Accuracy and complications of percutaneous transthoracic needle lung biopsy for the diagnosis of malignancy in patients with idiopathic pulmonary fibrosis.

OBJECTIVES: To determine the accuracy of CT-guided percutaneous transthoracic needle lung biopsy (PTNB) for the diagnosis of malignancy and the associated complication rates in patients with idiopathic pulmonary fibrosis (IPF). METHODS: This retrospective study included 91 CT-guided PTNBs performed in 80 patients with IPF from April 2003 through December 2016. Data regarding patients, target lesions, procedures, complications, and pathological reports were collected, and the final diagnosis was made. The diagnostic accuracy, sensitivity, specificity, percentage of nondiagnostic results, and complication rates were determined. Multivariable logistic regression analyses were performed to identify risk factors for nondiagnostic results and major complications. RESULTS: Three biopsies (technical failure [n = 2] and undetermined final diagnosis [n = 1]) were excluded from the diagnostic accuracy calculation. The diagnostic accuracy, sensitivity, and specificity were 89% (78/88), 90% (62/69), and 84% (16/19), respectively. The percentage of nondiagnostic results was 34% (30/88). Lesion size ≤ 3 cm (odds ratio [OR], 8.8; 95% confidence interval [CI], 2.5-31.2; p = 0.001) and needle tip placement outside the target lesion (OR, 13.7; 95% CI, 1.4-132.2; p = 0.02) were risk factors for nondiagnostic results. The overall and major complication rates were 51% (46/91) and 12% (11/91), respectively. The presence of honeycombing along the path of the needle (OR, 11.2; 95% CI, 1.4-89.1; p = 0.02) was an independent risk factor for major complications. CONCLUSIONS: CT-guided PTNB shows a relatively reasonable accuracy in diagnosing malignancy in patients with IPF. The complication rate may be high, especially when the needle passes through honeycomb lesions. KEY POINTS: • In patients with idiopathic pulmonary fibrosis (IPF), CT-guided percutaneous transthoracic needle lung biopsy (PTNB) showed a relatively reasonable accuracy for the diagnosis of malignancy. • Target lesion size ≤ 3 cm and biopsy needle tip placement outside the target lesion were risk factors for nondiagnostic results of CT-guided PTNB. • The complication rate may be high, especially in cases where the biopsy needle passes through honeycomb lesions.

Diagnostic Accuracy and Complication of Computed Tomography (CT)-Guided Percutaneous Transthoracic Lung Biopsy in Patients 80 Years and Older.

This research evaluated the diagnostic accuracy and complication rate of computed tomography (CT)-guided percutaneous transthoracic lung biopsy (PTNB) in patients 80 years and older. The study sought to identify risk factors for diagnostic failures or complications of PTNBs. We examined 247 CT-guided PTNBs performed from January 2017 through December 2020, noting patient demographics, lesion or procedure types, pathology reports, and other procedure-related complications. Study groups were divided into two: one with patients aged 80 years and older (Group 1) and the other with patients aged 60 to 80 years (Group 2). The research first determined each groups' diagnostic accuracy, sensitivity, specificity, diagnostic failure rate, and complication rate and then evaluated the risk factors for diagnostic failures and complications. The diagnostic accuracy, sensitivity, specificity, and diagnostic failure rates were 95.6%, 94.9%, 100%, and 18.9%, respectively, in Group 1. The overall and major complication rates in Group 1 were 29.6% and 3.7%, respectively. Lesion size was the only risk factor for diagnostic failure (adjusted odds ratio [OR], 0.46; 95% confidence interval [CI], 0.24-0.90). There was no significant risk factor for complications in Group 1. CT-guided PTNBs in patients 80 years and older indicate comparable diagnostic accuracy and complication rates.

Utilizing Lung Cancer Risk Prediction Models to Promote Smoking Cessation: Two Randomized Controlled Trials.

PURPOSE: The current project sought to examine whether delivery of lung cancer risk projections (calculated using the Liverpool Lung Project [LLP] risk model) predicted follow-up smoking status. DESIGN: Two single-blinded randomized controlled trials. SETTING: Stop Smoking Services in Liverpool (United Kingdom). PARTICIPANTS: Baseline current smokers (N = 297) and baseline recent former smokers (N = 216) were recruited. INTERVENTION: Participants allocated to intervention groups were provided with personalized lung cancer risk projections, calculated using the LLP risk model. MEASURES: Baseline and follow-up questionnaires explored sociodemographics, smoking behavior, and lung cancer risk perceptions. ANALYSIS: Bivariate analyses identified significant differences between randomization groups, and logistic regression models were developed to investigate the intervention effect on the outcome variables. RESULTS: Lung cancer risk projections were not found to predict follow-up smoking status in the trial of baseline current smokers; however, they did predict follow-up smoking status in the trial of baseline recent former smokers (odds ratio: 1.91; 95% confidence interval: 1.03-3.55). CONCLUSION: The current study suggests that lung cancer risk projections may help maintain abstinence among individuals who have quit smoking, but the results did not provide evidence to suggest that lung cancer risk projections motivate current smokers to quit.

Lung cancer mortality trends in Mexico, 1998-2018: the impact of the General Law on Tobacco Control / Tendências de mortalidade por câncer de pulmão no México, 1998-2018: o impacto da Lei Geral de Controle do Tabaco

ABSTRACT: Objective: The aim of this study was to describe trends in lung cancer (LC) mortality and trends in tobacco use. Methods: This is an ecological time-series study to determine mortality trends due to lung cancer resulting from tobacco consumption, based on secondary open-access sources, such as the National Surveys. Smoking prevalence, tobacco use trends, mortality rates, and percentage were determined by LC. The mortality trend from LC was calculated, and a linear regression analysis was performed to evaluate the impact of the General Law for Tobacco Control. Results: The prevalence of tobacco use decreased steadily between 1988 and 2015, particularly in men. Mortality rates and percentage decreased between 1998 and 2018. During this period, the mortality rate decreased from 6.3 to 5.4 per 100,000 population (−0.032/100,000 each year, p<0.001), with a net decrease of 0.9 per 100,000. We observe increases in mortality in women in the central and southeastern regions. Of 32 states, 18 showed a tendency to loss (p<0.005). The rate of change for men was −0.24, with a total reduction of 2.17 before the introduction of the laws and −0.32 after their introduction, a total reduction of 3.24 (p<0.005). Women showed no reduction. Conclusions: Mortality rates showed a limited decrease. Strategies need to be strengthened, mainly in the central and southeastern regions, and to focus on the control of tobacco use by women.

RESUMO: Objetivos: Descrever tendências na mortalidade por câncer de pulmão e no uso do tabaco. Métodos: Realizamos um estudo ecológico de séries temporais para determinar a tendência de mortalidade por câncer de pulmão de acordo com o consumo de tabaco, com base em fontes secundárias de acesso aberto, como as Pesquisas Nacionais. Prevalência de tabagismo, tendências de uso de tabaco, porcentagem e taxas de mortalidade foram determinadas pelo câncer de pulmão. A tendência de mortalidade por câncer de pulmão foi calculada e uma análise de regressão linear foi realizada para avaliar o impacto da lei geral para o controle do tabagismo. Resultados: A prevalência do uso de tabaco diminuiu continuamente entre 1988 e 2015, principalmente em homens. As taxas e percentuais de mortalidade diminuíram entre 1998 e 2018. Durante esse período, a taxa de mortalidade diminuiu de 6,3 para 5,4 por 100 mil habitantes (-0,032 por 100 mil a cada ano, p<0,001), com redução líquida de 0,9 por 100 mil. Observamos aumentos na mortalidade de mulheres nas regiões Centro e Sudeste. Dos 32 estados, 18 apresentaram tendência à perda (p<0,005). A taxa de mudança para os homens foi de -0,24, com redução total de 2,17 antes da introdução das leis e -0,32 após a sua introdução — redução total de 3,24 (p<0,005). As mulheres não apresentaram redução. Conclusões: As taxas de mortalidade mostraram redução limitada. Estratégias precisam ser fortalecidas, principalmente nas regiões Centro e Sudeste, e deve-se enfocar o controle do uso do tabaco pelas mulheres.

Nova proposta de estadiamento para o câncer de pulmão, não pequenas células, o que esperar para o ano de 2009: [revisão] / New proposal for the non-small cell lung cancer staging, what to wait for 2009: [review]

JUSTIFICATIVA E OBJETIVOS: Descrever as mudanças propostas para o estadiamento do câncer de pulmão para a próxima (sétima) edição da Classificação TNM, para neoplasias malignas prevista para publicação em 2009. CONTEÚDO: Revisão bibliográfica constando de 13 estudos publicados entre 1944 e 2008, selecionados no banco de dados do MedLine e SciElo, utilizando-se as palavras-chave: câncer de pulmão, estadiamento TNM. Os estudos realizados desde 1999 apontavam uma falha entre o prognóstico e o estadiamento dos pacientes com câncer de pulmão. Por isso, foi criado um Comitê com múltiplos profissionais e Instituições para rever a 6ª edição do TNM. O estudo contou com mais de 100.000 pacientes e só não alterou no descritor N. Quanto ao descritor T, sugere criação de novas subdivisões e a mudança da classificação do derrame pleural maligno deste para o descritor M. O M1 subdividiu-se em M1a e M1b considerando M1a como o derrame pleural maligno e M1b metástase à distância. A presença de metástase dentro do tórax também foi revista. CONCLUSÃO: Apesar de todos os problemas referentes aos estudos retrospectivos, a nova proposta de estadiamento pretende informar melhor o prognóstico dos pacientes com câncer de pulmão.

BACKGROUND AND OBJECTIVES: To describe the changes proposals for the staging of lung cancer in the forthcoming (Seventh) edition of the TNM Classification of malignant tumors, tobe published in 2009. CONTENTS: Bibliographical revision consisting of 13 study's published between 1944 and 2008 and chosen teams in the database of the MedLine and SciElo, using itself the word-key: cancer of lung, TNM staging. Studies carried through since 1999 pointed an imperfection between the prognostic and stage of the patients with lung cancer. Therefore, it was created a committee with professional multiples and institutions to review the sixth edition of the TNM. The study it counted more than on 100,000 patients and it did not only modify in the describing N. As theT descriptor, suggests creating of new subdivisions and change the classification of stroke malignant pleural this descriptor to the M. The M1 was subdivided in M1a and M1b considering M1a as the malignant pleural effusion and M1b metastasis in the distance. The presence of metastasis inside of the chest also was reviewed. CONCLUSION: Although all the problems presented for the retrospective studies, the new proposal of staging must define better the prognostic of patients with lung cancer.

Mechanisms of lumiracoxib on antitumor in human lung cancer cells / 中国药理学通报

Aim To investigate the possible mechanism of antitumor in human lung cancer cell lines A549 and NCI-H460 induced by lumiracoxib.Methods The expression of COX-2 was detected by Western blot and the levels of PGE2 and cAMP was determined by radioimmunoassay (RIA).Results COX-2 protein was highly expressed in A549 and NCI-H460 cells.After treatment with 15~240 ?mol?L-1 LUM for 24 hrs,LUM significantly decreased the level of COX-2 in A549 cells,but not in NCI-H460 cells.Compared with the control,the PGE2 production was reduced and the level of cAMP was increased after the treatment with 15,30,60,120,240 ?mol?L-1 of LUM,respectively.Conclusion The effect of Lumiracoxib on antitumor is in COX-2-dependent or-independent manner. The antitumor effect of LUM may be related to inhibiting the COX-2 activities by decreasing its secretion,up-regulating the level of cAMP,and down-regulating the level of PGE2.