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1.
BMC Musculoskelet Disord ; 22(1): 529, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107945

RESUMO

BACKGROUND: The prognosis of lung metastasis (LM) in patients with chondrosarcoma was poor. The aim of this study was to construct a prognostic nomogram to predict the risk of LM, which was imperative and helpful for clinical diagnosis and treatment. METHODS: Data of all chondrosarcoma patients diagnosed between 2010 and 2016 was queried from the Surveillance, Epidemiology, and End Results (SEER) database. In this retrospective study, a total of 944 patients were enrolled and randomly splitting into training sets (n = 644) and validation cohorts(n = 280) at a ratio of 7:3. Univariate and multivariable logistic regression analyses were performed to identify the prognostic nomogram. The predictive ability of the nomogram model was assessed by calibration plots and receiver operating characteristics (ROCs) curve, while decision curve analysis (DCA) and clinical impact curve (CIC) were applied to measure predictive accuracy and clinical practice. Moreover, the nomogram was validated by the internal cohort. RESULTS: Five independent risk factors including age, sex, marital, tumor size, and lymph node involvement were identified by univariate and multivariable logistic regression. Calibration plots indicated great discrimination power of nomogram, while DCA and CIC presented that the nomogram had great clinical utility. In addition, receiver operating characteristics (ROCs) curve provided a predictive ability in the training sets (AUC = 0.789, 95% confidence interval [CI] 0.789-0.808) and the validation cohorts (AUC = 0.796, 95% confidence interval [CI] 0.744-0.841). CONCLUSION: In our study, the nomogram accurately predicted risk factors of LM in patients with chondrosarcoma, which may guide surgeons and oncologists to optimize individual treatment and make a better clinical decisions. TRIAL REGISTRATION: JOSR-D-20-02045, 29 Dec 2020.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Neoplasias Pulmonares , Neoplasias Ósseas/epidemiologia , Condrossarcoma/diagnóstico , Condrossarcoma/epidemiologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Estudos Retrospectivos , Medição de Risco , Programa de SEER
2.
Pan Afr Med J ; 38: 245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104293

RESUMO

Pulmonary lesions on imaging are presumed to be metastatic lesions in patients with breast cancer. Here, we report an interesting case of a 63-year-old lady with breast carcinoma showing pulmonary lesions on imaging suggestive of pulmonary metastases. Detailed evaluation of pulmonary lesions confirmed the presence of co-existing pulmonary sarcoidosis. Modern diagnostic methods like 18-flurodeoxyglucose positron emission tomography (18-FDG PET) are unable to clearly differentiate metastatic disease from granulomatous diseases like sarcoidosis. Thus, histological confirmation is needed for accurate staging and determining response to treatment and rarely, in non-responders, detecting any co-existing disease. This case emphasizes the need for detailed histopathological examination of lymph nodes in patients with non-responsive disease or recurrent disease despite adequate chemotherapy.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias Pulmonares/diagnóstico , Sarcoidose Pulmonar/diagnóstico , Neoplasias da Mama/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Sarcoidose Pulmonar/patologia
3.
BMC Neurol ; 21(1): 221, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107910

RESUMO

BACKGROUND: Presentation with massive systemic embolization as the initial manifestation of occult malignancy is infrequent. The standard management of cancer-related arterial thromboembolism has not yet been established. CASE PRESENTATION: We described a case of Trousseau's syndrome resulting in acute ischemic stroke concomitant with multiple embolizations in the spleen and kidney during oral administration of dabigatran for pulmonary embolism preceding the diagnosis of a malignant tumor. A cancer-related hypercoagulable state was suspected because the patient was admitted to the neurology department due to acute ischemic stroke with three territory infarcts on diffusion-weighted imaging (DWI) in the absence of identifiable conventional risk factors and brain vessel narrowing. The patient was subsequently diagnosed with epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) (stage IV) with pleural metastasis. Administration of low-molecular-weight heparin followed by long-term dabigatran under effective cancer therapy comprising gefitinib and subsequent chemotherapy did not cause stroke relapse during the 1-year follow-up. CONCLUSIONS: This case suggests that cancer-related hypercoagulability should be considered an important etiology for stroke patients who develop unexplained disseminated acute cerebral infarction without conventional stroke risk factors, especially concomitant with multiple organ embolization. Novel oral anticoagulants may be an alternative therapy for the long-term management of cancer-related arterial thromboembolism under effective cancer therapy.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Acidente Vascular Cerebral/etiologia , Anticoagulantes/uso terapêutico , Isquemia Encefálica/etiologia , Carcinoma Pulmonar de Células não Pequenas/complicações , Imagem de Difusão por Ressonância Magnética , Embolia/etiologia , Receptores ErbB/genética , Feminino , Humanos , Neoplasias Pulmonares/complicações , Pessoa de Meia-Idade , Fatores de Risco
4.
Sensors (Basel) ; 21(11)2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34073351

RESUMO

The discrimination learning of multiple odors, in which multi-odor can be associated with different responses, is important for responding quickly and accurately to changes in the external environment. However, very few studies have been done on multi-odor discrimination by animal sniffing. Herein, we report a novel multi-odor discrimination system by detection rats based on the combination of 2-Choice and Go/No-Go (GNG) tasks into a single paradigm, in which the Go response of GNG was replaced by 2-Choice, for detection of toluene and acetone, which are odor indicators of lung cancer and diabetes, respectively. Three of six trained rats reached performance criterion, in 12 consecutive successful tests within a given set or over 12 sets with a success rate of over 90%. Through a total of 1300 tests, the trained animals (N = 3) showed multi-odor sensing performance with 88% accuracy, 87% sensitivity and 90% specificity. In addition, a dependence of behavior response time on odor concentrations under given concentration conditions was observed, suggesting that the system could be used for quantitative measurements. Furthermore, the animals' multi-odor sensing performance has lasted for 45 days, indicating long-term stability of the learned multi-odor discrimination. These findings demonstrate that multi-odor discrimination can be achieved by rat sniffing, potentially providing insight into the rapid, accurate and cost-effective multi-odor monitoring in the lung cancer and diabetes.


Assuntos
Diabetes Mellitus , Neoplasias Pulmonares , Animais , Discriminação Psicológica , Neoplasias Pulmonares/diagnóstico , Odorantes , Ratos , Olfato
6.
Rev Med Liege ; 76(5-6): 440-445, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080377

RESUMO

Lung cancer remains the deadliest cancer. It is the result of genetic aberrations in the cells of the respiratory tract exposed to carcinogenic agents, responsible for their anarchic multiplication. It is necessary to study these abnormalities in order to better understand the early stages and the mechanisms of evolution, thereby to establish new screening, monitoring and treatment strategies. The NELSON study confirms that systematic screening for lung cancer in target populations leads to a reduction in mortality from this disease. Despite this, there is currently no consensus in Belgium between medical experts and politicians for systematic lung cancer screening.


Assuntos
Detecção Precoce de Câncer , Neoplasias Pulmonares , Bélgica , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Programas de Rastreamento , Tomografia Computadorizada por Raios X
7.
Medicine (Baltimore) ; 100(21): e25961, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032706

RESUMO

RATIONALE: Amyloidosis is a heterogeneous group of diseases characterized by extracellular deposition of amyloid fibrils. Lung carcinoma is rarely reported to be associated with AA amyloidosis. With regard to the manifestation of amyloidosis infiltrating organs, most of the cases focus on the heart, liver, kidneys, and peripheral nervous system. Amyloidosis with diffuse abdominal involvement in combination with pulmonary squamous cell carcinoma carcinoma is an exceptionally rare occurrence. PATIENT CONCERNS: A 70-year-old man was admitted to hospital for a 2-month history of repeated cough, low grade fever, hemoptysis and left back shoulder pain, which was not relieved by nonsteroid anti-inflammatory drugs. Meanwhile, he complained of intermittent diffuse abdominal discomfort and chronic persistent constipation. DIAGNOSES: The patient was diagnosed with poorly differentiated lung squamous cell carcinoma and diffuse peritoneal and mesenteric amyloidosis based on the pathological biopsy. INTERVENTIONS: The patient received surgery and chemotherapy for lung tumor. He did not receive any treatment against amyloidosis. OUTCOMES: The patient died of a severe respiratory infection. LESSONS: This case indicates that lung carcinoma is suspected to play a causative role in the development of amyloidosis. In addition, amyloidosis should be considered in the differential diagnosis in cases in which diffuse greater omentum, peritoneal, and mesenteric calcifications on 18F-2-fluoro-2-deoxy-D-glucose(18F-FDG) photon emission computed tomography (PET/CT).


Assuntos
Amiloidose/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmão/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Idoso , Amiloidose/etiologia , Amiloidose/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/terapia , Quimioterapia Adjuvante , Evolução Fatal , Fluordesoxiglucose F18/administração & dosagem , Humanos , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/terapia , Masculino , Mesentério/diagnóstico por imagem , Mesentério/patologia , Omento/diagnóstico por imagem , Omento/patologia , Pneumonectomia
8.
Medicine (Baltimore) ; 100(18): e25690, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950949

RESUMO

OBJECTIVE: We conducted this study to evaluate the efficacy and safety of traditional Chinese medicine (TCM) in advanced non-small cell lung cancer (NSCLC) patients who underwent chemotherapy. DESIGN: This was a prospective, open-label, randomized controlled trial. NSCLC patients at stage IIIA, IIIB, or IV were randomly assigned to either TCM plus chemotherapy or chemotherapy alone. The comprehensive TCM treatment consisted of Kang Ai injection, herbal decoction, and Zhenqifuzheng capsules. The primary endpoint was quality of life (QOL) measured by the Functional Assessment of Cancer Therapy-Lung version 4.0. The secondary endpoints were chemotherapy completion rate, tumor response, and adverse events. All assessments were done at baseline, the third week, and the sixth week. RESULTS: Thirty-nine participants were randomly assigned to the treatment group and 36 to the control group. The QOL scores were significantly improved in the treatment group compared with those of the control group in social well-being (cycle 1, P = .048; cycle 2, P = .015), emotional well-being (cycle 1, P = .047; cycle 2, P = 4.29E-05), and functional well-being (cycle 1, P = .030; cycle 2, P = .003), while the QOL scores in the above 3 domains declined in the control group (P < .05). Both groups had a decline in the physical well-being score (cycle 1, P = .042; cycle 2, P = .017) and lung cancer symptom score (cycle 1, P = .001; cycle 2, P = .001) after 2 courses of intervention. The deterioration in physical well-being and lung cancer symptoms was noticeably smaller in the treatment group (P < .05). There were significant differences between the 2 groups in social well-being, emotional well-being, functional well-being, lung cancer symptom domain, and the total score (P < .05). Patients in the treatment group had a significantly lower incidence of platelet reduction than the control group (P = .028) after 2 cycles of treatment. No significant difference in nonhematological adverse events (AEs) was observed. CONCLUSION: This study illustrated that comprehensive TCM treatment could promote the QOL of NSCLC patients, alleviate symptoms, and reduce the AEs caused by chemotherapy, verifying the synergistic and attenuating effects of TCM in NSCLC patients undergoing chemotherapy. TRIAL REGISTRATION: Chinese Clinical Trial Registry (www.chictr.org.cn): ChiCTR-TRC-13003637.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Qualidade de Vida , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Carcinoma Pulmonar de Células não Pequenas/sangue , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Sinergismo Farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Feminino , Humanos , Incidência , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Contagem de Plaquetas , Estudos Prospectivos , Trombocitopenia/induzido quimicamente , Trombocitopenia/diagnóstico , Trombocitopenia/epidemiologia , Trombocitopenia/prevenção & controle , Adulto Jovem
9.
Medicine (Baltimore) ; 100(18): e25692, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950950

RESUMO

INTRODUCTION: The relationship between chronic empyema and malignant tumors, most of which are lymphoma, has been recognized for many decades. Sarcomatoid carcinoma associated with chronic empyema is extremely rare, may metastasize to other organs in the early stage, and rapidly progresses to death. As far as we know, this was the first case report on sarcomatoid carcinoma associated chronic empyema. THE PATIENTS MAIN CONCERNS AND IMPORTANT CLINICAL FINDINGS: A 59-year-old man presented to our hospital with a 9-year history of chronic empyema and a chief complaint of left chest wall pain for 5 months. The diagnostic contrast-enhanced computed tomography (CT) showed a large irregular soft tissue mass located on the left lower hemithorax at the margin of the empyema cavity extending to the adjacent chest wall and lung parenchyma. In addition, CT revealed pleural and pulmonary metastases surrounded by ground glass opacity. THE MAIN DIAGNOSIS, THERAPEUTICS INTERVENTIONS, AND OUTCOMES: The patient underwent CT guided percutaneous core needle biopsy (PCNB). The histopathological evaluation showed carcinomatous proliferation of pleomorphic spindle cells with extensive necrosis. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. The final histopathological diagnosis was sarcomatoid carcinoma underlying chronic empyema. The tumors showed rapid progression on serial simple radiography. Palliative treatments were performed, but the patient still developed severe dyspnea and died shortly after on day 16. CONCLUSION: Sarcomatoid carcinoma can occur very rarely as a complication of chronic empyema, and is more aggressive than usual. Early detection of developing malignancy during the follow-up of chronic empyema is an important factor for patient prognosis.


Assuntos
Carcinoma de Células Renais/diagnóstico , Dor no Peito/etiologia , Empiema Pleural/diagnóstico , Neoplasias Renais/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pleurais/diagnóstico , Biópsia com Agulha de Grande Calibre , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/secundário , Empiema Pleural/etiologia , Evolução Fatal , Humanos , Neoplasias Renais/diagnóstico , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Pleura/diagnóstico por imagem , Pleura/patologia , Neoplasias Pleurais/complicações , Neoplasias Pleurais/secundário , Tomografia Computadorizada por Raios X
10.
Khirurgiia (Mosk) ; (6): 106-111, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34029044

RESUMO

Benign lung tumors account 2-12% of all lung neoplasms. The classification of lung tumors, adopted by the World Health Organization in 2015, is reported with a detailed indication of all changes based on immunohistochemical and genetic studies. Diagnosis with computed tomography, dynamic and perfusion computed tomography, virtual bronchoscopy and positron emission tomography is described. These methods ensure 94-98% sensitivity for differentiation with malignancies. CT and ultrasound signs of benign tumors are presented. Surgical strategy for newly diagnosed nodes in the lungs is analyzed depending on their dimensions and risk factors. It was shown that comprehensive examination with possible surgical verification of the diagnosis is necessary for nodes over 6 mm and moderate-to-high risk factors. The authors describe argon plasma and laser destruction, bronchoplastic procedures for central benign tumors, thoracoscopy for peripheral neoplasms. One can conclude that high-tech methods of radiological and nuclear diagnosis are valuable to determine benign neoplasms and their dimensions with a high degree of reliability. Endoscopic and thoracoscopic procedures are successfully used for benign tumors.


Assuntos
Neoplasias Pulmonares , Broncoscopia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Tomografia por Emissão de Pósitrons , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Ultrassonografia
11.
Medicine (Baltimore) ; 100(20): e25972, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011083

RESUMO

RATIONALE: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor that is prevalent among children and adolescents. Surgery is the most important therapeutic approach for IMT and complete resection is recommended. Although 50% of IMTs show anaplastic lymphoma kinase (ALK) rearrangements, crizotinib has proven an effective therapeutic approach. However, the genetic landscape of this tumor is still not fully understood and treatment options are limited, especially in the majority of ALK-negative tumors. PATIENT CONCERNS: We describe the clinical case of a healthy 18-year-old female in whom a pulmonary nodule was incidentally detected. DIAGNOSES: Following a small increase in the size of the nodule, the patient underwent both 18FDG-PET/CT and 68Ga-PET/CT, resulting in a suspicion of bronchial hamartoma. INTERVENTIONS: The patient underwent surgery and a salivary gland-like lung tumor was diagnosed. OUTCOMES: After surgery, the patient was referred to our cancer center, where a review of the histology slides gave a final diagnosis of ALK-negative lung IMT. Given the histology, it was decided not to administer adjuvant therapy and the patient was placed in a 3-monthly follow-up program. The patient is still disease-free 2 years post-surgery. LESSONS: Although there is no standard of care for the treatment of IMT, identifying genomic alterations could help to redefine the management of patients with negative-ALK disease. Our review of the literature on IMT and other kinase fusions revealed, in addition to ALK rearrangements, the potential association of ROS1, NTRK, RET, or PDGFR beta alterations with the tumor.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Pulmonares/diagnóstico , Neoplasias de Tecido Muscular/diagnóstico , Adolescente , Quinase do Linfoma Anaplásico/genética , Broncopatias/diagnóstico , Diagnóstico Diferencial , Feminino , Hamartoma/diagnóstico , Humanos , Achados Incidentais , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/cirurgia , Miofibroblastos/patologia , Neoplasias de Tecido Muscular/genética , Neoplasias de Tecido Muscular/imunologia , Neoplasias de Tecido Muscular/cirurgia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
12.
Medicine (Baltimore) ; 100(20): e25994, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011092

RESUMO

ABSTRACT: In precision oncology, immune check point blockade therapy has quickly emerged as novel strategy by its efficacy, where programmed death ligand 1 (PD-L1) expression is used as a clinically validated predictive biomarker of response for the therapy. Automating pathological image analysis and accelerating pathology evaluation is becoming an unmet need. Artificial Intelligence and deep learning tools in digital pathology have been studied in order to evaluate PD-L1 expression in PD-L1 immunohistochemistry image. We proposed a Dual-scale Categorization (DSC)-based deep learning method that employed 2 VGG16 neural networks, 1 network for 1 scale, to critically evaluate PD-L1 expression. The DSC-based deep learning method was tested in a cohort of 110 patients diagnosed as non-small cell lung cancer. This method showed a concordance of 88% with pathologist, which was higher than concordance of 83% of 1-scale categorization-based method. Our results show that the DSCbased method can empower the deep learning application in digital pathology and facilitate computer-aided diagnosis.


Assuntos
Antígeno B7-H1/análise , Biomarcadores Tumorais/análise , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Diagnóstico por Computador/métodos , Neoplasias Pulmonares/diagnóstico , Antígeno B7-H1/antagonistas & inibidores , Antígeno B7-H1/genética , Biomarcadores Tumorais/antagonistas & inibidores , Biomarcadores Tumorais/genética , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Aprendizado Profundo , Regulação Neoplásica da Expressão Gênica , Humanos , Inibidores de Checkpoint Imunológico/farmacologia , Inibidores de Checkpoint Imunológico/uso terapêutico , Imuno-Histoquímica , Pulmão/imunologia , Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Seleção de Pacientes , Medicina de Precisão/métodos
13.
Molecules ; 26(9)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946997

RESUMO

The aim of the present study was to compare the efficiency of targeted and untargeted breath analysis in the discrimination of lung cancer (Ca+) patients from healthy people (HC) and patients with benign pulmonary diseases (Ca-). Exhaled breath samples from 49 Ca+ patients, 36 Ca- patients and 52 healthy controls (HC) were analyzed by an SPME-GC-MS method. Untargeted treatment of the acquired data was performed with the use of the web-based platform XCMS Online combined with manual reprocessing of raw chromatographic data. Machine learning methods were applied to estimate the efficiency of breath analysis in the classification of the participants. Results: Untargeted analysis revealed 29 informative VOCs, from which 17 were identified by mass spectra and retention time/retention index evaluation. The untargeted analysis yielded slightly better results in discriminating Ca+ patients from HC (accuracy: 91.0%, AUC: 0.96 and accuracy 89.1%, AUC: 0.97 for untargeted and targeted analysis, respectively) but significantly improved the efficiency of discrimination between Ca+ and Ca- patients, increasing the accuracy of the classification from 52.9 to 75.3% and the AUC from 0.55 to 0.82. Conclusions: The untargeted breath analysis through the inclusion and utilization of newly identified compounds that were not considered in targeted analysis allowed the discrimination of the Ca+ from Ca- patients, which was not achieved by the targeted approach.


Assuntos
Biomarcadores , Testes Respiratórios/métodos , Pneumopatias/diagnóstico , Neoplasias Pulmonares/diagnóstico , Idoso , Estudos de Casos e Controles , Diagnóstico Diferencial , Suscetibilidade a Doenças , Expiração , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Pneumopatias/etiologia , Pneumopatias/metabolismo , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/metabolismo , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Compostos Orgânicos Voláteis/análise
14.
Nat Commun ; 12(1): 2963, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34017001

RESUMO

Cancer patients have a higher risk of cardiovascular disease (CVD) mortality than the general population. Low dose computed tomography (LDCT) for lung cancer screening offers an opportunity for simultaneous CVD risk estimation in at-risk patients. Our deep learning CVD risk prediction model, trained with 30,286 LDCTs from the National Lung Cancer Screening Trial, achieves an area under the curve (AUC) of 0.871 on a separate test set of 2,085 subjects and identifies patients with high CVD mortality risks (AUC of 0.768). We validate our model against ECG-gated cardiac CT based markers, including coronary artery calcification (CAC) score, CAD-RADS score, and MESA 10-year risk score from an independent dataset of 335 subjects. Our work shows that, in high-risk patients, deep learning can convert LDCT for lung cancer screening into a dual-screening quantitative tool for CVD risk estimation.


Assuntos
Doenças Cardiovasculares/epidemiologia , Aprendizado Profundo , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Ensaios Clínicos como Assunto , Vasos Coronários/diagnóstico por imagem , Conjuntos de Dados como Assunto , Eletrocardiografia , Feminino , Seguimentos , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Tomografia Computadorizada por Raios X/estatística & dados numéricos
15.
Biomed Res Int ; 2021: 8865237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33869635

RESUMO

Under the background of 18F-FDG-PET/CT multimodal whole-body imaging for lung tumor diagnosis, for the problems of network degradation and high dimension features during convolutional neural network (CNN) training, beginning with the perspective of dividing sample space, an E-ResNet-NRC (ensemble ResNet nonnegative representation classifier) model is proposed in this paper. The model includes the following steps: (1) Parameters of a pretrained ResNet model are initialized using transfer learning. (2) Samples are divided into three different sample spaces (CT, PET, and PET/CT) based on the differences in multimodal medical images PET/CT, and ROI of the lesion was extracted. (3) The ResNet neural network was used to extract ROI features and obtain feature vectors. (4) Individual classifier ResNet-NRC was constructed with nonnegative representation NRC at a fully connected layer. (5) Ensemble classifier E-ResNet-NRC was constructed using the "relative majority voting method." Finally, two network models, AlexNet and ResNet-50, and three classification algorithms, nearest neighbor classification algorithm (NNC), softmax, and nonnegative representation classification algorithm (NRC), were combined to compare with the E-ResNet-NRC model in this paper. The experimental results show that the overall classification performance of the Ensemble E-ResNet-NRC model is better than the individual ResNet-NRC, and specificity and sensitivity are more higher; the E-ResNet-NRC has better robustness and generalization ability.


Assuntos
Algoritmos , Fluordesoxiglucose F18/química , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Imagem Corporal Total , Humanos , Imagem Molecular , Redes Neurais de Computação
16.
Anal Methods ; 13(18): 2114-2123, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33870958

RESUMO

Circulating tumor DNA (ctDNA)-based mutation detection is promising to change the clinical practice of genotype-directed therapy for cancer. A growing number of non-invasive tests for cancer screening and monitoring that involve the detection of ctDNA have been commercialized. Primary reference measurement procedures (PRMPs) and reference materials (RMs) are urgently needed to assess the non-invasive tests. In this study, a PRMP based on digital PCR (dPCR) and ctDNA RMs for quantification of the frequently occurring variant in epidermal growth factor receptor (EGFR L858R, T790M, and 19Del) in non-small cell lung cancer (NSCLC) were established. The candidate dPCR PRMP showed high specificity (false positive rate 0-0.003%), good repeatability (coefficient of variance (CV), 2-3% for 104 copies/reaction), and high interlaboratory reproducibility (3-10%). A good linearity (0.97 < slope < 1.03, R2 ≥ 0.9999) between the measured mutant (MU) value and prepared value was observed for all assays over the fractional abundance (FA) range, between 25% and 0.05%. The limit of quantification (LoQ) was determined to be 34 L858R, 23 T790M, and 34 19Del copies/reaction, corresponding to a FA of 0.2%. An inter-laboratory study of using the EGFR ctDNA RMs and dPCR assays demonstrated that the participating laboratories produced consistent concentrations of MU and wild-type (WT), as well as FA. This study demonstrates that dPCR can act as a potential PRMP for EGFR mutation for validation of NSCLC genotyping tests and ctDNA quantitative tests. The PRMP and RMs established here could improve interlaboratory repeatability and reproducibility, which supports rapid translation and application of non-invasive tests into clinical practice.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/diagnóstico , Mutação , Inibidores de Proteínas Quinases , Reprodutibilidade dos Testes
17.
Pan Afr Med J ; 38: 104, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889270

RESUMO

Isolated metastasis to pancreas from lung cancer is an extremely rare entity, usually reported in case series and case reports in the medical literature; estimated to account for up to 3-5% of all pancreatic lesions. Herein, we describe a case of a male patient suffering from metachronous metastatic lesion to the tail of the pancreas secondary to non small cell lung carcinoma treated 4 years prior to his presentation. The patient underwent pancreatic resection due to high clinical suspicion for the malignant nature of the mass, which was proved to be secondary lesion from its prior primary tumor. To the best of our insight this is one of the few reported cases of such type of pancreatic metastasis that may be misleading for hepatobiliary surgeons during preoperative evaluation.


Assuntos
Adenocarcinoma/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adenocarcinoma/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/secundário
18.
Pan Afr Med J ; 38: 127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33912297

RESUMO

Pulmonary infarction usually appears as a wedge-shaped opacity with its base placed laterally. Rarely, pulmonary infarctions may appear as a well-defined rounded opacity mimicking lung cancer and surgical lung biopsy may often be required for definitive diagnosis. We report a patient who was admitted with submassive pulmonary embolism who had an incidental finding of a well-defined opacity in computed tomography (CT) scan. The lesion was avid on positron emission tomography (PET) scan and the patient was a smoker. So, we investigated him further with a percutaneous and later a thoracoscopic lung biopsy. Tumour-like pulmonary infarction is often a challenge for the clinicians.


Assuntos
Neoplasias Pulmonares/diagnóstico , Embolia Pulmonar/diagnóstico , Infarto Pulmonar/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Tomografia por Emissão de Pósitrons , Embolia Pulmonar/patologia , Infarto Pulmonar/patologia , Tomografia Computadorizada por Raios X
19.
Zhonghua Bing Li Xue Za Zhi ; 50(5): 447-452, 2021 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-33915649

RESUMO

Objective: To investigate the value of chromosomes 7 and 8 polysomy in circulating tumor cells (CTCs) for the diagnosis of non-small cell lung cancer, and the correlation of CTCs with clinical pathological characteristics and epidermal growth factor receptor (EGFR) mutations in cancer tissue. Methods: Fifty-seven patients with non-small cell lung cancer and 21 patients with benign lung diseases were enrolled at Beijing Chaoyang Hospital, Capital Medical University, Beijing, China from November 2017 to October 2020. Negative enrichment combined with immunofluorescence in situ hybridization (imFISH) was used to identify CTCs polysomy on chromosomes 7 and 8. EGFR mutations in 56 lung cancer patients was detected using ARMS-PCR. Results: CTCs were detected in 93.0% (53/57) of non-small cell lung cancers and 28.6% (6/21) benign lung lesions. The difference between lung cancer patients and the control cohort was statistically significant (P<0.01). Receive operator curve (ROC) analyses showed that, when the cut-off value was 1 cell/3.2 mL, Youden index had the highest sensitivity of 93.0% and specificity of 71.4% (AUC=0.906, 95%CI:0.833-0.980, P<0.01). The positive rate of CTCs in stage Ⅲ-Ⅳ cancers was significantly higher than that in stage Ⅰ-Ⅱ (P=0.023). No significant correlation was observed between positive rate of CTCs or chromosome polysomy and age, gender, smoking status, pathologic types and EGFR mutation status. The number of CTCs in EGFR mutated group was higher than that in the non-mutated group (6.5±1.1 vs. 3.7±0.7, P=0.045). The detection rate for CTCs ≥5 in the EGFR mutated group was also higher than the EGFR non-mutated group (52.0% vs. 19.4%,P=0.010). Conclusion: Detection of CTCs with chromosomes 7 and 8 polysomy has potential value in auxiliary diagnosis of non-small cell lung cancer, and the number of CTCs is correlated to TNM stage and EGFR gene mutation status.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Células Neoplásicas Circulantes , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/genética , China , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Mutação
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