In recent years, the computer science represented by artificial intelligence and high-throughput sequencing technology represented by omics play a significant role in the medical field. This paper reviews the research progress of the application of artificial intelligence combined with omics data analysis in the diagnosis and treatment of non-small cell lung cancer (NSCLC), aiming to provide ideas for the development of a more effective artificial intelligence algorithm, and improve the diagnosis rate and prognosis of patients with early NSCLC through a non-invasive way.
The National Comprehensive Cancer Network (NCCN) updates the "NCCN clinical practice guidelines in oncology: Lung cancer screening" annually, and the second edition of 2024 was released in October 2023. The 2024 edition of the guidelines builds on the 2023 edition with some updates on description and assessment of risk factors for lung cancer, evaluation and follow-up of lung nodules found during initial and subsequent screening, and low-dose CT screening protocols and imaging modalities. In this article, we will introduce the above updates and provide reference for lung cancer screening in China by combining the relevant guidelines and consensus in China.
Intrathyroid thymic carcinoma (ITTC) is a rare type of malignent tumor. Two cases of ITTC were reported. Both patients underwent surgical treatment and recovered well after surgery, with no surgery-related complications and no recurrence during follow-up. In order to discuss the clinical features, diagnosis and treatment of ITTC, the literature review was conducted.
Based on new clinical evidence, the National Comprehensive Cancer Network (NCCN) annually updates and releases the "NCCN Guidelines for the Clinical Diagnosis and Treatment of Non-Small Cell Lung Cancer" which has become the reference for clinical diagnosis and treatment approved and complied by clinicians worldwide. On November 25, 2020, the latest 2021 V1 version of "NCCN Clinical Diagnosis and Treatment Guidelines for Non-Small Cell Lung Cancer" (hereinafter referred to as "Guidelines") was released. Compared with the 8th edition of the "Guidelines" in 2020, many updates focused on the progress of targeted and immunotherapy. This article will provide the interpretations of the updated therapy content of this edition of the guidelines.
Surgery is the preferred treatment for early esophageal cancer. Minimally invasive esophagectomy (MIE) can significantly reduce the incidence of postoperative complications and mortality, but due to the complex esophageal anatomy, intraoperative esophageal exposure, separation, anastomosis and lymph node dissection are difficult. The da Vinci surgical system provides a 3D vision and a more flexible as well as stable robotic arm, which is very helpful in completing fine surgical procedures. Robot-assisted minimally invasive esophagectomy(RAMIE) has been carried out in a number of countries, including China. Robot-assisted Ivor-Lewis esophagectomy (RAILE) is a transthoracic approach of robots developed in recent years. This paper summarizes the current researches on RAILE.
Segmentectomy is the removal of certain segments of the lung with lesions and retaining the normal lung tissue of the lobe. Lung segmentectomy is considered difficult due to the lack of clear anatomical boundaries between lung segments. Segmentectomy has a variety of indications, such as lung cancer, metastatic lung tumors, and many non-malignant diseases. In the treatment of early stage lung cancer, segmentectomy was initially considered only as a treatment option for patients not suitable for conventional lobectomy. As more evidence emerged, the indications for segmentectomy have continued to change over time, and segmentectomy has been widely performed in patients with early stage lung cancer. Theoretically, segmentectomy leads to better preservation of lung function than lobectomy, but the risk of incomplete tumor resection is higher, so the indication of segmentectomy has become a focus of debate. This article will introduce the surgical techniques of segmentectomy and summarize the published and unpublished clinical studies on segmentectomy for the treatment of early stage lung cancer.
Chinese Medical Association Guidelines for Clinical Diagnosis and Treatment of Lung Cancer (2023 Edition) has been released in July 2023. Based on the 2022 edition, the 2023 edition of the guideline has been updated in the aspects of lung cancer screening, pathology, surgical standards, neoadjuvant therapy, targeted therapy and treatment of advanced lung cancer. This article will give a brief introduction to these updated parts.
Recently, anatomical segmentectomy emerges as a hot spot in clinical research for surgical treatment of early-stage lung cancer. The techniques of segmentectomy are more elaborate and complicated than lobectomy, because of the considerable anatomic variations of segment blood vessels and bronchus. In a long term, video-assisted thoracic surgery is the mainly minimally invasive approach. As a new approach of minimally invasive surgery, da Vinci robot system possesses three-dimensional and high definition view, better dexterity mechanical wrist and tremor filtering system, which are the main advantages over video-assisted thoracic surgery. All the superiorities of robot system provide good supports for performing segmentectomy. Robot-assisted segmentectomy has been carried out in many medical centers in China and abroad until now. However, most surgery cases often lack adequate controls on quality.
The National Comprehensive Cancer Network (NCCN) released the latest version 1, 2022 of "NCCN guidelines for the clinical diagnosis and treatment of small cell lung cancer" (hereinafter referred to as "guideline"). Based on high-quality evidence-based medicine, this guideline provides references of clinical diagnosis and treatment for clinicians around the world. Compared with the version 3, 2021 of the "guideline", updates and revisions mainly focused on the progress of radiotherapy and systemic treatment. This article will interpret the updated therapy content in this new version of the "guideline".
ObjectiveTo explore the training mode for improving the innovative scientific research ability of postgraduates of thoracic surgery.MethodsTwenty-two postgraduate students enrolled in the Department of Thoracic Surgery, Ruijin Hospital from September 2016 to June 2019 were targeted for training, and the teachers were 13 doctors in our department. Training methods included grant-based learning, formative learning and translational medical learning. In addition to the postgraduate education provided by the medical school, the training content also included more than 50 lectures about thoracic surgery, including surgical video explanation, perioperative management of thoracic surgery, interpretation of clinical guidelines, and intensive reading of the literature; it also included half-year clinical internship, 100 surgical operations and management of 5 medical beds in ward.ResultsClinical ability of the postgraduates were improved. Six postgraduate students enrolled in 2016 graduated successfully. They published 15 SCI papers and won more than 20 awards.ConclusionCultivating postgraduates of thoracic surgery oriented by innovative scientific research ability is conducive to the comprehensive understanding of thoracic diseases and the ability of innovative translation research.