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  Citation statistics : Table of Contents
   2013| September  | Volume 9 | Issue 5  
    Online since September 30, 2013

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Comparative study of the anatomic segmentectomy versus lobectomy for clinical stage I A peripheral lung cancer by video assistant thoracoscopic surgery
Lin Zhang, Wei Ma, Yun Li, Yuanzhu Jiang, Guoyuan Ma, Guanghui Wang
September 2013, 9(5):106-109
Objective: The objective of this study was to compare the completely thoracoscopic anatomic segmentectomy with lobectomy to treat stage I A peripheral lung cancer <2 cm. Materials and Methods: A retrospective study was performed that 54 cases stage I A peripheral lung cancer patients were selected, including 26 cases of segmentectomy and 28 cases of lobectomy. We observed the operative time, blood loss, number of lymphadenectomy, post-operative chest drainage, hospital days, post-operative complications and mortality, post-operative recurrence and 3-year survival rate. Results: There was no significant difference about complications such as post-operative atelectasis, severe pneumonia, arrhythmia and cardiovascular/cerebrovascular in two groups (P > 0.05). The local recurrence rate was not significant different in two groups (P > 0.05). Two groups of operative time, blood loss and number of dissected lymph nodes was not statistically significant (P > 0.05), However, the difference was statistically significant in average chest drainage and less decreased pulmonary function, which led to patients received segmentectomy recovered faster and hospitalized less time (P < 0.05). We also found there was no significant difference on survival rate with 1 and 3 year follow-up of two groups (log-rank Chi-square = 0.028, P > 0.05). Conclusions: For stage I A peripheral lung cancer, the thoracoscopic anatomic segmentectomy was safe and effective just as thoracoscopic lobectomy, and furthermore with faster post-operative recovery.
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A severe dermatologic adverse effect related with gefitinib: Case report and review of the literature
Yuan-Qing Li, Hong Sun, Dong Xue
September 2013, 9(5):110-113
Gefitinib, a selective inhibitor of the epidermal growth factor receptor-tyrosine kinase, it's one of the most frequent drug-related adverse effects (AEs) reported in literature is dermatologic AEs. We report, a case of severe cutaneous adverse reactions induced by gefitinib as second-line treatment in a male patient with advanced non-small cell lung cancer after 1 month of treatment. Although tumor shrunk and patient got benefit from the treatment, gefitinib had to be stopped right away. We managed the symptoms of rash with a variety of treatments, including topical ethacridine lactate, antihistamine and so on. After the rash improved, we found his tumor were progress. Then he took gefitinib again without severe skin toxicity or disease progression. We think the development of gefitinib-induced rash may be a sign of effective and administrating it again maybe relieves the degree of rash.
  - 4,436 177
A case of parachordoma on the chest wall and literature review
Jie Zhang, Hao Wang, Xinyu Cheng, Min Wang, Yue Zhu
September 2013, 9(5):114-117
Parachordoma is an extremely uncommon soft-tissue tumor, which mainly occurs in the deep soft-tissue of the distal parts of the limbs, such as deep fascia, muscle tendon, synovial or soft-tissue closed to the bone. Nevertheless, the literature reports about parachordoma on the thoracic wall were scarce. The clinical and imaging manifestation has a non-specific appearance. In this article, we reported one case of parachordoma of the thoracic wall that we met in clinical works and reviewed the literature.
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Spontaneous pneumothorax as the initial manifestation of stage I B primary pulmonary carcinoma: Really early stage cancer?
Hua Jiang, Wei Ma, Jing Ping Zhang, Lin Zhang
September 2013, 9(5):118-120
Spontaneous pneumothorax (SP) is a rare manifestation of lung cancers, especially as the first sign. The mechanism producing pneumothorax from pulmonary cancer has three main reasons, One is that the cancer necrosis directly ruptured into the pleural space. Another is that endobronchial neoplasm acts as a check valve, leading to dilation and eventual rupture of distal alveolar spaces. The third is that the rupture of small subpleural blebs accidentally causes SP. However, the prognosis of lung cancer patients with initial manifestation of SP is very poor, SP seems to be an ominous sign for the primary cavity lung cancer patients, even in an early stage.
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The challenges of lung cancer in China
Qian Liu, Qinghua Zhou
September 2013, 9(5):65-66
  - 2,260 147
Pleuropneumonectomy for diffuse pleural metastasis in primary lung cancer
Wen-Bo Jin, Chao-Yang Liang, Yang-Hong Peng, Nai-Kang Zhou
September 2013, 9(5):92-97
Objective: The purpose of this study is to analyze a single institution experience with pleuropneumonectomy for pleural metastasis and malignant pleural effusion in primary lung cancer. Materials and Methods: From August 1978 to August 2011, 66 consecutive patients with lung cancer underwent pleuropneumonectomy. Patients were followed-up after the operation. The quality-of-life and the survival time were recorded. Results: All the 66 patients were successfully operated on, including 38 patients in early years (1978-1993) and 28 patients in recent years (1994-2011). Two patients in early years died after the operation. Post-operative complications occurred including heart arrhythmia, respiratory insufficiency and bacterial infection of residual lung, chylothoraxin and mental disorder. A total of 61 patients have been successfully followed-up and three patients in early years were lost in 1 year after the operation. Local recurrence was found in seven cases (4 in early years, 3 in recent years) and distant metastasis was found in 48 cases (29 in early years, 19 in recent years). A total of 54 patients died from tumors, seven patients survived. The actuarial 1, 2 and 3-year survival rates are 72.7%, 27.2% and 6.1% of 36 in patients of early years and 85.7%, 46.4% and 21.4% in 28 patients of recent years. The mean survival and the median survival of the total 64 patients were 20.0 ± 10.9 months and 17 months respectively. Further analysis showed that the mean survival and the median survival of the 36 patients in early years were 17.2 ± 9.7 months and 15 months, in contrast to 23.4 ± 11.3 months and 18 months of the 28 patients in recent years. Conclusion: Pleuropneumonectomy is an option of patients with advanced-stage lung cancer associated with uncontrolled malignant pleural fluid by conservative therapies. Strict selection of patient to be operated, careful procedures to eradicate obvious tumors and metastasis and enhanced post-operative combined therapy are beneficial to patients' long-term survival.
  - 2,125 107
Association between clinical pathology and multiple genes mRNA expression in Chinese patients with NSCLC
Gang Chen, GU Jundong, Jun Chen, Yi Liu, Zuoqing Song
September 2013, 9(5):98-100
Objective: The aim of this study was to evaluate whether there was an association between pathology type and ERCC1, BRCA1, RRM1, TUBB3, STMN1, TOP2A and epidermal growth factor receptor (EGFR) messenger ribonucleic acid (mRNA) expression level in Chinese patients with non-small cell lung carcinoma (NSCLC). Materials and Methods: mRNA expression level of these genes was analyzed in 181 cancer tissues by using xTAG-step liquid-chip array. The mRNA expression level of the seven genes was evaluated in association with the clinical pathology type. Results: The average mRNA expression level of the seven genes were ERCC1 (1.02 ± 0.03), BRCA1 (0.15 ± 0.04), RRM1 (0.19 ± 0.05), TUBB3 (0.31 ± 0.06), STMN1 (2.78 ± 0.42), TOP2A (3.04 ± 0.42) and EGFR (0.58 ± 0.09), respectively in Chinese patients with NSCLC. The mRNA expression level of ERCC1, STMN1 and TOP2A genes were statistical different with different pathology type (p a < 0.05); STMN1 and TOP2A genes mRNA expression were much higher in squamous cell lung carcinoma than that in non-squamous cell lung carcinoma (p a < 0.05). And ERCC1 gene expression was much lower in squamous cell carcinoma than that in non-squamous cell carcinoma (p a < 0.05). Conclusion: mRNA expression level of STMN1, TOP2A and ERCC1 were correlated with the clinical pathology type.
  - 1,719 94
Comparison of lobe-specific mediastinal lymphadenectomy versus systematic mediastinal lymphadenectomy for clinical stage T 1a N 0 M 0 non-small cell lung cancer
Wei Ma, Zhen-Jiang Zhang, Yun Li, Guo-Yuan Ma, Lin Zhang
September 2013, 9(5):101-105
Objective: This study was to explore the appropriate extent of mediastinal lymph node dissection for clinical stage T 1a N 0 M 0 non-small cell lung cancer (NSCLC) by comparison between two modes of mediastinal lymph node dissection. Materials and Methods: A total of 96 clinical stage T 1a N 0 M 0 NSCLC cases received radical surgery were randomly divided to lobe-specific mediastinal lymphadenectomy (LL) group and systematic mediastinal lymphadenectomy (SL) group from the year 2004 to 2008. The effects of SL and LL on morbidity, N staging, overall survival (OS) and disease-free survival (DFS) were investigated. Meanwhile, associations between clinicopathological parameters and metastasis of lymph nodes were analyzed. Results: The mean operating time and blood loss in LL group were significantly less than that in the SL group (135.48 ± 25.44 min vs. 180.85 ± 39.36 min, 155.11 ± 25.17 ml vs. 161.32 ± 28.20 ml, P < 0.05), the mean numbers of dissected lymph nodes of the SL group was significantly greater than that in the LL group (17.1 ± 3.7 vs. 9.4 ± 2.1, P < 0.05). The post-operative overall morbidity rate was higher in the SL group than that in the LL group (P < 0.05). There were no significant difference in migration of N staging, OS and DFS between two groups. The post-operative N staging, the tumor cells differentiation and the ratio of ground glass opacity (GGO) in tumor were the independent factors influencing long-term survival. Moreover, the significant correlation was seen between the metastasis of lymph nodes and clinicopathological parameters including tumor location and the GGO ratio. Conclusion: The LL group had similar efficacy as the SL group in the clinical stage T 1a N 0 M 0 NSCLC and there was unnecessary to perform systematic lymphadenectomy in such patients with a high ratio of GGO.
  - 2,195 138
Signal transducers and activators of transcription 3 function in lung cancer
Chun-Jie Li, Yue-Chuan Li, Dong-Rui Zhang, Jian-Hui Pan
September 2013, 9(5):67-73
Constitutively activation of signal transducers and activators of transcription 3 (STAT3) proteins are involved in multiple aberrant signaling pathway-oncogenic pathways, including pathways regulating tumor cell survival. STAT3 is one of the second messengers in the Janus activated family kinases/STAT signaling pathway and is regulated by many different factors involving tumorigenesis. Given that the activation of STAT3 is observed in nearly 50% of Lung cancers and more and more researches regarding STAT3 in tumors, here in, we reviewed the contribution of STAT3 to lung cancer growth and progression and then the context in which positive and negative regulation of STAT activation leading to cell competition provides a mechanism for therapeutic intervention for specific cancers is discussed.
  - 2,573 164
Protein kinase Cs in lung cancer: A promising target for therapies
Chenfang Fan, Yong Li, Jack Jia
September 2013, 9(5):74-79
Lung cancer has been identified as one of the most deadly oncologies. The most influential causes for disease progression include smoking, genetic mutation and inflammatory lung diseases. Conventional therapies for lung cancer including chemo and radio-treatments often cause serious adverse effects. The advent of novel therapeutics that specifically target signalling pathways activated by genetic alterations has revolutionized the way patients with lung cancer are treated. These are comprised of various molecular targets on its carcinogen signalling pathways, among which the protein kinase C (PKC) family is a promising target. The 12 isotypes in the family demonstrate complex interactions. This inter-linked signalling loop has added complexity of developing effective therapies. An improved understanding of different molecules involved in these signalling pathways will provide several profound implications, ranging from preclinical work on the mechanisms to trial design. Therapies developed targeting individual/multiple PKCs combined with conventional strategies offer promising future combating cancer.
  - 4,404 217
The regulation of cell polarity in the progression of lung cancer
Yang Liu, Li-Ping Chen
September 2013, 9(5):80-85
Lung cancer is the most frequent malignant disease, since it has often metastasized to distant organs by the time of diagnosis. Epithelial-mesenchymal transition (EMT) is an important process during the progression of lung cancer. Epithelial cells lose the polarity, which contributes to uncontrolled invasion and metastasis of cancer cells. Cell polarity establishment and maintenance depends upon the three complex proteins which are par, crumbs and scribble complexes, of which are reported as tumor suppressors. The cell polarity proteins could interact with cell-cell contact and cell-extracellular matrix contact and cell-intrinsic signaling. These interactions are proved to be involved in lung cancer metastasis. However, our understanding of the mechanisms by which this occurs is poor. In this review, we will discuss the regulatory network of cell polarity in the lung cancer, especially on EMT.
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The landscape of histone acetylation involved in epithelial-mesenchymal transition in lung cancer
Lin Zhang, Zuogong Liu, Wei Ma, Bin Wang
September 2013, 9(5):86-91
Epithelial-mesenchymal transition (EMT) has been widely accepted as the early stage of tumor metastasis, which is accomplished by a group of transcription factors based on cancer genome. However, with the progress of epigenome profiling technique, it has been demonstrated that aberrant histone modifications especially acetylation play an important role in EMT and cancer metastasis. Besides this, numerous studies have elucidated the mechanisms of histone acetyltransferases and deacetylases involved in EMT. Moreover, the network of these histone-related proteins and those transcription factors that play key roles in EMT is under increasing investigation. In addition, the crosstalk among deoxyribonucleic acid methylation, histone acetylation and micro Ribonucleic acid, three major epigenetic modifications, is also an important part in tumor progression. Here, we explore the mechanisms of histone acetylation in EMT and discuss the potential clinical strategies using the epigenetic drugs.
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