OBJECTIVE To determine the possibility of definitive diagnosis for solitary pulmonary nodules in patients with a primary extrathoracic malignant neoplasm (ETM-SPN), and to further evaluate the value of CT for differen...OBJECTIVE To determine the possibility of definitive diagnosis for solitary pulmonary nodules in patients with a primary extrathoracic malignant neoplasm (ETM-SPN), and to further evaluate the value of CT for differential diagnosis in ETM-SPN by a multivariate retrospective study.METHODS Eighty-three patients with pathologically and clinically proven ETM-SPN with a diameter smaller than 3cm were included in this study.The pathological characteristics of the SPN were correlated with those of the extrathoracic neoplasm, with the patient's age, gender, smoking history, disease-free time interval between the diagnosis of the extrathoracic malignancy and that of the lung lesion. In all 83 cases, CT scans were reviewed to confirm the solitary nature, size, and nodular morphology of the lung lesion.RESULTS Of all 83 cases, the mean age was (57.43±15.34) years. There were 51 males and 32 females, with the ratio of 1.59:1. The lesions included solitary metastasis in 43 cases, pulmonary malignant lesions in 33, and benign lesions in seven. Between the primary lung cancers and solitary metastasis groups, there was no significant difference in the gender ratio (1.20:1 vs 2.31:1, x^2=0.0209, P>0.05), but there was a significant difference between the mean age (62.48±11.96 years vs 54.10±16.49 years, t=3.34, P<0.05). In the primary lung cancer and metastasis patient group, the percentage of patients who had a smoking history were 39.3%(11/17) and 35.9%(14/39), respectively. Patients with a primary lung cancer had no significant higher frequency of smoking history than did those with a metastatic lesion (x^2=0.640, P>0.05). Of 81 cases who were followed-up, the mean time of the disease-free interval between extrapulmonary malignancy diagnosis and pulmonary lesion differentiation was 39.73±6.29 months (range 0-300 months, median 20.00 months), whereas those in the primary lung cancer group and metastatic group were 65.62±13.45 months and 22.83±4.19 months respectively. This difference was significant between the two groups (Wilcoxon rank sum test, U=2.796, P<0.01). Of all 83 cases, there were ten extrapulmonary squamous carcinomas and 58 adenocarcinomas with ratio of primary lung cancer and solitary metastasis of the tumors were 7:3 and 24:34, respectively (x^2=1.781, P>0.05), without showing a statistically significant relevance between the pathologic patterns of extrapulmonary malignancy and characteristics of the lung nodules. Of all the 83 cases, the mean diameters were (2.77±1.25)cm, whereas the diameters of 33 cases of primary lung cancer and 43 cases of a solitary metastatic lesion were (2.86±1.18)cm and (2.62±1.31)cm, respectively. There was no association between the two groups (t=1.29, P>0.05). There was a statistically significant association between primary lung cancer and the metastatic group with spiculate and smooth edges of the lung lesion (x^2=8.562, P<0.01; x^2=15.220, P<0.001).The study showed that a lung nodule with a spiculated margin correlated with a primary lung carcinoma,whereas those nodules with a smooth edge may more frequently show as a metastastic pulmonary lesion. CT-pathologic correlative analyses of hilar and mediastinal adenopathy were reviewed in 37 patients who underwent lobectomy and thoracotomy. There was no statistical significant difference between the primary lung cancer group and the metastatic group (x^2=2.801,P>0.05).CONCLUSION The likelihood of a primary lung cancer versus a metastasis of ETM-SPN smaller than 3cm mainly depends on the patient's age, free interval between the two tumors and CT morphological characteristics of the lung lesion. This study showed there was no significant relevancy to factors such as gender, smoking history, pathological patterns of the extrapulmonary neoplasm or whether there has hilar or mediastinal adenopathy.展开更多
There is now solid evidence that cell-to-cell trafficking of certain proteins and RNAs plays a critical role in trans-cellular regulation of gene expression to coordinate cellular differentiation and development. Such...There is now solid evidence that cell-to-cell trafficking of certain proteins and RNAs plays a critical role in trans-cellular regulation of gene expression to coordinate cellular differentiation and development. Such trafficking also is critical for viral infection and plant defense. The mechanisms of trafficking remain poorly understood. Although some proteins may move between cells by diffusion, many proteins and RNAs move in a highly regulated fashion. Regulation is likely achieved through interactions between distinct protein or RNA motifs and cellular factors. Some motifs and factors have been identified. One of the major focuses for future studies is to identify all motifs and their cognate factors and further elucidate their roles in trafficking between specific cells. With increasing information from such studies, we should be able to develop an understanding of the mechanisms that regulate trafficking of various proteins and RNAs across all and specific cellular boundaries. On the basis of such mechanistic knowledge, we can further investigate how the trafficking machinery has evolved to regulate developmental and physiological processes in a plant, how pathogens have co-evolved to use this machinery for systemic spread in a plant, and how plants use this machinery for counterdefense.展开更多
文摘OBJECTIVE To determine the possibility of definitive diagnosis for solitary pulmonary nodules in patients with a primary extrathoracic malignant neoplasm (ETM-SPN), and to further evaluate the value of CT for differential diagnosis in ETM-SPN by a multivariate retrospective study.METHODS Eighty-three patients with pathologically and clinically proven ETM-SPN with a diameter smaller than 3cm were included in this study.The pathological characteristics of the SPN were correlated with those of the extrathoracic neoplasm, with the patient's age, gender, smoking history, disease-free time interval between the diagnosis of the extrathoracic malignancy and that of the lung lesion. In all 83 cases, CT scans were reviewed to confirm the solitary nature, size, and nodular morphology of the lung lesion.RESULTS Of all 83 cases, the mean age was (57.43±15.34) years. There were 51 males and 32 females, with the ratio of 1.59:1. The lesions included solitary metastasis in 43 cases, pulmonary malignant lesions in 33, and benign lesions in seven. Between the primary lung cancers and solitary metastasis groups, there was no significant difference in the gender ratio (1.20:1 vs 2.31:1, x^2=0.0209, P>0.05), but there was a significant difference between the mean age (62.48±11.96 years vs 54.10±16.49 years, t=3.34, P<0.05). In the primary lung cancer and metastasis patient group, the percentage of patients who had a smoking history were 39.3%(11/17) and 35.9%(14/39), respectively. Patients with a primary lung cancer had no significant higher frequency of smoking history than did those with a metastatic lesion (x^2=0.640, P>0.05). Of 81 cases who were followed-up, the mean time of the disease-free interval between extrapulmonary malignancy diagnosis and pulmonary lesion differentiation was 39.73±6.29 months (range 0-300 months, median 20.00 months), whereas those in the primary lung cancer group and metastatic group were 65.62±13.45 months and 22.83±4.19 months respectively. This difference was significant between the two groups (Wilcoxon rank sum test, U=2.796, P<0.01). Of all 83 cases, there were ten extrapulmonary squamous carcinomas and 58 adenocarcinomas with ratio of primary lung cancer and solitary metastasis of the tumors were 7:3 and 24:34, respectively (x^2=1.781, P>0.05), without showing a statistically significant relevance between the pathologic patterns of extrapulmonary malignancy and characteristics of the lung nodules. Of all the 83 cases, the mean diameters were (2.77±1.25)cm, whereas the diameters of 33 cases of primary lung cancer and 43 cases of a solitary metastatic lesion were (2.86±1.18)cm and (2.62±1.31)cm, respectively. There was no association between the two groups (t=1.29, P>0.05). There was a statistically significant association between primary lung cancer and the metastatic group with spiculate and smooth edges of the lung lesion (x^2=8.562, P<0.01; x^2=15.220, P<0.001).The study showed that a lung nodule with a spiculated margin correlated with a primary lung carcinoma,whereas those nodules with a smooth edge may more frequently show as a metastastic pulmonary lesion. CT-pathologic correlative analyses of hilar and mediastinal adenopathy were reviewed in 37 patients who underwent lobectomy and thoracotomy. There was no statistical significant difference between the primary lung cancer group and the metastatic group (x^2=2.801,P>0.05).CONCLUSION The likelihood of a primary lung cancer versus a metastasis of ETM-SPN smaller than 3cm mainly depends on the patient's age, free interval between the two tumors and CT morphological characteristics of the lung lesion. This study showed there was no significant relevancy to factors such as gender, smoking history, pathological patterns of the extrapulmonary neoplasm or whether there has hilar or mediastinal adenopathy.
基金Supported by grants from the US National Science Foundation(IOB-0620143) the US Department of Agriculture National Research Initiative(2004-35304-15005).
文摘There is now solid evidence that cell-to-cell trafficking of certain proteins and RNAs plays a critical role in trans-cellular regulation of gene expression to coordinate cellular differentiation and development. Such trafficking also is critical for viral infection and plant defense. The mechanisms of trafficking remain poorly understood. Although some proteins may move between cells by diffusion, many proteins and RNAs move in a highly regulated fashion. Regulation is likely achieved through interactions between distinct protein or RNA motifs and cellular factors. Some motifs and factors have been identified. One of the major focuses for future studies is to identify all motifs and their cognate factors and further elucidate their roles in trafficking between specific cells. With increasing information from such studies, we should be able to develop an understanding of the mechanisms that regulate trafficking of various proteins and RNAs across all and specific cellular boundaries. On the basis of such mechanistic knowledge, we can further investigate how the trafficking machinery has evolved to regulate developmental and physiological processes in a plant, how pathogens have co-evolved to use this machinery for systemic spread in a plant, and how plants use this machinery for counterdefense.
