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Tian S, Li X, Liu J, Wang X, Chen H, Dai Z, Chen Q, Shi H, Li Y, Huang H, Bai C. Radial endobronchial ultrasound - guided bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta-analysis of prospective trials. Heliyon 2024; 10:e29446. [PMID: 38660275 PMCID: PMC11040069 DOI: 10.1016/j.heliyon.2024.e29446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
Background The diagnostic yield of radial endobronchial ultrasound (r-EBUS) for the diagnosis of peripheral pulmonary lesions (PPLs) varies between studies and is affected by multiple factors. We aimed to evaluate the efficacy and safety of r-EBUS, and to explore the factors influencing the diagnostic yield of r-EBUS in patients with PPLs. Methods The PubMed, Web of Science, and EMBASE databases were searched to identify relevant studies that used r-EBUS for diagnosing PPLs from the date of inception to Dec 2022. Meta-analysis was conducted using Review Manager 5.4 and Stata 15.1. Results An analysis of 46 studies with a total of 7252 PPLs was performed. The pooled diagnostic yield of r-EBUS was 73.4 % (95 % CI: 69.9%-76.7 %), with significant heterogeneity detected among studies (I2 = 90 %, P < 0.001). Further analysis demonstrated PPLs located in the middle or lower lobe, >2 cm in size, malignant in type, solid in appearance on computerized tomography (CT), present in bronchus sign, the within probe location, and the addition of rapid on-site evaluation (ROSE) were associated with increased diagnostic yield, whereas use of a guide sheath (GS), bronchoscopy type, and a multimodality approach failed to influence the outcome. The pooled incidence rates of overall complications, pneumothorax and moderate and severe bleeding were 3.1 % (95 % CI: 2.1%-4.3 %), 0.4 % (95 % CI: 0.1%-0.7 %) and 1.1 % (95 % CI: 0.5%-2.0 %), respectively. Conclusions r-EBUS has an appreciable diagnostic yield and an excellent safety manifestation when used to deal with PPLs.
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Affiliation(s)
- Sen Tian
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Department of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
| | - Xiang Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Department of Respiratory and Critical Care Medicine, General Hospital of Central Theater Command of Chinese People's Liberation Army, Wuhan, China
| | - Jian Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xinyu Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Hui Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Zeyu Dai
- Department of Orthopaedic Oncology, The Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Qian Chen
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Department of Cardiothoracic Surgery, No. 904 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Wuxi, China
| | - Hui Shi
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yonghua Li
- Department of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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Zarogoulidis P, Oikonomidou R, Petridis D, Huang H, Bai C, perdokouri EI, Vagionas A, Hohenforst-Schmidt W, Kosmidis C, Sapalidis K, Oikonomou P, Nikolaou C, Charalampidis C, Matthaios D, Pataka A, Sardeli C. Chronic Obstructive Pulmonary Disease and Non-Small Cell Lung Cancer an association. J Cancer 2024; 15:603-609. [PMID: 38213723 PMCID: PMC10777038 DOI: 10.7150/jca.90594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/14/2023] [Indexed: 01/13/2024] Open
Abstract
Objectives: Lung cancer is known to be associated with chronic obstructive pulmonary disease. Moreover; nutritional status is associated with chronic obstructive disease treatment and lung cancer. Our aim was to evaluate the interaction of the COPD status and treatment of non-small cell lung cancer. Methods: Eighty-two patients were enrolled in our multicenter study. Chronic obstructive disease stage, spirometry and treatment was recorded along with the treatment and Body Mass Index (BMI), Mediterranian Diet Score, Pack Years, Basic Metabolsim (RMR) (kcal/day), VO₂ (ml/min), Ve (lt/min) and Physical Activity. The statistical analysis was performed using the JMP 14.3 (SAS Inc 2018) software. Results: The drug pairs showed a steady and unchanged by time health condition for 48 patients. Overall, 31 patients were recorded with worse COPD health conditions. The one-way ANOVA clearly indicated that chemotherapy induced the best FEV1-difference conditions with a positive effect of 8.56 mean FEV volume, the combined treatment simply did not have an effect (-0.9), while immunotherapy and patients receiving radiation decreased their FEV1 volume down to -4.23 and -5.15 mean values. Conclusions: Patients receiving chemotherapy alone had their chronic obstructive disease improved with less drugs and exacerbations, while patients receiving immunotherapy had their chronic obstructive disease stable, while all other treatment combinations worsened the patients chronic obstructive disease. Nutritional status did not affect the chronic obstructive disease of these patients in any way.
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Affiliation(s)
- Paul Zarogoulidis
- 3 rd University General Hospital, ``AHEPA`` University Hospital, Thessaloniki, Greece
- Pulmonary Department, General Clinic Euromedica, Thessaloniki, Greece
| | | | - Dimitris Petridis
- Department of Food Science and Technology International Hellenic University, Alexander Campus, Sindos, Thessaloniki
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Chong Bai
- Department of Food Science and Technology International Hellenic University, Alexander Campus, Sindos, Thessaloniki
| | | | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Christoforos Kosmidis
- 3 rd University General Hospital, ``AHEPA`` University Hospital, Thessaloniki, Greece
| | | | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Nikolaou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | | | - Athanasia Pataka
- Pulmonary Department, G.Papnikolaou General Hospital, Aristotle University of Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Zarogoulidis P, Hohenforst-Schmidt W, Chen W, Porpodis K, Kosmidis C, Kotsakis A, Perdikouri EI, Tolis C, Ioannidis A, Sapalidis K, Matthaios D, Giannakidis D, Oikonomou P, Nikolaou C, Papadopoulos V, Sardeli C, Charalampidis C, Petanidis S, Bai C, Huang H. Endobronchial Radiofrequency Ablation for pulmonary nodules with Radial-Ebus and Navigation: Pros and Cons. J Cancer 2023; 14:1562-1570. [PMID: 37325061 PMCID: PMC10266245 DOI: 10.7150/jca.84894] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/29/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction: Pulmonary nodules are common in the everyday clinical practice. There is always a diagnostic issue with this imaging finding. Based on the size we can use a variety of imaging and diagnostic techniques. Moreover; in the case of primary lung cancer or metastasis we can use radiofrequency ablation endobronchially. Patients and Methods: We used the radial-endobronchial ultrasound with C-arm and Archemedes, Bronchus electromagnetic navigation in order to acquire biopsy sample and we also used rapid on-site evaluation as a rapid diagnosis for pulmonary nodules. After rapid diagnosis we used the radiofrequency ablation catheter in order to ablate central pulmonary nodules. Results: Both techniques provide efficient navigation, however, with the Bronchus system less time is needed. The new radiofrequency ablation catheter provides efficient results in central lesions with low watts ≤40. Conclusion: We provided in our research a protocol to diagnose and treat such lesions. Future larger studies will provide more data on this subject.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Wei Chen
- Department of Respiratory and Critical Care Medicine, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huai'an 223300, China
| | - Konstantinos Porpodis
- Pulmonary Department, ``G. Papanikolaou`` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3 rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Kotsakis
- Oncology Department, University General Hospital of Larissa, Larissa, Greece
| | | | | | - Aris Ioannidis
- Surgery Department, Genesis Private Clinic, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3 rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios Giannakidis
- 1st Department of Surgery, Attica General Hospital "Sismanogleio - Amalia Fleming", Athens, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Nikolaou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Savvas Petanidis
- Department of Medicine, Laboratory of Medical Biology and Genetics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
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Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Porpodis K, Kakavelas P, Steiropoulos P. Immunotherapy and Chemotherapy Versus Sleep Disturbances for NSCLC Patients. Curr Oncol 2023; 30:1999-2006. [PMID: 36826116 PMCID: PMC9955782 DOI: 10.3390/curroncol30020155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. PATIENTS AND METHODS We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of ≥50% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0-49 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. RESULTS For immunotherapy patients with PD-L1 expression ≥ 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. DISCUSSION In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. IN CONCLUSION Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 851 05 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977-2719-74
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 574 00 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | | | - Konstantinos Porpodis
- Pulmoanry Department, G. Papanikolaou General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit (ICU), General Clinic Euromedica, 153 43 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
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Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Papadopoulos V, Perdikouri EI, Porpodis K, Kakavelas P, Steiropoulos P. Non-Small-Cell Lung Cancer Immunotherapy and Sleep Characteristics: The Crossroad for Optimal Survival. Diseases 2023; 11:diseases11010026. [PMID: 36810540 PMCID: PMC9944906 DOI: 10.3390/diseases11010026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Non-small-cell lung cancer is still diagnosed at an inoperable stage and systematic treatment is the only option. Immunotherapy is currently considered to be the tip of the arrow as the first-line treatment for patients with a programmed death-ligand 1 ≥ 50. Sleep is known to be an essential part of our everyday life. PATIENTS AND METHODS We investigated, upon diagnosis and after nine months, 49 non-small-cell lung cancer patients undergoing immunotherapy treatment with nivolumab and pemprolisumab. A polysomnographic examination was conducted. Moreover, the patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS) and the Medical Research Council (MRC) dyspnea scale. RESULTS Tukey mean-difference plots, summary statistics, and the results of paired t-test of five questionnaire responses in accordance with the PD-L1 test across groups were examined. The results indicated that, upon diagnosis, patients had sleep disturbances which were not associated with brain metastases or their PD-L1 expression status. However, the PD-L1 status and disease control were strongly associated, since a PD-L1 ≥80 improved the disease status within the first 4 months. All data from the sleep questionnaires and polysomnography reports indicated that the majority of patients with a partial response and complete response had their initial sleep disturbances improved. There was no connection between nivolumab or pembrolisumab and sleep disturbances. CONCLUSION Upon diagnosis, lung cancer patients have sleep disorders such as anxiety, early morning wakening, late sleep onset, prolonged nocturnal waking periods, daytime sleepiness, and unrefreshing sleep. However, these symptoms tend to improve very quickly for patients with a PD-L1 expression ≥80, because disease status improves also very quickly within the first 4 months of treatment.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 68100 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977271974
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 64556 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54646 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | | | | | - Konstantinos Porpodis
- Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 54768 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit, General Clinic Euromedica, Private Hospital, 54667 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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6
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Zarogoulidis P, Hohenforst-Schmidt W, Papadopoulos V, Perdikouri EI, Courcoutsakis N, Porpodis K, Matthaios D, Trigonakis K. Case Report: Endoscopic radiofrequency ablation with radial-EBUS and ROSE. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1022220. [PMID: 36741470 PMCID: PMC9894892 DOI: 10.3389/fmedt.2023.1022220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
Background Single pulmonary nodules are a common issue in everyday clinical practice. Currently, there are navigation systems with radial-endobronchial ultrasound and electromagnetic navigation for obtaining biopsies. Moreover, rapid on-site evaluation can be used for a quick assessment. These small lesions, even when they do not have any clinically significant information with positron emission tomography, are important to investigate. Case description Radiofrequency and microwave ablation have been evaluated as local treatment techniques. These techniques can be used as therapy for a patient population that cannot be operated on. Currently, one verified operating system is used for endoscopic radiofrequency ablation through the working channel of a bronchoscope. Conclusion In our case, a new system was used to perform radiofrequency ablation with long-term follow-up.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica, Thessaloniki, Greece,3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece,Correspondence: Paul Zarogoulidis
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, “Hof” Clinics, University of Erlangen, Hof, Germany
| | | | | | | | - Konstantinos Porpodis
- Pulmonary Department, `G. Papanikolaoù` General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Kostas Trigonakis
- Vascular Surgery Department, General Clinic Euromedica, Thessaloniki, Greece
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Lee J, Song J. Diagnostic yield of radial probe endobronchial ultrasonography-guided transbronchial biopsy without fluoroscopy in peripheral pulmonary lesions: A systematic review and meta-analysis. Thorac Cancer 2022; 14:195-205. [PMID: 36480486 PMCID: PMC9834691 DOI: 10.1111/1759-7714.14733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Although radial probe endobronchial ultrasound (R-EBUS) has been used to investigate peripheral pulmonary lesions (PPLs), its diagnostic performance without fluoroscopy remains unclear. We sought to determine the diagnostic yield of R-EBUS-guided transbronchial biopsy (TBB) without fluoroscopy. METHODS We performed a systematic literature review using Pubmed, Embase, and the Cochrane Central Register. Then, we performed a proportional meta-analysis to determine the diagnostic yield of this modality. Subgroup and meta-regression analyses were used to identify factors affecting the performance of R-EBUS-guided TBB without fluoroscopy. RESULTS We identified 31 studies consisting of a total of 6491 patients. Pooled overall diagnostic yield of R-EBUS-guided TBB without fluoroscopy was 0.70 (95% confidence interval [CI], 0.67-0.74). There was significant heterogeneity across studies (I2 = 89.45%, p < 0.001). In subgroup and meta-regression analyses, air bronchus sign on chest computed tomography scans, larger size PPLs, probe location within lesions, and heterogeneous echogenicity were associated with significantly higher diagnostic yield. Diagnostic yield from the upper lobe was statistically lower than that from the middle and lower lobes. Pooled pneumothorax rate was 0.01 (95% CI, 0.01-0.01, I2 = 63.51%, p < 0.001). CONCLUSIONS R-EBUS-guided TBB without fluoroscopy appears to be a relatively useful tool with a low pneumothorax rate for the diagnosis of PPLs. Factors mentioned above may affect the diagnostic yield of this tool. Because of substantial between-study heterogeneity, our results should be interpreted with caution.
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Affiliation(s)
- Jonghoo Lee
- Department of Internal MedicineJeju National University Hospital, Jeju National University School of MedicineJejuSouth Korea
| | - Jae‐Uk Song
- Division of Pulmonary and Critical Care Medicine, Department of Internal MedicineKangbuk Samsung Hospital, Sungkyunkwan University School of MedicineSeoulSouth Korea
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Zarogoulidis P, Kosmidis CS, Hohenforst-Schmidt W, Matthaios D, Sapalidis K, Petridis D, Perdikouri EI, Courcoutsakis N, Hatzibougias D, Arnaoutoglou C, Freitag L, Ioannidis A, Huang H, Tolis C, Bai C, Turner JF. Radial-EBUS: CryoBiopsy Versus Conventional Biopsy: Time-Sample and C-Arm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063569. [PMID: 35329255 PMCID: PMC8955438 DOI: 10.3390/ijerph19063569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/14/2022] [Accepted: 03/10/2022] [Indexed: 12/21/2022]
Abstract
Introduction: Diagnosis of lung nodules is still under investigation. We use computed tomography scans and positron emission tomography in order to identify their origin. Patients and Methods: In our retrospective study, we included 248 patients with a single lung nodule or multiple lung nodules of size ≥1 cm. We used a radial-endobronchial ultrasound and a C-Arm. We used a 1.1 mm cryoprobe versus a 22G needle vs. forceps/brush. We compared the sample size of each biopsy method with the number of cell-block slices. Results: Central lesions indifferent to the method provided the same mean number of cell-block slices (0.04933–0.02410). Cryobiopsies provide less sample size for peripheral lesions due to the higher incidence of pneumothorax (0.04700–0.02296). Conclusion: The larger the lesion ≥2 cm, and central, more cell-blocks are produced indifferent to the biopsy method (0.13386–0.02939). The time of the procedure was observed to be less when the C-Arm was used as an additional navigation tool (0.14854–0.00089).
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary-Oncology Department, General Clinic Euromedica, Private Hospital, 54645 Thessaloniki, Greece
- Correspondence:
| | - Christoforos S. Kosmidis
- Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki (AUTH), 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece; (C.S.K.); (K.S.)
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, “Hof” Clinics, University of Erlangen, 91052 Hof, Germany;
| | - Dimitrios Matthaios
- Department of Medical Oncology, Rhodes General Hospital, 85133 Rhodes, Greece;
| | - Konstantinos Sapalidis
- Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki (AUTH), 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece; (C.S.K.); (K.S.)
| | - Dimitrios Petridis
- Department of Food Science and Technology, International Hellenic University, 54621 Thessaloniki, Greece;
| | | | - Nikos Courcoutsakis
- Department of Radiology and Medical Imaging, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | | | - Christos Arnaoutoglou
- Department of Obstetrics & Gynecology, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece;
| | - Lutz Freitag
- Pulmonary Department, University Hospital of Zurich, 8004 Zurich, Switzerland;
| | - Aristeidis Ioannidis
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai 200001, China; (A.I.); (H.H.); (C.B.)
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai 200001, China; (A.I.); (H.H.); (C.B.)
| | - Christos Tolis
- Oncoderm Private Oncology Clinic, 45221 Ioannina, Greece;
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai 200001, China; (A.I.); (H.H.); (C.B.)
| | - J. Francis Turner
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN 37001, USA;
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Zarogoulidis P, Kosmidis C, Perdikouri EI, Hohemforst-Schmidt W, Sardeli C. Cryobiopsy for pneumonitis diagnosis in NSCLC immunotherapy. Respir Med Case Rep 2022; 39:101741. [PMID: 36161237 PMCID: PMC9489498 DOI: 10.1016/j.rmcr.2022.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/15/2022] Open
Abstract
Nowadays immunotherapy is considered the tip of the arrow as treatment for non-small cell lung cancer for inoperable patients. Programmed death-ligand 1 is considered a valuable marker for the success of immunotherapy. The higher the score ≥50% the more successful the treatment will be. However; previous studies have presented favorable data even for those patients where the programmed death-ligand 1 was ≤50% or even 0%, therefore it can be administered as first line treatment in these patients with the addition of chemotherapy or radiotherapy. Other treatment modalities are tested as surrogates like gene therapy with immunotherapy to improve the results in patients with programmed death-ligand 1 was ≤50% or even 0%. The main issue for these patients is an adverse effect pneumonitis, in case we will present the valuable method of lung parenchyma sampling with cryobiopsy for early diagnosis of immunotherapy induced pneumonitis.
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10
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Pilikidou M, Palyvou F, Papadopoulou SK, Tsiouda T, Tsekitsidi E, Arvaniti K, Miziou A, Tsingerlioti Z, Apostolidis G, Ntiloudis R, Boniou K, Tsioudas AA, Cheva A, Petridis D, Zarogoulidis P. Lung cancer, treatment and nutritional status. Mol Clin Oncol 2021; 15:248. [PMID: 34671467 DOI: 10.3892/mco.2021.2410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 09/24/2021] [Indexed: 01/29/2023] Open
Abstract
Lung cancer is often diagnosed at inoperable advanced stages, and most patients exhibit cancer cachexia. The nutritional status of patients has been previously observed to serve a key role in cancer survival and cancer surgery. The aim of the current study was to collect information regarding the treatment of patients and associate them with different nutritional measurements. A total of 82 patients with non-small cell lung cancer were included in the present study. Several parameters were assessed, such as body mass index (BMI), Mediterranian diet score, number of years spent smoking, basic metabolsim (RMR; kcal/day), VO2 (ml/min), ventilation (lt/min) and physical activity. All the aforementioned parameters were associated with patient treatment, nutritional status and survival. Two-way ANOVA was conducted and pairwise group mean differences were tested using Fisher's LSD and Tukey tests. Normality and variance homogeneity was checked in all cases. The results revealed that RMR and oxygen consumption were negatively affected by the survival status of patients (P=0.012 and P=0.043, respectively). The mean fat difference was higher in patients treated with immunotherapy, and lower in those treated with chemotherapy in addition to immunotherapy, as demonstrated by Tukey comparisons. The survival of 25 patients were affected by the treatment they received (P=0.006). Chemotherapy administered in addition to immunotherapy prolonged patient life almost two-fold when compared with the individual effects of the two treatments, which became equal according to Fisher's LSD comparisons. In conclusion, the nutritional status of patients was associated with the administration of chemotherapy in addition to immunotherapy, and patient survival. Increased metabolism and fat mass were also associated with prolonged survival.
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Affiliation(s)
- Maria Pilikidou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 54623 Thessaloniki, Greece.,Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Foteini Palyvou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 54623 Thessaloniki, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 54623 Thessaloniki, Greece
| | - Theodora Tsiouda
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Eirini Tsekitsidi
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 54623 Thessaloniki, Greece
| | - Konstantina Arvaniti
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Angeliki Miziou
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Zoi Tsingerlioti
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Georgios Apostolidis
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Romanos Ntiloudis
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Konstantina Boniou
- Pulmonary-Oncology Department, 'Theageneio' Cancer Hospital, 54007 Thessaloniki, Greece
| | - Athanasios A Tsioudas
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 54623 Thessaloniki, Greece
| | - Angeliki Cheva
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Science and Technology, School of Geosciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Paul Zarogoulidis
- Pulmonary Department, 'Bioclinic' Private Hospital, 54622 Thessaloniki, Greece
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11
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Zarogoulidis P, Tryfon S, Saroglou M, Matthaios D, Tsakiridis K, Huang H, Bai C, Hohenforst-Schmidt W, Hatzibougias D, Athanasiou E, Michalopoulou-Manoloutsiou E, Mpoukovinas I, Ioannidis A, Kosmidis C. Tracheal fistula repair with stent placement after failure of reconstruction with muscle tissue. A lung cancer surgery complication. Respir Med Case Rep 2021; 34:101518. [PMID: 34603953 PMCID: PMC8473540 DOI: 10.1016/j.rmcr.2021.101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/10/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
A report a case of a 63 year old male diagnosed with lung cancer adenocarcinoma. The patient had a right paratracheal mass diagnosed with EBUS-TBNA 22G. The patient had surgery, however 7 days after the billau catheter was removed pneumothorax was diagnosed which did not resolved. Bronchoscopy reveled two minor fistulas in the interior wall of the trachea. An additional surgery was performed in order to add muscle patches on the exterior part of the trachea. Unfortunately additional stent placement was placed after a silicon stent since the muscle patches failed. We chose a metallic auto expandable stent since after three months of follow up a small metastatic lesion was observed in the liver. Stent placement is an option for these patients and the right stent has to be placed for each case.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, "Bioclinic" Private Hospital, Thessaloniki, Greece
- 3rd University General Hospital, "AHEPA" University Hospital, Thessaloniki, Greece
- Corresponding author. 3rd University General Hospital, "AHEPA" University Hospital, Thessaloniki, Greece.
| | - Stavros Tryfon
- Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece
| | - Maria Saroglou
- Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ’’Hof’’ Clinics, University of Erlangen, Hof, Germany
| | | | | | | | | | - Aris Ioannidis
- Surgery Department, "Genesis" Private Clinic, Thessaloniki, Greece
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12
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Zarogoulidis P, Petridis D, Huang H, Bai C, Hohenforst-Schmidt W, Freitag L, Baka S, Drougas D, Vagionas A, Tsakiridis K, Turner JF, Hatzibougias D, Boukovinas I, Zaric B, Kovacevic T, Ioannidis A, Courcoutsakis N, Matthaios D, Sardeli C. Biopsy and re-biopsy for PD-L1 expression in NSCLC. association between PD-L1 and checkpoint inhibitor efficacy through treatment in NSCLC. A pilot study. Expert Rev Respir Med 2021; 15:1483-1491. [PMID: 34591723 DOI: 10.1080/17476348.2021.1987888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Lung cancer is diagnosed at a late stage due to lack of early disease symptoms. Therefore an efficient treatment is necessary for prolonged disease free survival. PATIENTS AND METHODS In our study we recruited 124 patients NSCLC patients with adenocarcinoma and squamus cell carcinoma. All recuited patients had Programmed death-ligand 1 expression ≥50 (PD-L1)with DAKO technique. Immunotherapy was administered with as first line treatment. Re-biopsies were performed in the main lung lesion every 4 months with the restaging of the patient and also in the metastastic sites in other organs that occurred during treatment. PD-L1 expressed was evaluated in the biopsies of the metastatic sites. RESULTS It appears thereafter that the PD-L1 expression could easily be claimed as a promising bio-index with a cutoff value 65, below which a negative prognosis of the disease progress will be evident and above that value a positive continuation of the disease will be prominent. CONCLUSION The findings of this study suggest that the PD-L1-65 index works adequately either concerning the neo-metastatic sites or the patient disease responses. Re-biopsies in new metastastic sites are necessary since we probably have a new cancer and chemotherapy should be added. More studies should confirm are results and change the NSCLC treatment approach of these patients.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``ahepa`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Pulmonary Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Dimitris Drougas
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - J Francis Turner
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, USA
| | - Dimitris Hatzibougias
- Pulmonary department, Private Pathology Laboratory, "Microdiagnostics", Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Aris Ioannidis
- Surgery Department, ``genesis`` Private HJospital, Thessaloniki, Greece
| | - Nikolaos Courcoutsakis
- Radiology Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | - Chrisanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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Zarogoulidis P, Matthaios D, Kosmidis C, Hohenforst-Schmidt W, Tsakiridis K, Mpaka S, Boukovinas I, Drougas D, Theofilatou V, Zaric B, Courcoutsakis N, Nikolaidis G, Huang H, Bai C. Effective early diagnosis for NSCLC: an algorithm. Expert Rev Respir Med 2021; 15:1437-1445. [PMID: 34403620 DOI: 10.1080/17476348.2021.1969916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Lung cancer still remains undiagnosed for most patients until the disease is inoperable. AREAS COVERED We performed search on PubMed with the keywords: EBUS, radial-EBUS, bronchoscopy, lung cancer, electromagnetic navigation, ct-biopsy, transthoracic biopsy. We present diagnostic equipment and imaging techniques such as positron emission tomography, endoscopical navigation systems, endobronchial ultrasound, radial-endobronchial ultrasound, transthoracic ultrasound biopsy, and computed tomography guided biopsies. EXPERT OPINION However, lack of early disease symptoms remains the most important issue and therefore we should direct our efforts to screening and early disease diagnosis. An algorithm is proposed for biopsy upon initial disease diagnosis.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``ahepa`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Pulmonary Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | | | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Kosmas Tsakiridis
- Thoracic Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Sofia Mpaka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Drougas
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | - Vasiliki Theofilatou
- Nuclear Medicine Department, ``Bioiatriki`` Private PET-CT Laboratory, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Nikolaos Courcoutsakis
- Radiology Department, Democritus University of Thrace, General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - George Nikolaidis
- Surgery Department, ``General Clinic`` Euromedica, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
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14
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Zarogoulidis P, Sardeli C, Christakidis V, Hohenforst-Schmidt W, Huang H, Kosmidis C, Vagionas A, Baka S, Tsakiridis K, Perdikouri EI, Romanidis K, Sapalidis K. PD-L1 and standardized uptake value expression in lung cancer: a possible connection for efficient early lung cancer treatment. Biomark Med 2021; 15:463-466. [PMID: 33733828 DOI: 10.2217/bmm-2020-0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, 'AHEPA' University Hospital, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Intensive Care Unit, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Department of Cardiology/Pulmonology/Intensive Care/Nephrology, Sana Clinic Group Franken,'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, PR China
| | | | | | - Sofia Baka
- Oncology Department, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, 'Interbalkan' European Medical Center, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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15
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Zarogoulidis P, Hohenforst-Schmidt W, Huang H, Zhou J, Wang Q, Wang X, Xia Y, Ding Y, Bai C, Kosmidis C, Sapalidis K, Sardeli C, Tsakiridis K, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Baka S, Athanasiou E, Hatzibougias D, Michalopoulou-Manoloutsiou E, Petanidis S, Drougas D, Drevelegas K, Paliouras D, Barbetakis N, Vagionas A, Freitag L, Lallas A, Boukovinas I, Petridis D, Ioannidis A, Matthaios D, Romanidis K, Karapantzou C. Intratumoral Treatment with Chemotherapy and Immunotherapy for NSCLC with EBUS-TBNA 19G. J Cancer 2021; 12:2560-2569. [PMID: 33854617 PMCID: PMC8040712 DOI: 10.7150/jca.55322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/03/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Immunotherapy is being used for the past five years either as first line or second line treatment with great results. Chemotherapy and radiotherapy have been also used as combination to immunotherapy to further enhance this type of treatment. Intratumoral treatment has been previously proposed as a treatment option for certain non-small cell lung cancer patients. Patients and Methods: We recruited in total seventy four patients with non-small cell lung cancer in their second line treatment who received only chemotherapy in their first line treatment with programmed death-ligand-1 ≤ 50. Only adenocarcinoma or squamous cell carcinoma, and all negative for epidermal growth factor receptor, anaplastic lymphoma kinase, proto-oncogene tyrosine-protein kinase-1 and proto-oncogene B-Raf. Data were first examined with descriptive statistics choosing frequencies for categorical variables and histograms for the continuous ones. Twenty five received only intravenous immunotherapy and forty-nine intravenous cisplatin with immunotherapy. Data were first examined with descriptive statistics choosing frequencies for categorical variables and histograms for the continuous ones. Results: The relationships between changes of performance status and disease progression were examined via a single correspondence analysis. The two-dimensional scores (coordinates) derived from the correspondence analysis were then regressed against the predictors to form distinct splits and nodes obtaining quantitative results. The best fit is usually achieved by lowering exhaustively the AICc criterion and looking in parallel the change of R2 expecting improvements more than 5%. both types of therapy are capable of producing best ameliorative effects, when either the programmed death-ligand-1 expression or parenchymal site in joint with low pack years are present in the sampling data. Conclusions: Intratumoral treatment combination with cisplatin plus immunotherapy indifferent of nivolumab or pembrolizumab combination is an effective choice. In specific for those with endobronchial lesions. Moreover; patients with programmed death-ligand-1 ≥ 50 had their performance status and disease progression improved over the eight month observation.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Jun Zhou
- Department of Respiratory, Changzhou maternal and child health care hospital affiliated to Nanjing Medical University, Jiangsu Changzhou, China
| | - Qin Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Xiangqi Wang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Ying Xia
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Yinfeng Ding
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Naval Medical University ( Changhai Hospital, Second Military Medical University), Shanghai, China
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Respiratory, Changzhou maternal and child health care hospital affiliated to Nanjing Medical University, Jiangsu Changzhou, China
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | | | | | | | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Dimitris Drougas
- Scientigraphy Department, "Bioclinic" Private Laboratory, Thessaloniki, Greece
| | | | - Dimitris Paliouras
- Thoracic surgery Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic surgery Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | | | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich Switzerland
| | - Aimilios Lallas
- Dermatology Department, Aristotle University, School of Medicine, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Science and Technology, International Hellenic University, Thessaloniki, Greece
| | - Aris Ioannidis
- Surgery Department, ``Genesis`` Private Hospital, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Chrisanthi Karapantzou
- Ear, Nose and Throat (ENT) Department, Ludwig-Maximilians University of Munich, Munich, Germany
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Application of a Simulator-Based Teaching Method in the Training of the Flexible Bronchoscope-Guided Intubation. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:501-506. [PMID: 35444821 PMCID: PMC8987478 DOI: 10.12865/chsj.47.04.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The study aimed to explore the effect of a bronchoscopic simulator-based comprehensive teaching method in the training of flexible bronchoscope-guided intubation for suspected lung cancer patients for doctors without bronchofibroscopic operation background. METHODS We designed a prospective self-control study involved in 35 trainees from the Navy Military Medical University's affiliated hospital to evaluate flexible bronchoscope-guided intubation's training outcome. Before and after the practice training, we recorded the flexible bronchoscope passing time from nasal to visible glottis and carina, tracheal placement tube, and ventilation. RESULTS All 35 trainees could complete flexible bronchoscope-guided intubation independently after training. CONCLUSIONS The bronchial diagnosis for suspected lung cancer patients and treatment-based model can be widely applied in tracheal intubation training.
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17
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Sardeli C, Zarogoulidis P, Romanidis K, Oikonomou P, Sapalidis K, Huang H, Bai C, Hohenforst-Schmidt W, Tsakiridis K, Zaric B, Perin B, Ioannidis A, Baka S, Drevelegas K, Kosmidou M, Kosmidis C. Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer. Respir Med Case Rep 2020; 31:101258. [PMID: 33145157 PMCID: PMC7596337 DOI: 10.1016/j.rmcr.2020.101258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022] Open
Abstract
Nowadays we have novel therapies for advanced stage non-small cell lung cancer. Immunotherapy has been introduced in the market for several years and until now its administration is mostly based on the programmed death-ligand 1. First line treatment with immunotherapy can be administered alone if programmed death-ligand 1 expression is ≥ 50%. All therapies for advanced stage disease have advantages and disadvantages, immunotherapy until now has presented mild adverse effects when compared to chemotherapy. However; it is known to induce inflammatory response to different tissues within the body. In our case acute pneumothorax was induced after immunotherapy administration.
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Affiliation(s)
- Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ''Interbalkan'' European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Aris Ioannidis
- Surgery Department, ''Genesis'' Private Hospital, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, ''Intebalkan'' European Medical Center, Thessaloniki, Greece
| | | | - Maria Kosmidou
- Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ''AHEPA'' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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18
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Zarogoulidis P, Petridis D, Sapalidis K, Tsakiridis K, Baka S, Vagionas A, Hohenforst-Schmidt W, Freitag L, Huang H, Bai C, Drougas D, Theofilatou V, Romanidis K, Perdikouri EI, Petanidis S, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Perin B, Courcoutsakis N, Athanasiou E, Hatzibougias D, Drevelegas K, Boukovinas I, Kosmidou M, Kosmidis C. Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA. J Cancer 2020; 11:6454-6459. [PMID: 33033529 PMCID: PMC7532516 DOI: 10.7150/jca.48691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/25/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction: Novel technologies are currently used for lung cancer diagnosis. EBUS-TBNA 22G is considered one of the most important tools. However; there are still issues with the sample size.Patients and Methods: 223 patients underwent EBUS-TBNA with a 21G Olympus needle, 22GUS Mediglobe and 22GUB Mediglobe. In order to evaluate the efficiency of 22GUB novel needle design. In order to evaluate the sample size of each needle, we constructed cell blocks and measured the different number of slices from each biopsy site. Results: The 22GUB novel needle had similar and larger number of slices from each biopsy site compared to 21G needle. Discussion: Firstly as a novel methodology we used the number of slices from the constructed cell blocks in order to evaluate the sample size. Secondly, we should seek novel needle designs and not only concentrate on the volume of the sample size.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, "AHEPA" University Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich Switzerland
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Dimitris Drougas
- Scientigraphy Department, "Bioclinic" Private Laboratory, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Second Department of Surgery, General University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Branislav Perin
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | | | | | | | | | | | - Maria Kosmidou
- Internal Medicine Department, University of Ioannina, Ioannina, Greece
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19
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Shi D, Li F, Wang K, Kong C, Huang H, Li Q, Jin F, Hu C, Wang C, Shi H, Hu Z, Dong Y, Ning Y, Tsakiridis K, Sapalidis K, Kosmidis C, Vagionas A, Hohenforst-Schmidt W, Freitag L, Turner JF, Drevelegas K, Perdikouri EI, Kovacevic T, Sarcev T, Zaric B, Petanidis S, Baka S, Boukovinas I, Kakolyris S, Zarogoulidis P, Bai C. The development of bronchoscopy in China: a national cross-sectional study. J Cancer 2020; 11:5547-5555. [PMID: 32913450 PMCID: PMC7477436 DOI: 10.7150/jca.47183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/09/2020] [Indexed: 11/05/2022] Open
Abstract
Objective: To investigate the development of bronchoscopy in China and compare it with its application in the early 21st century. Methods: The data collection was based on questionnaires. Three hundred and nineteen hospitals, which distributed across 30 provinces and 130 cities, were included in the study. Data about the application of bronchoscopy in Shanghai and Hunan province in the early 21st century are also involved for comparison. Results: The median period of performing diagnostic and therapeutic bronchoscopy was 19.7±11.0 and 7.4±7.0 years, respectively. On average, about 155.2 cases and 28.4 cases received diagnostic and therapeutic bronchoscopy in each hospital per month. The average area and number of the examination room was 122.7m2 and 2.2m2, respectively. More examination items were performed in specialty hospitals than those in general hospitals (P<0.05) and specialty hospitals owned more rooms exclusively for bronchoscopy (P<0.05), while no difference of the number of allocated doctors was found (P>0.05). On the other side, the whole amount of diagnosis and therapeutic items in teaching hospitals was slightly higher than that in non-teaching hospitals (P<0.01). Comparison of diagnosis and therapeutic endoscopy in Shanghai and Hunan province shows that the number of flexible bronchoscopy increased by 5.8 times in Shanghai from 2002 to 2017, while that increased by 3.4 times in Hunan province from 2005 to 2017. Furthermore, the average number of allocated doctors increased by 0.85 times in Shanghai, which was more rapidly compared with that of Hunan province (0.66 times) (P<0.05). Besides, the development rate of the diagnosis and therapeutic projects in Shanghai was significantly higher than that in Hunan province (P<0.05). Conclusion: All different classes of hospitals in China are capable of carrying out conventional bronchoscopy diagnosis and therapeutic projects, and newly developed bronchoscopy technology has gradually spread in high-level hospitals since 21st century. The higher class the hospital was, the earlier bronchoscopy was performed. Respiratory endoscopy in China has developed rapidly since the early 21st century and the construction of respiratory endoscopy center and the personnel training are on the right track, but it is also faced with inadequate equipment, unbalanced regional development and insufficient personnel allocation.
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Affiliation(s)
- Dongchen Shi
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Fuqi Li
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Kaicheng Wang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chen Kong
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Qiang Li
- Department of Respiratory, Oriental Hospital, Tongji University, Shanghai, China
| | - Faguang Jin
- Department of Respiratory, Tangdu Hospital, The Fourth Military Medical University, Xian, China
| | - Chengping Hu
- Department of Respiratory, Xiangya Hospital, Central South University, Changsha, China
| | - Changhui Wang
- Department of Respiratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Hui Shi
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhenli Hu
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yuchao Dong
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Yunye Ning
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - J Francis Turner
- University of Tennessee Graduate School of Medicine, Department of Medicine, Knoxville, TN, USA
| | - Konstantinos Drevelegas
- Radiology Department, ``G. Papageorgiou`` University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Tomi Kovacevic
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Tatjana Sarcev
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Sofia Baka
- Oncology Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Ioannis Boukovinas
- Oncology Department, ``Bioclinic`` Private Hospital, Thessaloniki, Greece
| | - Stylianos Kakolyris
- Oncology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paul Zarogoulidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
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20
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Wu X, An Z, Zhao K, Yang S, Lin X, Dai X, Radisky D, Hu J. Integrated strategy combining endobronchial ultrasound with positron emission tomography to diagnose peripheral pulmonary lesions. Thorac Cancer 2020; 11:2094-2100. [PMID: 32543098 PMCID: PMC7396360 DOI: 10.1111/1759-7714.13484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 11/29/2022] Open
Abstract
Background Endobronchial ultrasound‐guided transbronchial lung biopsy (EBUS‐TBLB) and fluorodeoxyglucose positron emission tomography (FDG‐PET) have been widely used in the diagnosis of peripheral pulmonary lesions (PPLs). This study was conducted to determine the diagnostic value of EBUS‐TBLB combined with FDG‐PET in the assessment of PPLs. Methods The clinical data of 76 patients with PPLs who received both FDG‐PET and EBUS‐TBLB from January 2016 to February 2018 were retrospectively evaluated. Further subgroup analysis was performed according to lesion diameter (≤20 mm or >20 mm). Related diagnostic indices were calculated and compared between groups. Results When combining EBUS‐TBLB with FDG‐PET, the diagnostic accuracy rate, sensitivity, specificity, Youden's index, positive predictive value, and negative predictive value for PPLs were 86.8%, 90.2%, 73.3%, 63.5%, 93.2%, and 64.7%, respectively. In addition, the diagnostic accuracy rate of the combined approach was significantly higher than the single EBUS‐TBLB and FDG‐PET (P < 0.01 and P < 0.05, respectively), and its Youden's index was also at a higher level. When stratified by lesion diameter, the combined approach showed a significantly higher diagnostic accuracy rate (P < 0.05) and a higher Youden's index for PPLs >20 mm than PPLs ≤20 mm. In addition, we found that positive bronchus sign and probe within the probe were two important factors conducing to enhancing the diagnostic accuracy rate for EBUS‐TBLB. Conclusions An integrated approach combining EBUS‐TBLB with FDG‐PET is particularly useful for diagnosing PPLs, and the improved diagnostic yields were especially evident for PPLs >20 mm.
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Affiliation(s)
- Xiao Wu
- Department of Thoracic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhou An
- Department of Thoracic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Kui Zhao
- PET Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | | | - Xu Lin
- Department of Thoracic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaona Dai
- Hospital Administration Office of Zhejiang University, Hangzhou, China
| | - Derek Radisky
- Department of Cancer Biology, Mayo Clinic Cancer Center, Jacksonville, Florida, USA
| | - Jian Hu
- Department of Thoracic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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21
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Tsiouda T, Sardeli C, Porpodis K, Pilikidou M, Apostolidis G, Kyrka K, Miziou A, Kyrka K, Tsingerlioti Z, Papadopoulou S, Heva A, Koulouris C, Giannakidis D, Boniou K, Kesisoglou I, Vagionas A, Kosmidis C, Sevva C, Papazisis G, Goganau AM, Sapalidis K, Tsakiridis K, Tryfon S, Platanas M, Baka S, Zaric B, Perin B, Petanidis S, Zarogoulidis P. Sex Differences and Adverse Effects between Chemotherapy and Immunotherapy for Non-Small Cell Lung Cancer. J Cancer 2020; 11:3407-3415. [PMID: 32231747 PMCID: PMC7097940 DOI: 10.7150/jca.40196] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Lung cancer remains the leading cause of cancer mortality in men and women and around the world. Approximately 90% of cases of lung cancer are caused by smoking and the use of tobacco products. However, other factors such as asbestos, air pollution and chronic infections can contribute to pulmonary carcinogenesis. Lung cancer is divided into two broad histological categories, which develop and spread different small cell lung carcinomas and non-small cell lung carcinomas. The treatment options for lung cancer include surgery, radiotherapy, chemotherapy and targeted treatments. Tumor induced immune suppression is vital for malignant progression. Immunotherapies act by strengthening the patient's innate tendency for an immune response and give positive promise to patients with non-small cell lung cancer and small cell lung cancer. Immune checkpoint inhibitors are a new approach to cancer therapies. Just as immune therapies include a new approach to cancer biology, the toxicities associated with these factors have created new challenges in clinical practice. Materials & Methods: Patients (218) aged 40-80 years were treated with either chemotherapy or immunotherapy. Their response to treatment and any subsequent adverse drug reactions were studied. Results: 69% of patients were treated with chemotherapy and 31% were treated with immunotherapy. The type of treatment had a statistically significant effect on the undesirable effects of the treatment. Conclusions: The type of treatment was statistically significant in responding to the treatment and treatment side effects but not in the rate of death.
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Affiliation(s)
- Theodora Tsiouda
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Chrisanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, G. "Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Pilikidou
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Krystallia Kyrka
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Angeliki Miziou
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Konstantina Kyrka
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Zoi Tsingerlioti
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Anta Heva
- Pulmonary Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantina Boniou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Anastasios Vagionas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christina Sevva
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - George Papazisis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandru Marian Goganau
- General Surgery Clinic 1, University of Medicine and Pharmacy of Craiova, Craiova County Emergency Hospital, Craiova, Romania
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Stavros Tryfon
- Pulmonary Department (NHS), G.H. "G. Papanikolaou" Thessaloniki, Thessaloniki, Greece
| | - Michalis Platanas
- Urology Department (NHS), General Hospital of Giannitsa, Giannitsa, Greece
| | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Bojan Zaric
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Branislav Perin
- Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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22
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Sapalidis K, Romanidis K, Oikonomou P, Zarogoulidis P, Katsaounis A, Amaniti A, Michalopoulos N, Koulouris C, Tsakiridis K, Giannakidis D, Kesisoglou I, Ioannidis A, Nikolaos-Katsios I, Vagionas A, Hohenforst-Schmidt W, Huang H, Bai C, Goganau AM, Kosmidis C. Convex endobronchial ultrasound: same coin, two faces. Challenging biopsy and staging for non-small-cell lung cancer. Lung Cancer Manag 2020; 8:LMT20. [PMID: 31983928 PMCID: PMC6978727 DOI: 10.2217/lmt-2019-0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Lung cancer is still diagnosed at a late stage due to lack of early disease symptoms. Despite the development of new diagnostic endoscopic tools, such as radial/convex endobronchial ultrasounds (EBUS) and electromagnetic navigation, most patients are still diagnosed at advanced stage disease. Most of the patients refer to their doctor only if they cough blood or their cough changes character. There are challenging cases in the diagnosis and staging of a patient, such as the one that we will present. We present a case of lung cancer that was diagnosed through a biopsy from the main lesion, with access from the esophagus, through transbronchial needle aspiration with EBUS, under general anesthesia and intubation. Staging with transbronchial needle aspiration with EBUS was also performed at the same session.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paul Zarogoulidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Pulmonary Department, Creta InterClinic Private Hospital, Iraklio, Crete, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthesiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aris Ioannidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Iason Nikolaos-Katsios
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, 'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- The Diagnostic & Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Chong Bai
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandru Marian Goganau
- General Surgery Clinic 1, University of Medicine andPharmacy of Craiova, Craiova County Emergency Hospital, Craiova, Romania
| | - Christoforos Kosmidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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23
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Sardeli C, Zarogoulidis P, Kosmidis C, Amaniti A, Katsaounis A, Giannakidis D, Koulouris C, Hohenforst-Schmidt W, Huang H, Bai C, Michalopoulos N, Tsakiridis K, Romanidis K, Oikonomou P, Mponiou K, Vagionas A, Goganau AM, Kesisoglou I, Sapalidis K. Inhaled chemotherapy adverse effects: mechanisms and protection methods. Lung Cancer Manag 2020; 8:LMT19. [PMID: 31983927 PMCID: PMC6978726 DOI: 10.2217/lmt-2019-0007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Lung cancer is still diagnosed at a late stage due to a lack of symptoms. Although there are novel therapies, many patients are still treated with chemotherapy. In an effort to reduce adverse effects associated with chemotherapy, inhaled administration of platinum analogs has been investigated. Inhaled administration is used as a local route in order to reduce the systemic adverse effects; however, this treatment modality has its own adverse effects. In this mini review, we present drugs that were administered as nebulized droplets or dry powder aerosols for non-small-cell lung cancer. We present the adverse effects and methods to overcome them.
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Affiliation(s)
- Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthesiology Department, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charilaos Koulouris
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, 'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- The Diagnostic & Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Chong Bai
- The Diagnostic & Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Nikolaos Michalopoulos
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, 'Interbalkan' European Medical Center, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantina Mponiou
- Radiotherapy Department, 'Theageneio' Anti-Cancer Hospital, Thessaloniki, Greece
| | | | - Alexandru Marian Goganau
- General Surgery Clinic 1, University of Medicine and Pharmacy of Craiova, Craiova County Emergency Hospital, Craiova, Romania
| | - Isaak Kesisoglou
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Zarogoulidis P, Huang H, Yang M, Zhou J, Jiao Y, Wang Q, Petridis D, Sapalidis K, Sardeli C, Konsta P, Koulouris C, Michalopoulos N, Giannakidis D, Barbetakis N, Katsaounis A, Hohenforst-Schmidt W, Amaniti A, Petanidis S, Tsakiridis K, Courcoutsakis N, Goganau AM, Vagionas A, Romanidis K, Oikonomou P, Karanikas M, Katsios IN, Kesisoglou I, Kosmidis C. Pleurodesis and Immunotherapy in NSCLC; Medical Thoracoscopy or VATS? J Cancer 2020; 11:1606-1613. [PMID: 32047566 PMCID: PMC6995373 DOI: 10.7150/jca.40004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/29/2019] [Indexed: 12/15/2022] Open
Abstract
Introduction: Immunotherapy is a treatment option for non-small cell lung cancer advanced disease. However; immunotherapy in several patients induces orogonitis and effusion in different cavities. It is up to the treating physician to understand whether there is effusion due to adverse effect or disease progression. Pleurodesis in both cases might be a solution for recurrent pleura effusion. Patients and Methods: Three hundred and thirty seven non-small cell lung cancer patients with adenocarcinoma and pleura effusion during first line immunotherapy treatment underwent medical thoracoscopy or Video assisted thoracic surgery (VATS) for pleurodesis with talk poudrage. Uniportal medical thoracoscopy was performed under general with dual channel endotracheal tube in one hundred and eleven patients. Video assisted thoracic surgery was performed in one hundred and eighty seven patients and conversion from medical to VATS procedure was done to thirty nine patients. All patients had stage IV disease with pleura involvement and were under first line pembrolizumab treatment with 200mg (PD-L1 ≥ 50%). Results: The quantitative parameters of the study (expression, PY and cycle) were converted to an ordinal scale to facilitate the performance of statistical analysis. All parameters were examined as dependent against the parameter technique acting as independent to detect potential relationships. The results of multi Y versus X relationship revealed no statistically significant effect (p>0.05) of the three levels of technique against any response considered. Thus we can infer, quite safely, that the innovative operation (level 0) does not differ from the other two conventional methods (levels 2 and 3) through all parameters entered in the model. There was no significant difference between the different pleurodesis techniques. Discussion: Immunotherapy is known to induce in a number of patients pleura effusion and pericarditis. However; pleurodesis is efficient when the appropriate method is performed to every patient. Careful assessment in a case by case manner has to be performed for each patient before any procedure is performed.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Meng Yang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Jun Zhou
- Department of Respiratory, Changzhou 1st People's Hospital, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, P.R. China
| | - Yang Jiao
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Qin Wang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, P. R. China
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Parthenopi Konsta
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Aikaterini Amaniti
- Anesthisiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Savvas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, 119992, Russian Federation
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, Interbalkan ``European`` Medical Center, Thessaloniki, Greece
| | - Nikolaos Courcoutsakis
- Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexandru Marian Goganau
- General Surgery Clinic 1, University of Medicine and Pharmacy of Craiova, Craiova County Emergency Hospital, Craiova, Romania
| | | | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michael Karanikas
- Department of Surgery, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - Iason Nikolaos Katsios
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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Zarogoulidis P, Sapalidis K, Fyntanidou V, Kosmidis C, Amaniti A, Koulouris C, Giannakidis D, Tsakiridis K, Aidoni Z, Romanidis K, Oikonomou P, Huang H, Freitag L, Hohenforst-Schmidt W. Evaluating the use of elastography in endobronchial ultrasound technique as a diagnostic approach for mesothorax lymphadenopathy. Expert Rev Respir Med 2019; 13:1153-1159. [PMID: 31591914 DOI: 10.1080/17476348.2019.1677466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Non-small cell lung cancer is still diagnosed at a late stage although we have new diagnostic equipment such the radial endobronchial ultrasound, convex probe endobronchial ultrasound, and electromagnetic navigation. The diagnostic techniques have been upgraded with rapid on-site evaluation (ROSE) and currently from 2014 real-time elastography is being evaluated as a ROSE technique.Areas covered: A thorough search was performed on PubMed and Scopus with the following key words: elastography, strain ratio, convex probe EBUS, endoscopic ultrasound (EUS), elastography. In the current mini review, we will focus on published data regarding elastography with the convex probe endobronchial ultrasound in two different systems and comment on this future ROSE technique. Elastography, strain ratio, and factors such as(I) margin (indistinct or distinct); (II) shape (oval or round); (III) short-axis size less or more than 1 cm; (IV) presence or absence of central hilar structure (CHS); (V) echogenicity (homogeneous or heterogeneous); and (VI) presence or absence of coagulation necrosis sign are presented in our review based on published literature.Expert opinion: Current data indicate that we can have up to 93% sensitivity and specificity of real-time elastography and strain ratio for the evaluation of benignancy and malignancy; however, sample biopsy is still necessary. For now, we can only reduce the number of punctures.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Varvara Fyntanidou
- Anesthesiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthesiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, ``Interbalkan`` European Medical Center, Thessaloniki, Greece
| | - Zoi Aidoni
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Romanidis
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Panagoula Oikonomou
- Second Department of Surgery, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Haidong Huang
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Lutz Freitag
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Wolfgang Hohenforst-Schmidt
- Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Essen, Germany
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26
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Zarogoulidis P, Kosmidis C, Fyntanidou V, Aidoni Z, Tsakiridis K, Koulouris C, Michalopoulos N, Barmpas A, Huang H, Bai C, Hohenforst-Schmidt W, Sapalidis K. Biopsy and rebiopsy for non-small-cell lung cancer: current and future methods. Lung Cancer Manag 2019; 8:LMT16. [PMID: 31807144 PMCID: PMC6891930 DOI: 10.2217/lmt-2019-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Paul Zarogoulidis
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Varvara Fyntanidou
- Anesthesiology Department, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Zoi Aidoni
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- Thoracic Surgery Department, 'Interbalkan' European Medical Center, Thessaloniki, Greece
| | - Charilaos Koulouris
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Anastasios Barmpas
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, 'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Konstantinos Sapalidis
- Third Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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27
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Zarogoulidis P, Kosmidis C, Fyntanidou V, Barmpas A, Koulouris C, Aidoni Z, Huang H, Bai C, Hohenforst-Schmidt W, Tsakiridis K, Sapalidis K. Elastography during convex-probe (endobronchial ultrasound) for optimal biopsy sample and gene identification in non-small-cell lung cancer. Biomark Med 2019; 13:1153-1156. [PMID: 31559839 DOI: 10.2217/bmm-2019-0367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Varvara Fyntanidou
- Anesthesiology Department, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Anastasios Barmpas
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Zoi Aidoni
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, PR China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, PR China
| | - Wolfgang Hohenforst-Schmidt
- Department of Cardiology/Pulmonology/Intensive Care/Nephrology, Sana Clinic Group Franken, 'Hof' Clinics, University of Erlangen, Hof, Germany
| | - Kosmas Tsakiridis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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28
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Sapalidis K, Zarogoulidis P, Petridis D, Kosmidis C, Fyntanidou B, Tsakiridis K, Maragouli E, Amaniti A, Giannakidis D, Koulouris C, Mantalobas S, Katsaounis A, Alexandrou V, Koimtzis G, Pavlidis E, Barmpas A, Tsiouda T, Sardeli C, Aidoni Z, Huang H, Li Q, Hohenforst-Schmidt W, Kesisoglou I. EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE ®. J Cancer 2019; 10:4739-4746. [PMID: 31598145 PMCID: PMC6775521 DOI: 10.7150/jca.35898] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/19/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction: Lung cancer is diagnosed at advanced stage due to lack of early disease symptoms. Currently we have several different biopsy techniques such as; radial endobronchial ultrasound, convex probe endobronchial ultrasound, electromagnetic navigation, ct guided biospy and transthoracic ultrasound biopsy. Novel therapies such as; immunotherapy is being used for non-small cell lung cancer in the everyday clinical practice as first and second line treatment. Programmed ligand-1 is essential in order to administer immunotherapy as first line treatment. Patients and Methods: Two thousands and two patients were included in our study where programmed ligand 1 was evaluated with DAKO technique and BIOCARE®. Cell blocks were obtain with convex probe ebus-tbna 22G needle. Results: The Deming regression between DAKO and BIOCARE clone revealed an amazingly strong linear relationship as the coefficient of determination indicated (R2=0.999) and the variance ratio close to 1 (0.978), proving that both techniques can equally well be substituted for each other. The regression coefficient equals to 1 and the intercept hardly differs from 0 (0.936). In practice, this relationship permits adopting the economically affordable BIOCARE clone for further medical considerations. Conclusion: No statistical difference was observed between DAKO and BIOCARE®, therefore we propose that both techniques can be used in order to investigate the expression of programmed ligand 1 with safety. PD-L1 expression was higher in the central mass instead of the lymphnodes.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Barbara Fyntanidou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Kosmas Tsakiridis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Elena Maragouli
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthisiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitris Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalobas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Vyron Alexandrou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Georgios Koimtzis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Efstathios Pavlidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Anastasios Barmpas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Theodora Tsiouda
- Pulmonary Oncology Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Intensive Care Unit, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Zoi Aidoni
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haidong Huang
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Qiang Li
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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Kosmidis C, Sapalidis K, Zarogoulidis P, Sardeli C, Koulouris C, Giannakidis D, Pavlidis E, Katsaounis A, Michalopoulos N, Mantalobas S, Koimtzis G, Alexandrou V, Tsiouda T, Amaniti A, Kesisoglou I. Inhaled Cisplatin for NSCLC: Facts and Results. Int J Mol Sci 2019; 20:ijms20082005. [PMID: 31022839 PMCID: PMC6514814 DOI: 10.3390/ijms20082005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 12/20/2022] Open
Abstract
Although we have new diagnostic tools for non-small cell lung cancer, diagnosis is still made in advanced stages of the disease. However, novel treatments are being introduced in the market and new ones are being developed. Targeted therapies and immunotherapy have brought about a bloom in the treatment of non-small cell lung cancer. Still we have to find ways to administer drugs in a more efficient and safe method. In the current review, we will focus on the administration of inhaled cisplatin based on published data.
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Affiliation(s)
- Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece.
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece.
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Efstathios Pavlidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Nikolaos Michalopoulos
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Stylianos Mantalobas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Georgios Koimtzis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Vyron Alexandrou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Theodora Tsiouda
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Aikaterini Amaniti
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
| | - Issak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, 57001 Thessaloniki, Greece.
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30
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Sapalidis K, Sardeli C, Pavlidis E, Koimtzis G, Koulouris C, Michalopoulos N, Mantalovas S, Tsiouda T, Passos I, Kosmidis C, Giannakidis D, Surlin V, Katsaounis A, Alexandrou V, Amaniti A, Zarogoulidis P, Huang H, Li Q, Mogoanta S, Kesisoglou I. Scar tissue to lung cancer; pathways and treatment. J Cancer 2019; 10:810-818. [PMID: 30854086 PMCID: PMC6400809 DOI: 10.7150/jca.30300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/15/2018] [Indexed: 12/12/2022] Open
Abstract
Lung cancer still remains diagnosed at a late stage although we have novel diagnostic techniques at our disposal. However; for metastatic disease we have novel therapies based on pharmacogenomics. Tumor heterogenity provides us different treatments. There are several reasons for carcinogenesis; fibrosis and scar tissue provides an environment that induces malignancy. In the current review we will try and elucidate the pathways involved from scar tissue to carcinogenesis.
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Affiliation(s)
- Konstantinos Sapalidis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efstathios Pavlidis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Georgios Koimtzis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalovas
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Theodora Tsiouda
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Ioannis Passos
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Valeriu Surlin
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Vyron Alexandrou
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anaisthisiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haidong Huang
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Qiang Li
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Stelian Mogoanta
- Department of Surgery, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Isaac Kesisoglou
- Third Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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Sapalidis K, Kosmidis C, Laskou S, Katsaounis A, Mantalobas S, Passos I, Michalopoulos N, Amaniti A, Sardeli C, Zarogoulidis P. Targeted Nanotechnology from Bench to Bedside. Curr Cancer Drug Targets 2019; 19:3-4. [PMID: 30672409 DOI: 10.2174/156800961901181204130142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stela Laskou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalobas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Ioannis Passos
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Chrysa Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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32
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Kosmidis C, Koimtzis G, Giannakidis D, Tteralli N, Mantalovas S, Tsakalidis A, Tsopouridou K, Atmatzidis S, Liavas L, Zarogoulidis P. Transformation of ALK expression and PD-L1 0% to PD-L1 90% only after surgery: the need for rebiopsy in lung cancer patients. Int Med Case Rep J 2019; 12:15-20. [PMID: 30666169 PMCID: PMC6333155 DOI: 10.2147/imcrj.s191526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Lung cancer is still diagnosed at a late stage although novel diagnostic techniques are in use. However, as pharmacogenomics have evolved novel targeted therapies either with tyrosine kinase inhibitors or immunotherapy can be currently used as daily treatment. We present the case of a woman with anaplastic lymphoma-positive expression and programmed death-ligand 1 (PD-L1) 0% score upon diagnosis who underwent therapeutic surgery and represented PD-L1 90% expression, however, without anaplastic lymphoma kinase expression. Transformation of the tumor or new tumor is a question to be answered for this patient and possibly we should try and direct rebiopsies for this group of targeted therapy patients.
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Affiliation(s)
- Christoforos Kosmidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Georgios Koimtzis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikos Tteralli
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalovas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Alexandros Tsakalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantina Tsopouridou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stefanos Atmatzidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Lazaros Liavas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Department of Pharmacology and Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece,
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33
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Huang Z, Huang H, Ning Y, Han J, Shen Y, Shi H, Wang Q, Bai C, Li Q, Michael S, Zarogoulidis P, Hohenforst-Schmidt W, Konstantinou F, Turner JF, Koulouris C, Katsaounis A, Amaniti A, Mantalovas S, Pavlidis E, Giannakidis D, Passos I, Michalopoulos N, Kosmidis C, Mogoantă SŞ, Sapalidis K. Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi. J Cancer 2019; 10:634-642. [PMID: 30719161 PMCID: PMC6360410 DOI: 10.7150/jca.28755] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/27/2018] [Indexed: 12/22/2022] Open
Abstract
Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5%, 87.5% and 12.5%, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75%, 93.75% and 6.25%, respectively. There were 2 cases of bleeding complications >5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials.
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Affiliation(s)
- Zhiang Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.,Department of Respiratory, The First Affiliated Hospital of Henan University, Henan Kaifeng, 475000, China
| | - Haidong Huang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Yunye Ning
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Jin Han
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.,Department of Respiratory Medicine, The Hospital of Yantaishan, Shandong Yantai, 264000, China
| | - Yibo Shen
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.,Department of Respiratory Medicine, The Fourth People's Hospital of Zigong, Sichuan Zigong, 643000, China
| | - Hui Shi
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Qin Wang
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Chong Bai
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Qiang Li
- The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Simoff Michael
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.Detroit,USA
| | - Paul Zarogoulidis
- Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Fotis Konstantinou
- Thoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - J Francis Turner
- University of Tennessee Graduate School of Medicine, Department of Medicine, Knoxville, TN, USA
| | - Charilaos Koulouris
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Department of Respiratory & Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.,Department of Respiratory, The First Affiliated Hospital of Henan University, Henan Kaifeng, 475000, China.,Department of Respiratory Medicine, The Hospital of Yantaishan, Shandong Yantai, 264000, China.,Department of Respiratory Medicine, The Fourth People's Hospital of Zigong, Sichuan Zigong, 643000, China.,The Diagnostic and Therapeutic Center of Respiratory Diseases, Shanghai East Hospital, Tongji University, Shanghai, China.,Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.Detroit,USA.,Pulmonary Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany.,Thoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.,University of Tennessee Graduate School of Medicine, Department of Medicine, Knoxville, TN, USA.,3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Surgery, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Stylianos Mantalovas
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efstathios Pavlidis
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Passos
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Michalopoulos
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stelian Ştefăniţă Mogoantă
- Department of Surgery, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Konstantinos Sapalidis
- 3rd Surgery Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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34
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Conventional Versus Therapeutic Stents for Airway Malignancies: Novel Local Therapies Underway. EBioMedicine 2018; 33:10-11. [PMID: 30049382 PMCID: PMC6085519 DOI: 10.1016/j.ebiom.2018.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 12/26/2022] Open
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35
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Zarogoulidis P, Laskou S, Katsaounis A, Pavlidis E, Giannakidis D, Koulouris C, Mantalovas S, Kougioumtzi I, Katsikogiannis N, Konstantinou F, Hohenforst-Schmidt W, Huang H, Bai C, Euthimiou A, Hatzibougas D, Fitili I, Sardeli C, Rapti A, Kesisoglou I, Sapalidis K. Esophagus lyomyoma diagnosed with convex endobronchial ultrasound (EBUS). Respir Med Case Rep 2018; 24:95-97. [PMID: 29977771 PMCID: PMC6010648 DOI: 10.1016/j.rmcr.2018.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 04/27/2018] [Accepted: 05/02/2018] [Indexed: 12/20/2022] Open
Abstract
Esophageal lyomyoma are rare benign tumors of the esophagus and they remain usually undiagnosed until local compression symptoms occur in the esophagus. Gastroscopy or esophageal ultrasonography (EUS) are usually the methods of choice for diagnosis. Moreover; surgery is the solution for this entity. In our case we present diagnosis of esophageal lyomyoma using convex probe endobronchial ultrasound (EBUS) with a fine needle aspiration of 22G.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary-Oncology Unit, "Theageneio" Cancer Hospital, Thessaloniki, Greece.,3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stella Laskou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Efstathios Pavlidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalovas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Ioanna Kougioumtzi
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Katsikogiannis
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Fotis Konstantinou
- Thoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology /Pulmonology /Intensive Care /Nephrology, "Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Alkis Euthimiou
- Gastroenterology Department, "Saint Luke" Private Hospital, Thessaloniki, Panorama, Greece
| | | | - Iota Fitili
- Microdiagnostics, Private Pathology Lab, Thessaloniki, Greece
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aggeliki Rapti
- Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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36
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Sapalidis K, Zarogoulidis P, Pavlidis E, Laskou S, Katsaounis A, Koulouris C, Giannakidis D, Mantalovas S, Huang H, Bai C, Wen Y, Wang L, Sardeli C, Amaniti A, Karapantzos I, Karapantzou C, Hohenforst-Schmidt W, Konstantinou F, Kesisoglou I, Benhanseen N. Aerosol Immunotherapy with or without Cisplatin for metastatic lung cancer non-small cell lung cancer disease: In vivo Study. A more efficient combination. J Cancer 2018; 9:1973-1977. [PMID: 29896282 PMCID: PMC5995940 DOI: 10.7150/jca.24782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/07/2018] [Indexed: 12/30/2022] Open
Abstract
Lung cancer is the leading cause of cancer death after prostate cancer for males and breast cancer for females. There are novel therapies in the past five years such as; tyrosine kinase inhibitors and most recently in the last two years immunotherapy. Immunotherapy is currently being investigated if it can be administered alone or in combination. Previously we have investigated whether immunotherapy compounds can be produced as aerosols, and in the current study we investigated the safety and efficiency independently of the programmed death-ligand 1. The aerosol administration of both cisplatin and nivolumab is possible. The combination of the two drugs has a synergistic effect and therefore should be considered an option. Time of administration for immunotherapy is also very important.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Efstathios Pavlidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stella Laskou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Athanasios Katsaounis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalovas
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yuting Wen
- Department of Respiratory Diseases, The Affiliated Jiangning hospital of Nanjing Medical University, Nanjing, China
| | - Li Wang
- Department of Respiratory Diseases, The Affiliated Jiangning hospital of Nanjing Medical University, Nanjing, China
| | - Chrysanthi Sardeli
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthesiology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Ilias Karapantzos
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Chrysanthi Karapantzou
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Fotis Konstantinou
- Thoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Naim Benhanseen
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
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37
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Hohenforst-Schmidt W, Zarogoulidis P, Huang H, Man YG, Laskou S, Koulouris C, Giannakidis D, Mantalobas S, Florou MC, Amaniti A, Steinheimer M, Sinha A, Freitag L, Turner JF, Browning R, Vogl T, Roman A, Benhassen N, Kesisoglou I, Sapalidis K. A New and Safe Mode of Ventilation for Interventional Pulmonary Medicine: The Ease of Nasal Superimposed High Frequency Jet Ventilation. J Cancer 2018; 9:816-833. [PMID: 29581760 PMCID: PMC5868146 DOI: 10.7150/jca.23737] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/03/2017] [Indexed: 12/14/2022] Open
Abstract
We use pulmonary interventional procedures for the diagnosis of pulmonary diseases either for benign or malignant lesions. Flexible bronchoscopy with or without radial endobronchial ultrasound, convex-probe endobronchial ultrasound and electromagnetic navigation are procedures performed in centers with experience in diagnostic pulmonary medicine. The method of sedation and ventilation is very important in order to avoid or handle with success complications. Proper respiration during pulmonary (or other interventional) procedures is a key factor. Apart from the proper sedation method we have to choose the proper ventilation method which decides respiratory movement. Superimposed high-frequency jet ventilation (SHFJV) is supposed to be safe and effective in clinical practice. Although this perception is commonly accepted, there is no study proving its safety on the basic of reliable data. We analyzed the data of 100 patients in different interventional settings (bronchoscopy with or without navigational approach, left atrial appendage closure (LAAC) or intracardiac catheterization) using nasal SHFJV. Mainly analyzed were capillary ABG-Data at the beginning and end of the intervention under sedation. The aim was to analyze if a risk scenario for the patient by using the nasal SHFJV can be derived by measuring the changes of pCO2, pO2, cBase Excess, cHCO3 and PH. Due to our data we conclude that this method of ventilation can be easily and safely used in interventional medicine for patients with all kind of comorbidities such as; chronic respiratory disease, lung cancer, interstitial lung disease, structural heart disease and heart failure.
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Affiliation(s)
- Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Paul Zarogoulidis
- Pulmonary-Oncology Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | - Haidong Huang
- Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, People's Republic of China
| | - Yan-Gao Man
- Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA
| | - Stella Laskou
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany.,Pulmonary-Oncology Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece.,Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, People's Republic of China.,Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA.,3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Anesthesiology Department, "AHEPA" University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany.,Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ.,Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A.,Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany.,Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany
| | - Charilaos Koulouris
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany.,Pulmonary-Oncology Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece.,Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, People's Republic of China.,Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA.,3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Anesthesiology Department, "AHEPA" University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany.,Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ.,Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A.,Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany.,Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany
| | - Dimitris Giannakidis
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany.,Pulmonary-Oncology Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece.,Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, People's Republic of China.,Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA.,3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Anesthesiology Department, "AHEPA" University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany.,Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ.,Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A.,Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany.,Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany
| | - Stylianos Mantalobas
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany.,Pulmonary-Oncology Department, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece.,Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, People's Republic of China.,Research Laboratory and International Collaboration, Bon Secours Cancer Institute, VA, USA.,3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.,Anesthesiology Department, "AHEPA" University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany.,Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ.,Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A.,Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany.,Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany
| | - Maria C Florou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- Anesthesiology Department, "AHEPA" University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michael Steinheimer
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Anil Sinha
- Sana Clinic Group Franken, Department of Cardiology / Pulmonology / Intensive Care / Nephrology, ''Hof'' Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Essen-Duisburg, Tueschener Weg 40, 45239 Essen, Germany
| | - J Francis Turner
- Division of Interventional Pulmonology & Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ
| | - Robert Browning
- Pulmonary & Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, U.S.A
| | - Thomas Vogl
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany
| | - Andrei Roman
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Frankfurt, Germany
| | - Naim Benhassen
- Medical Clinic I, "Fuerth" Hospital, University of Erlangen, Fuerth, Germany
| | - Isaak Kesisoglou
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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38
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Convex-probe endobronchial ultrasound for thyroid biopsy a new hybrid method. Respir Med Case Rep 2018; 23:125-127. [PMID: 29719797 PMCID: PMC5925947 DOI: 10.1016/j.rmcr.2018.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 01/24/2018] [Accepted: 01/31/2018] [Indexed: 01/28/2023] Open
Abstract
Nowadays we use novel diagnostic equipment for lung cancer. Bronchoscopy was the tip of the arrow for diagnosis, however; ultrasound systems have brought a revolution. We have the radial-endobronchial ultrasound for peripheral lesions and the convex probe endobronchial ultrasound for central lesions. Ultrasound endoscopic systems can be used for the diagnosis of any lesion that can be approached from the airways. In the current manuscript we will present two methods for the biopsy of thyroid gland. The first method is using anesthisiological tools and the second tools from the ear, nose and throat department.
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39
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Zarogoulidis P, Papadopoulos V, Maragouli E, Papatsibas G, Karapantzos I, Bai C, Huang H. Tumor heterogenicity: multiple needle biopsies from different lesion sites-key to successful targeted therapy and immunotherapy. Transl Lung Cancer Res 2018. [PMID: 29531904 DOI: 10.21037/tlcr.2018.01.07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Elena Maragouli
- Oncology Department, University of Thessaly, Larissa, Greece
| | | | - Ilias Karapantzos
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200000, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200000, China
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40
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Zarogoulidis P, Athanasiou E, Tsiouda T, Hatzibougias D, Huang H, Bai C, Trakada G, Veletza L, Kallianos A, Kosmidis C, Barbetakis N, Paliouras D, Rapti A, Drougas D, Hohenforst-Schmidt W. Immunotherapy "Shock" a case series of PD-L1 100% and pembrolizumab first-line treatment. Respir Med Case Rep 2017; 22:197-202. [PMID: 28879076 PMCID: PMC5576975 DOI: 10.1016/j.rmcr.2017.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 01/03/2023] Open
Abstract
In this decade a “bloom” of novel therapies has been observed for non-small cell lung cancer. We have new tools for the diagnosis of lung cancer and also we can re-biospy easier than before in different lesions and obtain tissue samples in order to investigate whether a patient can receive new targeted therapies. Immunotherapy has been well established previously for other forms of cancer, and nowadays it is also available for lung cancer. There are two immunotherapies for now nivolumab and pembrolizumab which can be administered as second line treatment, the second can also be administered as first-line if there is a programmed death-ligand 1 ≥50% expression.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary-Oncology Unit, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | | | - Theodora Tsiouda
- Pulmonary-Oncology Unit, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | | | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Shanghai Hospital, Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Shanghai Hospital, Second Military Medical University, Shanghai, China
| | - Georgia Trakada
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | - Lemonia Veletza
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | - Anastasios Kallianos
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | | | - Nikolaos Barbetakis
- Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | - Dimitrios Paliouras
- Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | - Aggeliki Rapti
- 2nd Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Dimitrios Drougas
- Private Scientigraphy Department, "Bioiatriki", Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
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41
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Ali MS, Trick W, Mba BI, Mohananey D, Sethi J, Musani AI. Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: A systematic review and meta-analysis. Respirology 2017; 22:443-453. [DOI: 10.1111/resp.12980] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 11/18/2016] [Accepted: 11/20/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Muhammad S. Ali
- Division of Pulmonary, Critical Care and Sleep Medicine; Medical College of Wisconsin; Milwaukee Wisconsin USA
| | - William Trick
- Department of Medicine; John H. Stroger, Jr. Hospital of Cook County; Chicago Illinois USA
| | - Benjamin I. Mba
- Department of Medicine; John H. Stroger, Jr. Hospital of Cook County; Chicago Illinois USA
| | | | - Jaskaran Sethi
- Department of Medicine; John H. Stroger, Jr. Hospital of Cook County; Chicago Illinois USA
| | - Ali I. Musani
- Division of Pulmonary, Critical Care and Sleep Medicine; Medical College of Wisconsin; Milwaukee Wisconsin USA
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42
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Hibare KR, Goyal R, Nemani C, Avinash R, Ram B, Ullas B. Radial endobronchial ultrasound for the diagnosis of bronchoscopically invisible lesions: First case series from India. Lung India 2017; 34:43-46. [PMID: 28144060 PMCID: PMC5234198 DOI: 10.4103/0970-2113.197100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: A peripheral, bronchoscopically invisible pulmonary lesion is a diagnostic challenge. Transthoracic needle aspiration has long been the investigation of choice but runs the risk of pneumothorax (up to 44%). Newer technologies like radial endobronchial ultrasound (R-EBUS) offer a safer approach. We present our results of R-EBUS in the diagnosis of bronchoscopically invisible lesions. This is the first large case series from India. Aims: (1) To determine the yield of R-EBUS for the diagnosis of bronchoscopically invisible lesions. (2) To compare the yields of forceps versus cryobiopsies in the diagnosis of these lesions. Setting: Tertiary care cancer center. Design: Prospective study. Methods: Consecutive patients presenting between January and October 2015 with bronchoscopically invisible peripheral pulmonary lesions were included. R-EBUS was used to localize and sample the lesion and the yields were analyzed. Yields of cryo and forceps biopsy were compared where both methods had been used. Data were analyzed using SPSS version 22. Results: A definite diagnosis obtained in 67.3% (37/55) patients with no major complications. No significant difference was found in yield between: (1) small (<3 cm) and large (>3 cm) lesions: (46.2% versus 78.6%, P = 0.38). (2) central and adjacent lesions: 61.5% versus 70%. (3) forceps and cryobiopsy (n = 28, 75% versus 67.9% P = 0.562). Conclusions: R-EBUS is a safe procedure in our setting and its yield is comparable to that reported in literature. The yield of central and adjacent lesions and forceps or cryobiopsy appears similar. Further refinements in the technique could improve yield.
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Affiliation(s)
| | - Rajiv Goyal
- Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India
| | - Chetan Nemani
- Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India
| | - Rao Avinash
- Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India
| | - Bajpai Ram
- Nayati Healthcare and Research Center, Mathura, Uttar Pradesh, India
| | - Batra Ullas
- Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India
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43
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Ho CC, Lin CK, Yang CY, Chang LY, Lin SY, Yu CJ. Current advances of endobronchial ultrasonography in the diagnosis and staging of lung cancer. J Thorac Dis 2016; 8:S690-S696. [PMID: 28066671 DOI: 10.21037/jtd.2016.08.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The diagnosis and staging of patients with lung cancer has relied on tissue sampling. Endobronchial ultrasound (EBUS) is a minimally invasive procedure for the rapid and safe acquisition of tissue and can be done easily and repeatedly. EBUS transbronchial needle aspiration (TBNA) is now the standard for diagnosis of mediastinal and hilar lymphadenopathy and should be considered in patients who have a high probability of lymph node metastases without systemic involvement. EBUS also provides guidance for biopsy of peripheral lung lesions. Recent advances of EBUS with new techniques help to improve the diagnostic yield and decrease the complication rate and total procedure time.
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Affiliation(s)
- Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching-Kai Lin
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, National Taiwan University College of Medicine, Hsin-Chu, Taiwan
| | - Ching-Yao Yang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Lih-Yu Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, National Taiwan University College of Medicine, Hsin-Chu, Taiwan
| | - Shu-Yung Lin
- Department of Internal Medicine, National Taiwan University Hospital, Jinshan Branch, National Taiwan University College of Medicine, New Taipei City, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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