extent of lung fibrosis, activity of profibrotic cytokines and signaling pathway, adaptive immunity, and AMPK activity were then studied. RESULTS: Allogeneic recipients without maintenance CsA treatment manifested CLAD pathological characteristics, but these changes were not observed in rats treated with metformin. For the antifibrotic effect, metformin suppressed the fibrosis extent and profibrotic cytokine expression in lung grafts. Regarding immunomodulatory effect, metformin reduced T- and B-cell infiltration in lung grafts, spleen and thymus weights, the T- and B-cell zone areas in the spleen, and the thymic medullary area. In addition, metformin activated AMPK in lung allografts and in α-SMA+ cells and T cells in the lung grafts. CONCLUSIONS: Metformin attenuates CLAD in rat models, which could be attributed to the antifibrotic and immunomodulatory effects. AMPK activation suggests the potential molecular mechanism. Our study provides an experimental rationale for further clinical trials.


Metformin , Animals , Rats , Metformin/pharmacology , AMP-Activated Protein Kinases , Thorax , Cytokines , Lung , Allografts
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