Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articul...Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.展开更多
Honeycombing Lung(HCL)is a chronic lung condition marked by advanced fibrosis,resulting in enlarged air spaces with thick fibrotic walls,which are visible on Computed Tomography(CT)scans.Differentiating between normal...Honeycombing Lung(HCL)is a chronic lung condition marked by advanced fibrosis,resulting in enlarged air spaces with thick fibrotic walls,which are visible on Computed Tomography(CT)scans.Differentiating between normal lung tissue,honeycombing lungs,and Ground Glass Opacity(GGO)in CT images is often challenging for radiologists and may lead to misinterpretations.Although earlier studies have proposed models to detect and classify HCL,many faced limitations such as high computational demands,lower accuracy,and difficulty distinguishing between HCL and GGO.CT images are highly effective for lung classification due to their high resolution,3D visualization,and sensitivity to tissue density variations.This study introduces Honeycombing Lungs Network(HCL Net),a novel classification algorithm inspired by ResNet50V2 and enhanced to overcome the shortcomings of previous approaches.HCL Net incorporates additional residual blocks,refined preprocessing techniques,and selective parameter tuning to improve classification performance.The dataset,sourced from the University Malaya Medical Centre(UMMC)and verified by expert radiologists,consists of CT images of normal,honeycombing,and GGO lungs.Experimental evaluations across five assessments demonstrated that HCL Net achieved an outstanding classification accuracy of approximately 99.97%.It also recorded strong performance in other metrics,achieving 93%precision,100%sensitivity,89%specificity,and an AUC-ROC score of 97%.Comparative analysis with baseline feature engineering methods confirmed the superior efficacy of HCL Net.The model significantly reduces misclassification,particularly between honeycombing and GGO lungs,enhancing diagnostic precision and reliability in lung image analysis.展开更多
Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by ...Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by Hu et al,which evaluated the survival outcomes of patients with metastatic CRC who received image-guided thermal ablation(IGTA).These findings provide valuable clinical evidence supporting IGTA as a feasible,minimally invasive approach and underscore the prognostic significance of metastatic distribution.However,the study by Hu et al has several limitations,including that not all pulmonary lesions were pathologically confirmed,postoperative follow-up mainly relied on dynamic contrast-enhanced computed tomography,no comparative analysis was performed with other local treatments,and the impact of other imaging features on efficacy and prognosis was not evaluated.Future studies should include complete pathological confirmation,integrate functional imaging and radiomics,and use prospective multicenter collaboration to optimize patient selection standards for IGTA treatment,strengthen its clinical evidence base,and ultimately promote individualized decision-making for patients with metastatic CRC.展开更多
Background:A significant proportion of patients still cannot benefit from existing targeted therapies and immunotherapies,making the search for new treatment strategies extremely urgent.In this study,we combined integ...Background:A significant proportion of patients still cannot benefit from existing targeted therapies and immunotherapies,making the search for new treatment strategies extremely urgent.In this study,we combined integrate public data analysis with experimental validation to identify novel prognostic biomarkers and therapeutic targets for lung adenocarcinoma(LUAD).Methods:We analyzed RNA and protein databases to assess the expression levels of cytochrome C oxidase 5B(COX5B)in LUAD.Several computational algorithms were employed to investigate the relationship between COX5B and immune infiltration in LUAD.To further elucidate the role of COX5B in LUAD,we utilized multiple experimental approaches,including quantitative reverse transcription PCR assays,western blot,immunohistochemistry,electron microscopy,flow cytometry,and EdU proliferation assays.Results:We revealed that COX5B was significantly elevated in LUAD and positively correlated with poor prognosis of LUAD patients.Analysis of co-expression network indicated that COX5B may take part in the intracellular adenosine triphosphate(ATP)synthesis through the oxidative phosphorylation pathway.There was a negative correlation between COX5B expression and immune infiltration in LUAD.Furthermore,we validated that COX5B levels were significantly elevated in both LUAD tissues and cell lines.Specifically,immunohistochemistry(IHC)assays revealed a 2.32-fold increase of COX5B in tumor tissues compared to that in adjacent normal tissues(p=0.0044).Additionally,COX5B knockdown disrupted the redox homeostasis,ultimately suppressed the proliferation of LUAD cells.Subsequent investigations demonstrated that berberine effectively targeted COX5B,diminishing its protein expression and consequently inhibiting cell proliferation and tumor growth in LUAD.Conclusions:This study established that upregulated COX5B was positive associated with poor patient prognosis in LUAD,elucidating the mechanisms by which berberine targets COX5B to inhibit tumor growth,thereby providing a novel therapeutic target and strategy for the clinical management of LUAD.展开更多
Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinom...Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].展开更多
Neuroendocrine neoplasms are a group of tumors with heterogenous malignancy that evolve from neuroendocrine cells,most frequently in the gastrointestinal tract and in the lung.The latest 2021 World Health Organization...Neuroendocrine neoplasms are a group of tumors with heterogenous malignancy that evolve from neuroendocrine cells,most frequently in the gastrointestinal tract and in the lung.The latest 2021 World Health Organization(WHO)classification of lung tumors defines neuroendocrine neoplasms of the lung as an independent group of tumors,including typical and atypical neuroendocrine tumors and small cell and large cell neuroendocrine carcinomas.Although the overall nomenclature is essentially unchanged from the fourth WHO classification,there are several clinically relevant updates.In this review article,we discuss the epidemiological,clinical,diagnostic,therapeutic and prognostic features of these fascinating neoplasms,including the latest insights,current challenges and future perspectives.展开更多
BACKGROUND Krüppel-like factor-5(KLF5)is a zinc-finger transcription factor related to tumor progression.However,the relationship between KLF5 and lung cancer remains to be identified.AIM To investigate the clini...BACKGROUND Krüppel-like factor-5(KLF5)is a zinc-finger transcription factor related to tumor progression.However,the relationship between KLF5 and lung cancer remains to be identified.AIM To investigate the clinical value of KLF5 and interference with KLF5 mRNA transcription on the effects of biological behaviors in lung squamous-cell carcinoma(LUSC).METHODS Lung KLF5 mRNA data were extracted from bioinformatics databases.Blood and tissues from a cohort of patients with benign or malignant lung diseases were collected with ethical committee consent to validate KLF5 expression via multiplex immunofluorescence and immunohistochemistry,Western blot,Enzyme Linked Immunosorbent Assay or quantitative polymerase chain reaction.Furthermore,KLF5 mRNA was silenced in lung A549 cells to validate biological behaviors in vitro and nude mouse xenograft growth in vivo,respectively.RESULTS A cohort of bioinformatics databases revealed high KLF5 mRNA expression in LUSC(P<0.001)but lower KLF5 mRNA expression in lung adenocarcinoma.Upregulated KLF5 in the lung or sera of patients with lung cancer(P<0.001)were confirmed that related to poor differentiation,lymph node or distant metastasis.Furthermore,the incidence of KLF5 levels greater than 500 ng/mL in LUSC patients was 86.7%,which was significantly greater(P<0.001)than that in cases with benign lung diseases(13.3%)or healthy controls.Functionally,silencing KLF5 mRNA with a specific shRNA significantly suppressed A549 cell proliferation,decreased cell migration,increased the ratio of G2 phase cells in vitro,and inhibited the growth of nude mouse xenografts in vivo.CONCLUSION KLF5 is a novel diagnostic biomarker or potential therapeutic target for LUSC.展开更多
Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung trans...Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung transplantation offers a crucial therapeutic option for patients with advanced ILD,extending survival and improving quality of life.This review explores optimal management strategies in both the pre-and post-transplant phases to enhance patient outcomes.Comprehensive pre-transplant evaluation,including pulmonary function testing,imaging,and comorbidity assessment,is critical for determining transplant eligibility and timing.Post-transplant care must focus on preventing complications such as primary graft dysfunction and chronic lung allograft dysfunction,managed through tailored immunosuppression and proactive monitoring.Recent advancements in diagnostic techniques and therapeutic approaches,including emerging technologies like ex vivo lung perfusion and precision medicine,promise to further improve outcomes.The ultimate goal is to establish an evidencebased,multidisciplinary framework for optimizing ILD management and lung transplantation.展开更多
BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions ...BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions are relatively rare,and some may be misdiagnosed as pulmonary tuberculosis.CASE SUMMARY In this report,we present an uncommon instance of IgG4-related lung disease,which was diagnosed through lung tissue biopsy conducted via puncture.A 67-year-old male was hospitalized with a two-month history of cough and sputum production.Chest computed tomography(CT)revealed infiltrative pulmonary tuberculosis in both upper lungs.However,the initial diagnosis was unclear,and the patient received HZRE quadruple therapy for tuberculosis at a local hospital.After 45 days of anti-tuberculosis treatment,the patient's cough and sputum worsened,and he began coughing up blood,prompting transfer to our hospital.Serum tests revealed elevated IgG4 levels.A biopsy of a right lung showed localized fibrous and extensive plasma cell infiltration,with 30-40 IgG4-positive cells per high-power field,and an IgG4/IgG ratio of 40%.These findings led to a diagnosis of IgG4-related lung disease.Following treatment with prednisone and mycophenolate mofetil,follow-up lung CT scans showed significant lesion improvement.CONCLUSION The chest CT findings of IgG4-RD are diverse and nonspecific,often leading to misdiagnosis as pulmonary tuberculosis,especially in primary care settings with limited diagnostic resources.We confirmed the diagnosis of IgG4-related lung disease through histological examination.展开更多
Lung cancer is among the most prevalent cancers and has the highest mortality rate globally.The diagnosis,pathohistological classification,and molecular testing of lung cancer primarily rely on tissue biopsy or surgic...Lung cancer is among the most prevalent cancers and has the highest mortality rate globally.The diagnosis,pathohistological classification,and molecular testing of lung cancer primarily rely on tissue biopsy or surgical resection.These methods are invasive and associated with limitations,including sample quantity and quality,as well as patient tolerance.Radiomics,an emerging technology,enables the extraction of high-throughput quantitative information from medical images,providing radiomic features applicable to clinical diagnosis and treatment.Significant advancements have been made in the application of radiomics to the diagnosis,molecular detection,efficacy prediction,and prognosis of lung cancer.This review examines the progress in radiomics for individualized and precise diagnosis and treatment of lung cancer in recent years.展开更多
Background:Lung cancer is one of the deadliest cancers worldwide,creating a pressing need to develop novel drugs that inhibit oncogenic signaling pathways.Numerous studies have shown that berberine(BBR)has anti–lung ...Background:Lung cancer is one of the deadliest cancers worldwide,creating a pressing need to develop novel drugs that inhibit oncogenic signaling pathways.Numerous studies have shown that berberine(BBR)has anti–lung cancer potential.We aimed to explore the anti–lung cancer effect of BBR and related mechanisms by targeting the glycogen synthase kinase 3β(GSK3β)/β-catenin pathway.Methods:Lung adenocarcinoma(LUAD)cells A549 and NCI-H1975 were treated with BBR.Results:Our results showed that BBR inhibited cell proliferation by decreasing c-Myc levels and induced cel cycle arrest in the G0/G1 phase by lowering cyclin D1 levels.BBR induced apoptosis by upregulating cleaved caspase 3 levels.BBR inhibited cell migration and invasion by decreasing N-cadherin levels.Furthermore,BBR upregulated the expression of GSK3βprotein and phospho-β-catenin proteins in the cytoplasm,while decreasing the expression ofβ-catenin protein.Next,LUAD cel s were exposed to CHIR-99021(a GSK3βinhibitor).This treatment led to an increase in c-Myc,cyclin D1,andβ-catenin levels at specific concentrations.BBR partially reversed the effects of CHIR-99021.Finally,LUAD cells were treated with CHIR-99021(4μmoL/L)combined with BBR(30 and 60μmoL/L)for 24 h.The expression of programmed death ligand 1(PD-L1)was assessed by Western blot analysis.Jurkat T cells and A549 cel s were cocultured for 24 h to examine the lactate dehydrogenase release rate.Results suggested that BBR suppressed the expression of PD-L1 and heightened the immune lethality of T cells.Conclusions:BBR suppressed the proliferative activity of LUAD cell lines A549 and NCI-H1975 in vitro,induced cell cycle arrest and cancer cel apoptosis in the G0/G1 stage,and repressed the migration and invasion of cancer cells.BBR reduced the PD-L1 protein expression and enhanced T-cell–mediated cytotoxicity.These effects appear to be related to BBR's regulation of the GSK3β/β-catenin pathway.展开更多
Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortal...Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.展开更多
Background:Long noncoding RNA,LINC01106 exhibits high expression in lung adenocarcinoma(LUAD)tumor tissues,but its functional role and regulatory mechanism in LUAD cells remain unclear.Methods:LINC01106 expression was...Background:Long noncoding RNA,LINC01106 exhibits high expression in lung adenocarcinoma(LUAD)tumor tissues,but its functional role and regulatory mechanism in LUAD cells remain unclear.Methods:LINC01106 expression was analyzed in LUAD tissues and its functional impact on LUAD cells was assessed.LUAD cells were silenced with sh-LINC01106 and injected into nude mice to investigate tumor growth.The downstream transcription factors and molecular mechanism were determined using the Human transcription factor database(TFDB)database and Gene Expression Profiling Interactive Analysis(GEPIA)database.Additionally,the impact of linc01106 on autophagy was analyzed by determining the expression of autophagy-related genes(ATGs)in LUAD cells.Results:Our results showed that LINC01106 exhibited upregulation in both LUAD tissues and cell lines.The silencing of LINC01106 demonstrated a suppressive effect on tumorigenesis in a xenograft mouse model of LUAD.Additionally,LINC01106 was found to recruit TATA-binding protein-associated factor 15(TAF15),an RNA-binding protein,thereby enhancing the mRNA stability of TEA domain transcription factor 4(TEAD4).In turn,TEAD4 served as a transcription factor that bound to the LINC01106 promoter and regulated its expression.Further assays indicated that LINC01106 promoted autophagy in LUAD cells by upregulating the expression of autophagy-related genes(ATGs).The silencing of LINC01106 in LUAD cells inhibited autophagy,and cell proliferation,and promoted apoptosis,which all were effectively reversed by ATG5 overexpression.Conclusions:Overall,LINC01106,transcriptionally activated by TEAD4,interacts with TAF15 to promote the stability of TEAD4 and upregulates the expression of ATGs,promoting malignancy of LUAD cells.展开更多
BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastat...BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.展开更多
BACKGROUND Most non-small cell lung cancer patients have epidermal growth factor receptor(EGFR)activating mutations,such as exon 19 deletion and exon 21 replacement mutations.Osimertinib is a third-generation EGFR-tyr...BACKGROUND Most non-small cell lung cancer patients have epidermal growth factor receptor(EGFR)activating mutations,such as exon 19 deletion and exon 21 replacement mutations.Osimertinib is a third-generation EGFR-tyrosine kinase inhibitors ap-proved for the treatment of lung cancer patients carrying EGFR activating mu-tations.Osimertinib-induced interstitial lung disease(ILD)is a rare and poten-tially fatal pulmonary toxic manifestation of drug therapy.At present,there is no international consensus on the risks and treatment of the osimertinib-induced ILD.CASE SUMMARY We report a case of a 56-year-old woman who was diagnosed with lung adenocar-cinoma with lung hilum,mediastinal lymph nodes and brain metastases(T4N3-M1c stage IVB).The patient received targeted treatment with osimertinib after radiotherapy and chemotherapy.But she developed ILD after osimertinib treat-ment.Following active symptomatic treatment and hormone treatment,the lung injury alleviated.The patient was retreated with furmonertinib combined with prednisone and did not experience ILD again.So far,she has survived for 14 months without disease progression.CONCLUSION Retreatment with furmonertinib under prednisone could be considered as an effective therapeutic option after risk-benefit assessment for EGFR-mutant lung adenocarcinoma patients.展开更多
Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 ...Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 to May 2024 were selected as the study subjects.Their clinical data were retrospectively analyzed and grouped by nursing methods.The bundled nursing care group(n=40)received bundled nursing care,while the conventional nursing care group(n=40)received routine nursing care.Lung function,immune function,complication rate,pain level,exercise tolerance,and quality of life were compared between the two groups.Results:Before nursing,there were no statistically significant differences in lung function,immune function,pain level,exercise tolerance,and quality of life between the bundled nursing care group and the conventional nursing care group(P>0.05).After nursing,both groups showed improvement in lung function,immune function,pain level,exercise tolerance,and quality of life,but the bundled nursing care group had better results and a lower complication rate,with statistical significance(P<0.05).Conclusion:The bundled nursing care has a higher clinical application value in postoperative recovery of lung cancer patients and is worthy of widespread clinical use.展开更多
This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing ...This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing an evolution from the current standard of rigid-body dose distribution verification.A 3D ex vivo biological lung motion simulation device(3D-BioLungEx)was designed to replicate human respiration.A radiotherapy plan of the patient was copied to the porcine lung,which was driven by 3D-BioLungEx to simulate various respiratory patterns that occur during treatment.To ensure anatomical consistency with the patient’s lung structure,during transmission,skin,skeleton,and organs were adjusted according to CT images of the porcine lung.The patient’s radiotherapy plan was then adapted to the porcine lung using the Monaco treatment planning system(TPS).Next,an iterative optimization and scatter inversion-based dose distribution retro-analysis algorithm(IOSI-BLDose)was developed to calculate the dose distribution during treatment.Gamma passing rates were used to quantify discrepancies between this dose distribution and that of the radiotherapy plan.When respiratory conditions were replicated,the passing rate reached up to 93.61%,while irregular breathing dropped it to 70%-90%,primarily due to amplitude changes.However,cycle variations had minimal impact.Compared to conventional rigid-body dose distribution verification,our method provides real-time biological feedback and more effectively captures motion-induced deviations.Accordingly,our biological in vivo 3D dose distribution verification has potential for improving treatment precision and enabling adaptive radiotherapy in clinical practice.展开更多
Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 ...Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 is insufficient to predict therapeutic outcomes3,4.A recently identified vulnerability in SCLC involves the dysregulation of nuclear-cytoplasmic transport,particularly through exportin 1(XPO1)5-7.展开更多
Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presen...Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presence of BM,which affects up to 60%of patients with NSCLC,is correlated with an unfavorable prognosis and markedly decreased quality of life.Standard treatment options for BMs,such as whole-brain radiation therapy and surgery,have displayed limited efficacy in controlling disease progression,and they can cause significant neurocognitive side effects.Stereotactic radiotherapy(SRT),including stereotactic radiosurgery,fractionated SRT,and stereotactic body radiotherapy,represents an advanced and precise approach for treating BM that minimizes damage to surrounding healthy tissues.This review highlights recent advances in the application of SRT for treating BM of NSCLC,focusing on its underlying biological principles and mechanisms of action as well as the quality standards necessary for effective SRT implementation.The ability of SRT to deliver substantial radiation doses in a precisely targeted manner has resulted in better local tumor management,fewer side effects,and increased patient survival rates.Future research is crucial to improve SRT procedures and successfully incorporate them into multimodal therapy plans for patients with NSCLC and BM.展开更多
文摘Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.
文摘Honeycombing Lung(HCL)is a chronic lung condition marked by advanced fibrosis,resulting in enlarged air spaces with thick fibrotic walls,which are visible on Computed Tomography(CT)scans.Differentiating between normal lung tissue,honeycombing lungs,and Ground Glass Opacity(GGO)in CT images is often challenging for radiologists and may lead to misinterpretations.Although earlier studies have proposed models to detect and classify HCL,many faced limitations such as high computational demands,lower accuracy,and difficulty distinguishing between HCL and GGO.CT images are highly effective for lung classification due to their high resolution,3D visualization,and sensitivity to tissue density variations.This study introduces Honeycombing Lungs Network(HCL Net),a novel classification algorithm inspired by ResNet50V2 and enhanced to overcome the shortcomings of previous approaches.HCL Net incorporates additional residual blocks,refined preprocessing techniques,and selective parameter tuning to improve classification performance.The dataset,sourced from the University Malaya Medical Centre(UMMC)and verified by expert radiologists,consists of CT images of normal,honeycombing,and GGO lungs.Experimental evaluations across five assessments demonstrated that HCL Net achieved an outstanding classification accuracy of approximately 99.97%.It also recorded strong performance in other metrics,achieving 93%precision,100%sensitivity,89%specificity,and an AUC-ROC score of 97%.Comparative analysis with baseline feature engineering methods confirmed the superior efficacy of HCL Net.The model significantly reduces misclassification,particularly between honeycombing and GGO lungs,enhancing diagnostic precision and reliability in lung image analysis.
文摘Colorectal cancer(CRC)with lung oligometastases,particularly in the presence of extrapulmonary disease,poses considerable therapeutic challenges in clinical practice.We have carefully studied the multicenter study by Hu et al,which evaluated the survival outcomes of patients with metastatic CRC who received image-guided thermal ablation(IGTA).These findings provide valuable clinical evidence supporting IGTA as a feasible,minimally invasive approach and underscore the prognostic significance of metastatic distribution.However,the study by Hu et al has several limitations,including that not all pulmonary lesions were pathologically confirmed,postoperative follow-up mainly relied on dynamic contrast-enhanced computed tomography,no comparative analysis was performed with other local treatments,and the impact of other imaging features on efficacy and prognosis was not evaluated.Future studies should include complete pathological confirmation,integrate functional imaging and radiomics,and use prospective multicenter collaboration to optimize patient selection standards for IGTA treatment,strengthen its clinical evidence base,and ultimately promote individualized decision-making for patients with metastatic CRC.
基金supported by grants from the Guangxi Natural Science Foundation(2024GXNSFAA010150)the Guangdong Basic and Applied Basic Research Foundation(2022A1515111167).
文摘Background:A significant proportion of patients still cannot benefit from existing targeted therapies and immunotherapies,making the search for new treatment strategies extremely urgent.In this study,we combined integrate public data analysis with experimental validation to identify novel prognostic biomarkers and therapeutic targets for lung adenocarcinoma(LUAD).Methods:We analyzed RNA and protein databases to assess the expression levels of cytochrome C oxidase 5B(COX5B)in LUAD.Several computational algorithms were employed to investigate the relationship between COX5B and immune infiltration in LUAD.To further elucidate the role of COX5B in LUAD,we utilized multiple experimental approaches,including quantitative reverse transcription PCR assays,western blot,immunohistochemistry,electron microscopy,flow cytometry,and EdU proliferation assays.Results:We revealed that COX5B was significantly elevated in LUAD and positively correlated with poor prognosis of LUAD patients.Analysis of co-expression network indicated that COX5B may take part in the intracellular adenosine triphosphate(ATP)synthesis through the oxidative phosphorylation pathway.There was a negative correlation between COX5B expression and immune infiltration in LUAD.Furthermore,we validated that COX5B levels were significantly elevated in both LUAD tissues and cell lines.Specifically,immunohistochemistry(IHC)assays revealed a 2.32-fold increase of COX5B in tumor tissues compared to that in adjacent normal tissues(p=0.0044).Additionally,COX5B knockdown disrupted the redox homeostasis,ultimately suppressed the proliferation of LUAD cells.Subsequent investigations demonstrated that berberine effectively targeted COX5B,diminishing its protein expression and consequently inhibiting cell proliferation and tumor growth in LUAD.Conclusions:This study established that upregulated COX5B was positive associated with poor patient prognosis in LUAD,elucidating the mechanisms by which berberine targets COX5B to inhibit tumor growth,thereby providing a novel therapeutic target and strategy for the clinical management of LUAD.
基金support through Manipal University Jaipur for the Enhanced Seed Grant under the Endowment Fund(Grant No.E3/2023-24/QE-04-05).
文摘Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].
文摘Neuroendocrine neoplasms are a group of tumors with heterogenous malignancy that evolve from neuroendocrine cells,most frequently in the gastrointestinal tract and in the lung.The latest 2021 World Health Organization(WHO)classification of lung tumors defines neuroendocrine neoplasms of the lung as an independent group of tumors,including typical and atypical neuroendocrine tumors and small cell and large cell neuroendocrine carcinomas.Although the overall nomenclature is essentially unchanged from the fourth WHO classification,there are several clinically relevant updates.In this review article,we discuss the epidemiological,clinical,diagnostic,therapeutic and prognostic features of these fascinating neoplasms,including the latest insights,current challenges and future perspectives.
基金Supported by Jiangsu Commission of Health of China,No.M2020096.
文摘BACKGROUND Krüppel-like factor-5(KLF5)is a zinc-finger transcription factor related to tumor progression.However,the relationship between KLF5 and lung cancer remains to be identified.AIM To investigate the clinical value of KLF5 and interference with KLF5 mRNA transcription on the effects of biological behaviors in lung squamous-cell carcinoma(LUSC).METHODS Lung KLF5 mRNA data were extracted from bioinformatics databases.Blood and tissues from a cohort of patients with benign or malignant lung diseases were collected with ethical committee consent to validate KLF5 expression via multiplex immunofluorescence and immunohistochemistry,Western blot,Enzyme Linked Immunosorbent Assay or quantitative polymerase chain reaction.Furthermore,KLF5 mRNA was silenced in lung A549 cells to validate biological behaviors in vitro and nude mouse xenograft growth in vivo,respectively.RESULTS A cohort of bioinformatics databases revealed high KLF5 mRNA expression in LUSC(P<0.001)but lower KLF5 mRNA expression in lung adenocarcinoma.Upregulated KLF5 in the lung or sera of patients with lung cancer(P<0.001)were confirmed that related to poor differentiation,lymph node or distant metastasis.Furthermore,the incidence of KLF5 levels greater than 500 ng/mL in LUSC patients was 86.7%,which was significantly greater(P<0.001)than that in cases with benign lung diseases(13.3%)or healthy controls.Functionally,silencing KLF5 mRNA with a specific shRNA significantly suppressed A549 cell proliferation,decreased cell migration,increased the ratio of G2 phase cells in vitro,and inhibited the growth of nude mouse xenografts in vivo.CONCLUSION KLF5 is a novel diagnostic biomarker or potential therapeutic target for LUSC.
文摘Interstitial lung diseases(ILD)encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis,which can lead to severe respiratory impairment.Lung transplantation offers a crucial therapeutic option for patients with advanced ILD,extending survival and improving quality of life.This review explores optimal management strategies in both the pre-and post-transplant phases to enhance patient outcomes.Comprehensive pre-transplant evaluation,including pulmonary function testing,imaging,and comorbidity assessment,is critical for determining transplant eligibility and timing.Post-transplant care must focus on preventing complications such as primary graft dysfunction and chronic lung allograft dysfunction,managed through tailored immunosuppression and proactive monitoring.Recent advancements in diagnostic techniques and therapeutic approaches,including emerging technologies like ex vivo lung perfusion and precision medicine,promise to further improve outcomes.The ultimate goal is to establish an evidencebased,multidisciplinary framework for optimizing ILD management and lung transplantation.
文摘BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions are relatively rare,and some may be misdiagnosed as pulmonary tuberculosis.CASE SUMMARY In this report,we present an uncommon instance of IgG4-related lung disease,which was diagnosed through lung tissue biopsy conducted via puncture.A 67-year-old male was hospitalized with a two-month history of cough and sputum production.Chest computed tomography(CT)revealed infiltrative pulmonary tuberculosis in both upper lungs.However,the initial diagnosis was unclear,and the patient received HZRE quadruple therapy for tuberculosis at a local hospital.After 45 days of anti-tuberculosis treatment,the patient's cough and sputum worsened,and he began coughing up blood,prompting transfer to our hospital.Serum tests revealed elevated IgG4 levels.A biopsy of a right lung showed localized fibrous and extensive plasma cell infiltration,with 30-40 IgG4-positive cells per high-power field,and an IgG4/IgG ratio of 40%.These findings led to a diagnosis of IgG4-related lung disease.Following treatment with prednisone and mycophenolate mofetil,follow-up lung CT scans showed significant lesion improvement.CONCLUSION The chest CT findings of IgG4-RD are diverse and nonspecific,often leading to misdiagnosis as pulmonary tuberculosis,especially in primary care settings with limited diagnostic resources.We confirmed the diagnosis of IgG4-related lung disease through histological examination.
文摘Lung cancer is among the most prevalent cancers and has the highest mortality rate globally.The diagnosis,pathohistological classification,and molecular testing of lung cancer primarily rely on tissue biopsy or surgical resection.These methods are invasive and associated with limitations,including sample quantity and quality,as well as patient tolerance.Radiomics,an emerging technology,enables the extraction of high-throughput quantitative information from medical images,providing radiomic features applicable to clinical diagnosis and treatment.Significant advancements have been made in the application of radiomics to the diagnosis,molecular detection,efficacy prediction,and prognosis of lung cancer.This review examines the progress in radiomics for individualized and precise diagnosis and treatment of lung cancer in recent years.
基金Supported by a grant from the National Natural Science Foundation of China(no.82174457)。
文摘Background:Lung cancer is one of the deadliest cancers worldwide,creating a pressing need to develop novel drugs that inhibit oncogenic signaling pathways.Numerous studies have shown that berberine(BBR)has anti–lung cancer potential.We aimed to explore the anti–lung cancer effect of BBR and related mechanisms by targeting the glycogen synthase kinase 3β(GSK3β)/β-catenin pathway.Methods:Lung adenocarcinoma(LUAD)cells A549 and NCI-H1975 were treated with BBR.Results:Our results showed that BBR inhibited cell proliferation by decreasing c-Myc levels and induced cel cycle arrest in the G0/G1 phase by lowering cyclin D1 levels.BBR induced apoptosis by upregulating cleaved caspase 3 levels.BBR inhibited cell migration and invasion by decreasing N-cadherin levels.Furthermore,BBR upregulated the expression of GSK3βprotein and phospho-β-catenin proteins in the cytoplasm,while decreasing the expression ofβ-catenin protein.Next,LUAD cel s were exposed to CHIR-99021(a GSK3βinhibitor).This treatment led to an increase in c-Myc,cyclin D1,andβ-catenin levels at specific concentrations.BBR partially reversed the effects of CHIR-99021.Finally,LUAD cells were treated with CHIR-99021(4μmoL/L)combined with BBR(30 and 60μmoL/L)for 24 h.The expression of programmed death ligand 1(PD-L1)was assessed by Western blot analysis.Jurkat T cells and A549 cel s were cocultured for 24 h to examine the lactate dehydrogenase release rate.Results suggested that BBR suppressed the expression of PD-L1 and heightened the immune lethality of T cells.Conclusions:BBR suppressed the proliferative activity of LUAD cell lines A549 and NCI-H1975 in vitro,induced cell cycle arrest and cancer cel apoptosis in the G0/G1 stage,and repressed the migration and invasion of cancer cells.BBR reduced the PD-L1 protein expression and enhanced T-cell–mediated cytotoxicity.These effects appear to be related to BBR's regulation of the GSK3β/β-catenin pathway.
基金supported by the National Natural Science Foundation of China(grant numbers 82204127 and 72204172)。
文摘Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.
基金supported by the 2022 Natural Science Foundation of Fujian Province(No.2022J011486).
文摘Background:Long noncoding RNA,LINC01106 exhibits high expression in lung adenocarcinoma(LUAD)tumor tissues,but its functional role and regulatory mechanism in LUAD cells remain unclear.Methods:LINC01106 expression was analyzed in LUAD tissues and its functional impact on LUAD cells was assessed.LUAD cells were silenced with sh-LINC01106 and injected into nude mice to investigate tumor growth.The downstream transcription factors and molecular mechanism were determined using the Human transcription factor database(TFDB)database and Gene Expression Profiling Interactive Analysis(GEPIA)database.Additionally,the impact of linc01106 on autophagy was analyzed by determining the expression of autophagy-related genes(ATGs)in LUAD cells.Results:Our results showed that LINC01106 exhibited upregulation in both LUAD tissues and cell lines.The silencing of LINC01106 demonstrated a suppressive effect on tumorigenesis in a xenograft mouse model of LUAD.Additionally,LINC01106 was found to recruit TATA-binding protein-associated factor 15(TAF15),an RNA-binding protein,thereby enhancing the mRNA stability of TEA domain transcription factor 4(TEAD4).In turn,TEAD4 served as a transcription factor that bound to the LINC01106 promoter and regulated its expression.Further assays indicated that LINC01106 promoted autophagy in LUAD cells by upregulating the expression of autophagy-related genes(ATGs).The silencing of LINC01106 in LUAD cells inhibited autophagy,and cell proliferation,and promoted apoptosis,which all were effectively reversed by ATG5 overexpression.Conclusions:Overall,LINC01106,transcriptionally activated by TEAD4,interacts with TAF15 to promote the stability of TEAD4 and upregulates the expression of ATGs,promoting malignancy of LUAD cells.
文摘BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.
基金Supported by Guangxi Guilin Science and Technology Fund,No.20190218-7-6.
文摘BACKGROUND Most non-small cell lung cancer patients have epidermal growth factor receptor(EGFR)activating mutations,such as exon 19 deletion and exon 21 replacement mutations.Osimertinib is a third-generation EGFR-tyrosine kinase inhibitors ap-proved for the treatment of lung cancer patients carrying EGFR activating mu-tations.Osimertinib-induced interstitial lung disease(ILD)is a rare and poten-tially fatal pulmonary toxic manifestation of drug therapy.At present,there is no international consensus on the risks and treatment of the osimertinib-induced ILD.CASE SUMMARY We report a case of a 56-year-old woman who was diagnosed with lung adenocar-cinoma with lung hilum,mediastinal lymph nodes and brain metastases(T4N3-M1c stage IVB).The patient received targeted treatment with osimertinib after radiotherapy and chemotherapy.But she developed ILD after osimertinib treat-ment.Following active symptomatic treatment and hormone treatment,the lung injury alleviated.The patient was retreated with furmonertinib combined with prednisone and did not experience ILD again.So far,she has survived for 14 months without disease progression.CONCLUSION Retreatment with furmonertinib under prednisone could be considered as an effective therapeutic option after risk-benefit assessment for EGFR-mutant lung adenocarcinoma patients.
基金Science and Technology Support Program of Baoding City,Hebei Province(Project No.:2241ZF326)。
文摘Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 to May 2024 were selected as the study subjects.Their clinical data were retrospectively analyzed and grouped by nursing methods.The bundled nursing care group(n=40)received bundled nursing care,while the conventional nursing care group(n=40)received routine nursing care.Lung function,immune function,complication rate,pain level,exercise tolerance,and quality of life were compared between the two groups.Results:Before nursing,there were no statistically significant differences in lung function,immune function,pain level,exercise tolerance,and quality of life between the bundled nursing care group and the conventional nursing care group(P>0.05).After nursing,both groups showed improvement in lung function,immune function,pain level,exercise tolerance,and quality of life,but the bundled nursing care group had better results and a lower complication rate,with statistical significance(P<0.05).Conclusion:The bundled nursing care has a higher clinical application value in postoperative recovery of lung cancer patients and is worthy of widespread clinical use.
基金supported by the National Natural Science Foundation of China(No.62371243)National Key Research and Development Program of China(No.2025YFC2427600)+4 种基金the Jiangsu Provincial Key Research and Development Program Social Development Project(No.BE2022720)the Natural Science Foundation of Jiangsu Province(No.BK20231190)Jiangsu Provincial Medical Key Discipline Cultivation Unit of Oncology Therapeutics(Radiotherapy)(No.JSDW202237)Changzhou Social Development Program(Nos.CE20235063 and CJ20244020)Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.JX13614239).
文摘This study introduces a novel concept,biological in vivo three-dimensional(3D)dose distribution verification,aimed at investigating how respiratory motion affects the efficacy of lung cancer radiotherapy,representing an evolution from the current standard of rigid-body dose distribution verification.A 3D ex vivo biological lung motion simulation device(3D-BioLungEx)was designed to replicate human respiration.A radiotherapy plan of the patient was copied to the porcine lung,which was driven by 3D-BioLungEx to simulate various respiratory patterns that occur during treatment.To ensure anatomical consistency with the patient’s lung structure,during transmission,skin,skeleton,and organs were adjusted according to CT images of the porcine lung.The patient’s radiotherapy plan was then adapted to the porcine lung using the Monaco treatment planning system(TPS).Next,an iterative optimization and scatter inversion-based dose distribution retro-analysis algorithm(IOSI-BLDose)was developed to calculate the dose distribution during treatment.Gamma passing rates were used to quantify discrepancies between this dose distribution and that of the radiotherapy plan.When respiratory conditions were replicated,the passing rate reached up to 93.61%,while irregular breathing dropped it to 70%-90%,primarily due to amplitude changes.However,cycle variations had minimal impact.Compared to conventional rigid-body dose distribution verification,our method provides real-time biological feedback and more effectively captures motion-induced deviations.Accordingly,our biological in vivo 3D dose distribution verification has potential for improving treatment precision and enabling adaptive radiotherapy in clinical practice.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82172635,82272686,and 82203628)Natural Science Foundation of Tianjin(Grant No.23JCZDJC00200)Tianjin Key Medical Discipline(Specialty)Construction Project(Grant No.TJYXZDXK-010A).
文摘Introduction Small cell lung cancer(SCLC)is a highly aggressive malignancy with limited treatment options.Despite advances in immunotherapy,response rates remain low,and the efficacy of current molecular subtyping1,2 is insufficient to predict therapeutic outcomes3,4.A recently identified vulnerability in SCLC involves the dysregulation of nuclear-cytoplasmic transport,particularly through exportin 1(XPO1)5-7.
基金Supported by the National Key Research and Development Program of China,No.2022YFE0110200Project of Science and Technology Department of Jilin Province,No.20240501002GH and No.YDZJ202102CXJD020+3 种基金Jilin University Norman Bethune Medical Department“Medicine+X”Project,No.2022JBGS04Project of Development and Reform Commission of Jilin Province,No.2021C023Department of Human Resources and Social Security Project of Jilin Province20th Batch of Innovation and Entrepreneurship Talent Funding Project of Jilin Province.
文摘Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presence of BM,which affects up to 60%of patients with NSCLC,is correlated with an unfavorable prognosis and markedly decreased quality of life.Standard treatment options for BMs,such as whole-brain radiation therapy and surgery,have displayed limited efficacy in controlling disease progression,and they can cause significant neurocognitive side effects.Stereotactic radiotherapy(SRT),including stereotactic radiosurgery,fractionated SRT,and stereotactic body radiotherapy,represents an advanced and precise approach for treating BM that minimizes damage to surrounding healthy tissues.This review highlights recent advances in the application of SRT for treating BM of NSCLC,focusing on its underlying biological principles and mechanisms of action as well as the quality standards necessary for effective SRT implementation.The ability of SRT to deliver substantial radiation doses in a precisely targeted manner has resulted in better local tumor management,fewer side effects,and increased patient survival rates.Future research is crucial to improve SRT procedures and successfully incorporate them into multimodal therapy plans for patients with NSCLC and BM.
