目的 探討18氟-脫氧葡萄糖（18F-FDG）雙探頭符合線路對非小細胞肺癌胸內淋巴結轉移的診斷價值，并分析其假陽性、假陰性診斷的原因。 方法 回顧性分析2010年12月－2012年6月非小細胞肺癌患者161例的臨床資料，其中腺癌122例，鱗癌23例，其他類型16例。分析患者術前18F-FDG雙探頭符合線路顯像對肺門、縱膈淋巴結的診斷結果（其中陽性53例，陰性108例），以術后病理診斷為金標準，評價其診斷價值。分析9例假陽性、26例假陰性診斷患者的吸煙史、慢性支氣管炎肺氣腫、肺結核病史、局限性肺炎、腫瘤標志物、淋巴結短徑、腫瘤原發灶T/N比值、外周血白細胞等指標。 結果 18F-FDG雙探頭符合線路單光子發射計算機斷層成像（SPECT）診斷非小細胞肺癌淋巴結轉移的靈敏度、特異性、準確性、陽性預測值、陰性預測值分別是62.9%、90.1%、78.3%、83%、75.9%。假陽性組患者慢支炎肺氣腫、局限性肺炎者高于真陽性組。假陰性組的淋巴結短徑、原發灶T/N比值小于真陽性組。 結論 18F-FDG雙探頭符合線路SPECT是術前診斷肺癌淋巴結轉移的有效手段；假陽性淋巴結與慢支炎肺氣腫、局限性肺炎有關；假陰性淋巴結與淋巴結短短徑小、原發腫瘤攝取18F-FDG低有關。
ObjectiveTo evaluate the diagnostic value of artificial intelligence (AI)-assisted diagnostic system for pulmonary cancer based on CT images.MethodsDatabases including PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and Chinese BioMedical Literature Database (CBM) were electronically searched to collect relevant studies on AI-assisted diagnostic system in the diagnosis of pulmonary cancer from 2010 to 2019. The eligible studies were selected according to inclusion and exclusion criteria, and the quality of included studies was assessed and the special information was identified. Then, meta-analysis was performed using RevMan 5.3, Stata 12.0 and SAS 9.4 softwares. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were pooled and the summary receiver operating characteristic (SROC) curve was drawn. Meta-regression analysis was used to explore the sources of heterogeneity.ResultsTotally 18 studies were included with 4 771 patients. Random effect model was used for the analysis due to the heterogeneity among studies. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the SROC curve were 0.87 [95%CI (0.84, 0.90)], 0.89 [95%CI (0.84, 0.92)], 7.70 [95%CI (5.32, 11.15)], 0.14 [95%CI (0.11, 0.19)], 53.54 [95%CI (30.68, 93.42)] and 0.94 [95%CI (0.91, 0.95)], respectively.ConclusionAI-assisted diagnostic system based on CT images has high diagnostic value for pulmonary cancer, and thus it is worthy of clinical application. However, due to the limited quality and quantity of included studies, above results should be validated by more studies.
Objective To understand the epidemiological characteristics of lung cancer death in adults of Zhuhai in order to provide decision-making evidence for lung cancer control and prevention. Methods The data of Mortality Registration System from 2004 to 2005 in Zhuhai were applied to analyze the epidemiological features of lung cancer death in adults. Results From 2004 to 2005, the average mortality from lung cancer and the standardized rate in adults of Zhuhai were 25.3/lakh and 30.3/lakh, respectively. Lung cancer ranked the first on the list of death causes in all cases of cancer death. The standardized rate of the male and female population was 40.1/lakh and 19.2/lakh, respectively. The standardized rate of males was higher than that of females (u=7.23, Plt;0.01). The average mortality from lung cancer increased with age, especially in males over 60 years old. The standardized mortality from lung caner in Xiangzhou, Doumen and Jinwan was 30.5/lakh, 31.1/lakh and 27.3/lakh, respectively. No statistical significance was found in these areas. Conclusion Lung cancer is one of the major malignant tumors among Zhuhai people. Lung cancer mortality is increasing with population aging. Based on the main risk factors of lung cancer, effective preventive measures including tobacco control and environment improvement should be taken.
Objective An animal model of lung cancer was established to study whether wasabi could inhibit the expression of hnRNP A2/B1 in lung.Methods Thirty-six Wistar rats were randomly divided as model group and wasabi group.0.1 mL of arcinogenic iodized oil [50 mg 3-methylcholanthrene (MCA) in 1 mL carcinogenic iodized oil] were instilled intratracheally to induce lung cancer.A week before instillation of MCA，the wasabi group was orally administered wasabi extract solution until the animals were killed while the model group was given isometric saline at the same time.Six rats in each group were randomly killed on 30th day，60th day and 90th day.Immunohistochemisty and RT-PCR were used to measure the protein and mRNA expression of hnRNP A2/B1，respectively.Results Wasabi lowered the protein expression of hnRNP A2/B1 with a total inhibitory rate of 48.5%.At the 30th，60th and 90th day，the inhibitory rate was 51.0%，51.0% and 45.1% respectively.Meanwhile，wasabi lowered the mRNA expression of hnRNP A2/B1 with a total inhibitory rate of 60.5%.At the 60th and 90th day，the inhibitory rate was 79.5% and 58.0%，respectively.Conclusion Wasabi solution can down-regulate the expression of hnRNP A2/B1 which may be a molecular mechanisms by which wasabi inhibits lung cancer.
目的:研究非小細胞肺癌中PGSK-3β、CEA、C-myc的表達,探討它們與肺癌臨床病理因素的相關性及在肺癌中三指標之間的相關性。方法:運用免疫組化法檢測90例肺癌PGSK-3β、CEA、C-myc的表達情況。結果 肺腺癌PGSK-3β陽性率明顯高于鱗癌(Plt;0.05),臨床Ⅲ-Ⅳ期陽性率顯著高于Ⅰ-Ⅱ期(Plt;0.05)。周圍型肺癌CEA陽性率顯著高于中央型肺癌(Plt;0.01),有淋巴結轉移者陽性率顯著高于無淋巴結轉移者(Plt;0.05)。肺癌中、低分化組C-myc陽性率顯著高于高分化組(Plt;0.05);C-myc陽性強度表達呈拋物線狀趨勢,在中分化組顯著高于低分化組和高分化組。肺癌中PGSK-3β與CEA表達呈正相關(Plt;0.05)。 結論:PGSK-3β促進肺癌的演進過程,與肺癌的分化、分期相關。肺癌高表達CEA時癌組織異質性粘附增加,有利于其浸潤與轉移。肺癌中C-myc表達增加是肺癌發生中的常見分子事件,與癌細胞分化有關。肺癌中PGSK-3β與CEA表達呈正相關。
Objective To systematically evaluate the efficiency and safety of Vandetanib plus Docetaxel versus Docetaxel alone for advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) of Vandetanib plus Docetaxel versus Docetaxel for NSCLC published before October 26, 2010 were searched in EMbase, The Cochrane Library, PubMed, Wanfang database, VIP Database, China National Knowledge Infrastructure(CNKI), and China biological medical literature database. The methodological quality of the included studies was evaluated according to the Cochrane assessment handbook 5.0.2, and the meta-analysis was conducted by using RevMan 5.0 software. Results A total of 3 RCTs involving 1 626 patients were included. The meta-analysis showed that there were positive effects between the Vandetanib group and the control group in the overall response rate (OR=1.81, 95%CI 1.37 to 2.38, Plt;0.000 1), disease control rate and 1-year survival rate; and all studies showed that Vandetanib could significantly lengthen the progression-free survival. Conclusion The Vandetanib group is superior to the control group for its better effectiveness and fewer adverse effects, and it is worth referring and applying in clinic.