Tumor size, but not consolidation-to-tumor ratio, is an independent prognostic factor for part-solid clinical T1 non-small cell lung cancer

Peripheral blood immune cell dynamics associate with growth of incidental indeterminate pulmonary nodules

OBJECTIVES

Previous studies suggest peripheral blood immune cells associate with the progression and prognosis of lung cancer. The main purpose of this study was to explore the association of peripheral immune cell and its dynamics with the growth of pulmonary nodules.

MATERIALS AND METHOD

Of 9280 subjects whom had blood cell counts and chest CT scan in health check-up, 1068 participants were enrolled with the incidental pulmonary nodules of above 5 mm in diameter and subsequently followed up for 2 years. The pulmonary nodules were identified as growth based on the increase of at least 2 mm in the diameters within the two years. The relationships of pulmonary nodules growth with peripheral immune cell dynamics and clinical variables were analyzed using univariable inter-group comparison and multivariable logistic regression analyses.

RESULTS

During the two years, 116 (10.9 %) of 1068 participants had the growth pulmonary nodules. Overall, emphysema, nodule diameter and non-solid characteristics associated with the growth of nodules. In the subgroup of pure solid nodules, high baseline eosinophil percentage (OR 1.220; 95 % CI 1.009-1.474; P = 0.040) and the increase of neutrophil count (OR 3.805; 95 % CI 1.027-14.093; P = 0.045) were significant risk factors for the nodule growth. In the subgroup of solid-predominant nodules, the increase of lymphocyte was associated with a lower risk of growth (OR 0.039; 95 % CI 0.002-0.839; P = 0.038).

CONCLUSIONS

High baseline eosinophil and increase of neutrophil were associated with the growth of pure solid pulmonary nodules. The decrease of lymphocyte related to the growth of solid-predominant nodules.

Exploring the impact of variable power outputs on the efficacy and safety during microwave ablation for lung carcinoma: a real-world study

Background

Microwave ablation (MWA) is an important method for the treatment of lung cancer, but there is still a lack of standard guidelines for the selection of power. This study aimed to explore the effectiveness and safety of MWA at different power levels.

Methods

The study gathered individuals underwent MWA for lung cancer between January 2012 and December 2020. All patients were divided into low power group and high power group based on the power of MWA. By intergroup comparisons, we clarified the differences between the two groups.

Results

In this study, 265 participants were involved, with 192 in the low power group and 73 in the high power group. Compared to the low power group, the high power group had a significantly higher incidence of postoperative complications (63.0% vs. 24.0%). In the Kaplan-Meier analysis, overall survival (OS) and disease-free survival (DFS) of the high power group were both better than the low power group. We found through Cox regression analysis that smoking, tumor volume, tumor differentiation, gene mutation, neutrophil count, and lymphocyte count were independent factors affecting the OS of patients. Based on the above factors, we constructed a nomogram, with areas under the curve (AUCs) of 0.941, 0.903, and 0.905 for predicting 1-, 2-, and 3-year OS after MWA, respectively.

Conclusions

While high-power MWA brings better long-term prognosis to patients, it also leads to an increase in postoperative complications. The application of a nomogram for stratifying the prognosis of patients may be a more feasible approach to further develop individualized treatment plans.

Preoperative systemic immune-inflammation index-based nomogram for lung carcinoma following microwave ablation -a real world single center study

Background

The preoperative inflammatory condition significantly influences the prognosis of malignancies. We aimed to investigate the potential significance of preoperative inflammatory biomarkers in forecasting the long-term results of lung carcinoma after microwave ablation (MWA).

Method

This study included patients who received MWA treatment for lung carcinoma from Jan. 2012 to Dec. 2020. We collected demographic, clinical, laboratory, and outcome information. To assess the predictive capacity of inflammatory biomarkers, we utilized the area under the receiver operating characteristic curve (AUC-ROC) and assessed the predictive potential of inflammatory biomarkers in forecasting outcomes through both univariate and multivariate Cox proportional hazard analyses.

Results

A total of 354 individuals underwent MWA treatment, of which 265 cases were included in this study, whose average age was 69.1 ± 9.7 years. The AUC values for the Systemic Inflammatory Response Index (SIRI) to overall survival (OS) and disease-free survival (DFS) were 0.796 and 0.716, respectively. The Cox proportional hazards model demonstrated a significant independent association between a high SIRI and a decreased overall survival (hazard ratio [HR]=2.583, P<0.001). Furthermore, a high SIRI independently correlated with a lower DFS (HR=2.391, P<0.001). We developed nomograms utilizing various independent factors to forecast the extended prognosis of patients. These nomograms exhibited AUC of 0.900, 0.849, and 0.862 for predicting 1-year, 3-year, and 5-year OS, respectively. Additionally, the AUC values for predicting 1-year, 3-year, and 5-year DFS were 0.851, 0.873, and 0.883, respectively.

Conclusion

SIRI has shown promise as a valuable long-term prognostic indicator for forecasting the outcomes of lung carcinoma patients following MWA.

A rare case report: co-occurrence of two types of lung cancer with hamartoma and pulmonary tuberculosis

With the widespread use of low-dose chest Computed Tomography (CT), lung nodules are being increasingly detected. Common pulmonary conditions such as lung adenocarcinoma, lung squamous cell carcinoma, and tuberculosis are typically diagnosable through imaging examinations. Nevertheless, when multiple types of lung cancer are combined with other benign tumors, how can an accurate diagnosis be made? In this report, we present a rare case of a patient with the simultaneous occurrence of lung adenocarcinoma, lung squamous cell carcinoma, pulmonary tuberculosis, and pulmonary hamartoma, which has not been previously reported. This patient underwent surgical intervention in the Department of Thoracic Surgery at the Second Hospital of Jilin University and has now fully recovered and been discharged. The patient's preoperative positron emission tomography-CT(PET-CT)results did not align with the postoperative pathological diagnosis. The imaging findings were atypical, and the pathological diagnosis was exceptionally rare. We share this case report to contribute to the accumulation of clinical experience.