Objective: The aim of this study was to investigate the clinicopathologic and prognostic factors of the partial subtypes of lung adenocarcinoma, including pure bronchioloalveolar carcinoma (BAC), adenocarcinoma (AC) w...Objective: The aim of this study was to investigate the clinicopathologic and prognostic factors of the partial subtypes of lung adenocarcinoma, including pure bronchioloalveolar carcinoma (BAC), adenocarcinoma (AC) with BAC component and AC without BAC component. Methods: One hundred and six adenocarcinoma specimens which were followed up completely for 3 years, were obtained from 106 patients (45 men and 61 women) who underwent surgical resection for pathologically confirmed pulmonary adenocarcinoma in the Cancer Hospital of Tianjin Medical University, from June 2004 to December 2005. According to the recent 2004 World Health Organization (WHO) pathological classification criteria of lung cancer, lung adenocarcinomas were divided into three subgroups: pure BAC, AC with BAC component and AC without BAC component. The clinical data were retrospectively analyzed based on statistical methods. All data were analyzed using SPSS statistics software and Kaplan-Meier survival curves were constructed, meanwhile, we conducted a Log-rank test. Results: The statistical analysis showed that no significant association was found among the three groups in gender and age; however, smoke index, tumor size, N stage, TNM stage, postoperative recurrence and metastasis had a statistically significant correlation among three groups (P < 0.01). The 3-year survival rates of the three groups were 96.4%, 61.0% and 40.5% respectively, which had a statistically significant difference. And the 3-year survival rate was significantly higher in the patients with pure BAC than in the patients with other types of lung adenocarcinomas (P < 0.01). In contrast to the other two groups (pure BAC and AC with BAC component), we found the evidence that the 3-year prognosis of lung adenocarcinoma without BAC component was worse than the two formers. Conclusion: The three groups (pure BAC, AC with BAC component and AC without BAC component) have their own distinct clinicopathologic features respectively and completely different clinical prognosis. The strict distinction of the subtypes of lung adenocarcinoma can provide more reliable basis for scientific and comprehensive clinical treatment and contribute to assess the clinical prognosis effectively.展开更多
BACKGROUND Pulmonary alveolar microlithiasis(PAM)is a rare idiopathic lung disease characterized by the accumulation of innumerable microliths.Currently,effective therapeutics for PAM are not available,and the only tr...BACKGROUND Pulmonary alveolar microlithiasis(PAM)is a rare idiopathic lung disease characterized by the accumulation of innumerable microliths.Currently,effective therapeutics for PAM are not available,and the only treatment for end-stage lung disease is lung transplantation(LuTx).Further,there are few reports that focus on LuTx for the treatment of PAM,and the follow-up reports of postoperative imaging are even rarer.CASE SUMMARY A 52-year-old man presented to Shanghai Pulmonary Hospital in 2017 after experiencing shortness of breath and exacerbation.The patient was diagnosed with PAM and referred for single-LuTx(SLuTx)on March 14,2018.Preoperative imaging results from a chest X-ray demonstrated bilateral,diffuse,symmetrical,sandstorm-like radiopaque micronodules,and pneumothorax and a computed tomography scan revealed minute,calcified military nodules in both lungs.We performed a left SLuTx,and intraoperative pathology was consistent with PAM.One week after surgery,a chest X-ray revealed slight exudation of the left lung,and one month later,the left transplanted lung exhibited good dilation,mild pulmonary perfusion injury with local infection,and left pleural effusion.Fiberoptic bronchoscopy revealed left hyperplastic granulation at the left bronchial anastomosis.Multiple sputum cultures suggested the presence of Klebsiella pneumoniae and Acinetobacter baumannii.The last follow-up was conducted in April 2019;the patient recovered well.CONCLUSION This case presents the imaging findings of a patient with PAM before and after LuTx and confirms the effectiveness of LuTx for the treatment of this disease.展开更多
Smoking during pregnancy is a major source of fetal exposure to numerous harmful agents present in tobacco smoke. Lung development involves complex biochemical processes resulting in dramatic changes which continue ev...Smoking during pregnancy is a major source of fetal exposure to numerous harmful agents present in tobacco smoke. Lung development involves complex biochemical processes resulting in dramatic changes which continue even after birth. In addition to type I cells which form the blood-air barrier, type II alveolar epithelial (AE) cells have important and diverse functions related to immunological protection and stabilization of the alveolus through synthesis and secretion of the pulmonary surfactant. Apoptosis or programmed cells death is an important physiological process during lung embryogenesis and for the proper maintenance of homeostasis. Caspases are proteases that play important roles in regulating apoptosis. Caspase-3 is the key executioner caspase in the cascade of events leading to cell death by apoptosis. We explored the hypothesis that cigarette smoke extract (CSE) induces apoptosis in fetal rat lung type II AE cells by activation of caspase-3. To analyze these factors, isolated fetal rat lung type II AE cells were used. The cells were exposed to different concentrations of CSE (5%, 10% or 15%) (v/v) for 60 min. The results of the present study showed that CSE induced apoptosis in fetal rat lung type II AE cells with a significant increase (p 0.05) in caspase-3 activity and decrease in cell proliferation at CSE concentrations of 10% and 15% (v/v). These observations indicate that cigarette smoke extract induces apoptosis by activation of caspase-3 in fetal rat lung type II AE cells in a dose-dependent manner and may potentially alter the regulated development of the lung and the appearance of the surfactant-producing type II alveolar cells which are critical for the establishment of adequate gas exchange at birth.展开更多
基金Supported by a grant from the National Nature Sciences Foundation of China (No. 30770828)
文摘Objective: The aim of this study was to investigate the clinicopathologic and prognostic factors of the partial subtypes of lung adenocarcinoma, including pure bronchioloalveolar carcinoma (BAC), adenocarcinoma (AC) with BAC component and AC without BAC component. Methods: One hundred and six adenocarcinoma specimens which were followed up completely for 3 years, were obtained from 106 patients (45 men and 61 women) who underwent surgical resection for pathologically confirmed pulmonary adenocarcinoma in the Cancer Hospital of Tianjin Medical University, from June 2004 to December 2005. According to the recent 2004 World Health Organization (WHO) pathological classification criteria of lung cancer, lung adenocarcinomas were divided into three subgroups: pure BAC, AC with BAC component and AC without BAC component. The clinical data were retrospectively analyzed based on statistical methods. All data were analyzed using SPSS statistics software and Kaplan-Meier survival curves were constructed, meanwhile, we conducted a Log-rank test. Results: The statistical analysis showed that no significant association was found among the three groups in gender and age; however, smoke index, tumor size, N stage, TNM stage, postoperative recurrence and metastasis had a statistically significant correlation among three groups (P < 0.01). The 3-year survival rates of the three groups were 96.4%, 61.0% and 40.5% respectively, which had a statistically significant difference. And the 3-year survival rate was significantly higher in the patients with pure BAC than in the patients with other types of lung adenocarcinomas (P < 0.01). In contrast to the other two groups (pure BAC and AC with BAC component), we found the evidence that the 3-year prognosis of lung adenocarcinoma without BAC component was worse than the two formers. Conclusion: The three groups (pure BAC, AC with BAC component and AC without BAC component) have their own distinct clinicopathologic features respectively and completely different clinical prognosis. The strict distinction of the subtypes of lung adenocarcinoma can provide more reliable basis for scientific and comprehensive clinical treatment and contribute to assess the clinical prognosis effectively.
文摘BACKGROUND Pulmonary alveolar microlithiasis(PAM)is a rare idiopathic lung disease characterized by the accumulation of innumerable microliths.Currently,effective therapeutics for PAM are not available,and the only treatment for end-stage lung disease is lung transplantation(LuTx).Further,there are few reports that focus on LuTx for the treatment of PAM,and the follow-up reports of postoperative imaging are even rarer.CASE SUMMARY A 52-year-old man presented to Shanghai Pulmonary Hospital in 2017 after experiencing shortness of breath and exacerbation.The patient was diagnosed with PAM and referred for single-LuTx(SLuTx)on March 14,2018.Preoperative imaging results from a chest X-ray demonstrated bilateral,diffuse,symmetrical,sandstorm-like radiopaque micronodules,and pneumothorax and a computed tomography scan revealed minute,calcified military nodules in both lungs.We performed a left SLuTx,and intraoperative pathology was consistent with PAM.One week after surgery,a chest X-ray revealed slight exudation of the left lung,and one month later,the left transplanted lung exhibited good dilation,mild pulmonary perfusion injury with local infection,and left pleural effusion.Fiberoptic bronchoscopy revealed left hyperplastic granulation at the left bronchial anastomosis.Multiple sputum cultures suggested the presence of Klebsiella pneumoniae and Acinetobacter baumannii.The last follow-up was conducted in April 2019;the patient recovered well.CONCLUSION This case presents the imaging findings of a patient with PAM before and after LuTx and confirms the effectiveness of LuTx for the treatment of this disease.
文摘Smoking during pregnancy is a major source of fetal exposure to numerous harmful agents present in tobacco smoke. Lung development involves complex biochemical processes resulting in dramatic changes which continue even after birth. In addition to type I cells which form the blood-air barrier, type II alveolar epithelial (AE) cells have important and diverse functions related to immunological protection and stabilization of the alveolus through synthesis and secretion of the pulmonary surfactant. Apoptosis or programmed cells death is an important physiological process during lung embryogenesis and for the proper maintenance of homeostasis. Caspases are proteases that play important roles in regulating apoptosis. Caspase-3 is the key executioner caspase in the cascade of events leading to cell death by apoptosis. We explored the hypothesis that cigarette smoke extract (CSE) induces apoptosis in fetal rat lung type II AE cells by activation of caspase-3. To analyze these factors, isolated fetal rat lung type II AE cells were used. The cells were exposed to different concentrations of CSE (5%, 10% or 15%) (v/v) for 60 min. The results of the present study showed that CSE induced apoptosis in fetal rat lung type II AE cells with a significant increase (p 0.05) in caspase-3 activity and decrease in cell proliferation at CSE concentrations of 10% and 15% (v/v). These observations indicate that cigarette smoke extract induces apoptosis by activation of caspase-3 in fetal rat lung type II AE cells in a dose-dependent manner and may potentially alter the regulated development of the lung and the appearance of the surfactant-producing type II alveolar cells which are critical for the establishment of adequate gas exchange at birth.
