Wenjie Jiao

Identification of plasma microRNAs as novel noninvasive biomarkers for early detection of lung cancer.

Recent diagnostic procedure advances have considerably improved early lung cancer detection. However, the invasive, unpleasant, and inconvenient nature of current diagnostic procedures limits their application. There is a great need for novel noninvasive biomarkers for early lung cancer diagnosis. In the present study, we aimed to determine whether microRNA (miRNA) blood signatures are suitable for early detection of lung cancer. Using quantitative reverse transcriptase PCR analysis, we first selected and identified three aberrant plasma expression miRNAs (miR-21, miR-145, and miR-155) in a training set of 62 patients and 60 healthy smokers to define a panel that had high diagnostic efficiency for lung cancer. Then, we validated the detective ability of this miRNA panel in a testing set of 34 malignant tumor patients, 30 patients with benign pulmonary nodules and 32 healthy smokers. In the training set, miR-21 and miR-155 showed higher plasma expression levels, whereas miR-145 showed a lower expression level in patients with malignant cancer, compared with healthy controls (P⩽0.001). The three miRNAs used in combination produced the area under receiver operating characteristic curve at 0.847, which helped distinguish lung cancer from healthy smokers with 69.4% sensitivity and 78.3% specificity. A logistic regression model with the best prediction was constructed on the basis of miR-21, miR-145, and miR-155. Validation of the miRNA panel in the testing set confirmed their diagnostic value, which yields a significant improvement over any single one. Plasma miR-21, miR-145, and miR-155 have strong potential as novel noninvasive biomarkers for early detection of lung cancer.

Two-port approach for fully thoracoscopic right upper lobe sleeve lobectomy

This report describes a case report of a minimally invasive technique for VATS right upper sleeve lobectomy with a two-port approach. To our knowledge it is the first report of this kind. A 50-year-old man with a pulmonary nodule occluding the orifice of the right upper lobe bronchus was referred to our department. Dissection, stapling the right upper lobe pulmonary vessels and anastomosis between the right intermediate and the right main bronchus were performed via the two port. To deal with blocking of pulmonary artery and obtain a satisfactory exposure and manipulating space in the course of bronchial anastomosis were the key points. Intraoperative blood loss was 150 ml and total operative time was 220 minutes. The postoperative course was uneventful. Chest X-rays showed no sign of atelectasis. Postoperative histopathological examination revealed that the tumor was T3N0M0 squamous cell carcinoma. The patient was discharged from hospital on postoperative day 9 without any complications. We conclude that video-assisted thoracoscopic sleeve lobectomy with mediastinal dissection by two-port approach is feasible and convenient.

Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system

BackgroundDespite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system.Case presentationA case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful.ConclusionsRobotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.

Loss expression of micro ribonucleic acid (miRNA)-200c induces adverse post-surgical prognosis of advanced stage non-small cell lung carcinoma and its potential relationship with ETAR messenger RNA

Non‐small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. As micro ribonucleic acid (miRNA)‐200 and ETAR may play an essential role in the process of epithelial to mesenchymal transition (EMT) simultaneously, the purpose of this study was to detect the expression of miRNA‐200c and ETAR messenger (m)RNA and assess their prognostic significance in early stage NSCLC.

Computed tomography-guided iodine-125 interstitial implantation as an alternative treatment option for lung cancer.

PURPOSE The aim was to evaluate the safety, feasibility and efficacy of computed tomography (CT)-guided percutaneous interstitial brachytherapy using radioactive iodine-125 ( 125 I) seeds for the treatment of lung cancer. MATERIALS AND METHODS Included in this study were 45 male and 35 female patients aged 52-85 years (mean 72-year) who were diagnosed with lung cancer. Of the 80 cases of lung cancer, 38 were pathologically confirmed as squamous cell carcinoma, 29 as adenocarcinoma, 2 as small cell lung cancer, and 11 as metastatic lung cancer. Percutaneous interstitial implantation of radioactive 125 I seeds was performed under CT guidance. The treatment planning system was used to reconstruct three-dimensional images of the tumor to determine the quantity and distribution of 125 I seeds to be implanted. Under CT guidance, 125 I seeds were embedded into the tumor, with the matched peripheral dose set at 100-130 Gy. Follow-up CT scan was done in 2-month to explore the treatment efficacy. RESULTS The procedure was successful in all patients. No major procedure-associated death occurred. The duration of follow-up was 6-month. Complete response (CR) was seen in 38 cases (47.5%), partial response (PR) in 27 cases (33.75%), stable disease (SD) in 10 cases (12.5%), and progressive disease in 5 cases (6.25%), with a local control rate (CR + PR + SD) of 93.75%. The 2-, 4- and 6-month overall response rate (CR + PR) was 78%, 83% and 81%, respectively. CONCLUSION Implantation of CT-guided 125 I seeds is a safe and effective alternative option for the treatment of lung cancer.

Robotic-assisted double-sleeve lobectomy

Double-sleeve lobectomy, which includes bronchoplasty and pulmonary arterial angioplasty, is required for certain cases of central-type lung cancer. It is usually done by open surgery or video-assisted thoracoscopic surgery (VATS). In recently, da Vinci system and robotic surgery have been applied in such complicated cases. Here we describe the details associated with robotic-assisted double-sleeve lobectomy.

Quality of life and survival after II stage nonsmall cell carcinoma surgery: Video-assisted thoracic surgery versus thoracotomy lobectomy.

PURPOSE Due to the improvement of thoracoscopic technology and surgeons ability, plenty of nonsmall cell lung cancer (NSCLC) was treated by video-assisted thoracic surgery (VATS). This study was designed to evaluate the quality of life (QOL) and survival in II stage NSCLC patients following lobectomy, comparing VATS with thoracotomy. METHODS Between 2010 and 2012, 217 II stage NSCLC patients (VATS: 114 patients, OPEN: 103 patients) were enrolled in a long-standing, prospective observational lung cancer surgery outcomes study. Short-form 36 health survey (SF-36) and time to progression (TTP) were measured to evaluate the QOL and postoperative survival. RESULTS There were significant differences between the two groups in the preoperative radiation therapy and differentiation, and the VATS group had less postoperative complication, blood loss, intraoperative fluid administration, and shorter length of stay. Statistical analysis of SF-36 questionnaire revealed that VATS group score was higher on seven health dimensions: Bodily pain (BP), energy (EG), general health, physical functioning, mental health, SF, and role-physical (RP), but only BP, EG, and RP have statistical significance. Using survival analysis, there was no significant difference between VATS and OPEN group, in which the mean TTP of VATS group is 18.5 months, while OPEN group is 20 months. CONCLUSIONS VATS lobectomy tends to score higher on the QOL and functioning scales and has equivalent postsurgical survival compared with OPEN lobectomy for II stage nonsmall cell carcinoma patients.

Differential protein-coding gene and long noncoding RNA expression in smoking-related lung squamous cell carcinoma

Cigarette smoking is one of the greatest preventable risk factors for developing cancer, and most cases of lung squamous cell carcinoma (lung SCC) are associated with smoking. The pathogenesis mechanism of tumor progress is unclear. This study aimed to identify biomarkers in smoking‐related lung cancer, including protein‐coding gene, long noncoding RNA, and transcription factors.

Lymph node evaluation in totally thoracoscopic lobectomy with two-port for clinical early-stage nonsmall-cell lung cancer: Single-center experience of 1086 cases.

OBJECTIVES Although more and more video-assisted thoracoscopic surgery (VATS) lobectomies via two-port have been performed to treat early-stage nonsmall-cell lung cancer (NSCLC) in recent years, concern remains whether it can achieve satisfactory adequacy of lymphadenectomy. This retrospective study was aimed to evaluate the adequacy of lymphadenectomy by VATS via two-port, compared with three-port. MATERIALS AND METHODS The clinical and pathological data of patients who underwent VATS lobectomy via two-port or three-port with systematic lymphadenectomy for clinical early-stage NSCLC were reviewed. As the main evaluation criterion, the number of mediastinal nodes and node stations, and the total number of nodes and node stations was compared by approach. RESULTS 1872 patients with NSCLC underwent VATS lobectomy, 1086 via a two-port approach and 786 through a three-port approach. In the two-port and three-port groups, the baseline patient characteristics were similar, and there was no significant difference in the mean number of dissected mediastinal lymph nodes (MLNs) (12.3 ± 2.2 and 13.1 ± 1.7, P > 0.05) and the mean number of dissected MLN stations (3.5 ± 0.7 and 3.4 ± 0.8, P > 0.05). Meanwhile, the mean total number of dissected lymph nodes (24.1 ± 4.2 and 25.7 ± 4.3, P > 0.05) and the mean total number of dissected lymph node stations (6.8 ± 1.3 and 6.9 ± 1.1, P > 0.05) were also similar. Otherwise, in terms of postoperative complications, there was no obvious difference in the two groups. CONCLUSIONS The adequacy of lymphadenectomy including MLN dissection by VATS via two-port is similar to that via three-port for patients undergoing lobectomy for clinical early-stage NSCLC.

Prognostic impact of CUG-binding protein 1 expression and vascular invasion after radical surgery for stage IBnonsmall cell lung cancer

BACKGROUND Nonsmall cell lung cancer is the leading cause of cancer mortality worldwide because of distant metastasis and frequent recurrence. Only few reliable and easily accessible tumor markers have been clinically implemented to the early nonsmall cell cancer prognosis. OBJECTIVE The purpose of this study is to detect the expression of CUG-binding protein (CUGBP1) and assess the prognostic significance of CUGBP1 in early stage (IB) lung adenocarcinoma patients. MATERIALS AND METHODS Using quantitative reverse transcription-polymerase chain reaction (PCR) and immunohistochemistry (IHC) analysis, we detect the expression of CUGBP1 and assess their correlation with clinicopathological parameters by Chi-square test. Time to progression (TTP) was used as a recurrent index and was evaluated by univariate and multivariate analysis in the Cox hazard model. RESULTS Using PCR and IHC analyses, the expression of CUGBP1 and CUGBP1 messenger RNA (mRNA) had a close relationship with differentiation and vascular-invasion (VI). However, there were no significant differences between the CUGBP1 mRNA expression and CUGBP1 protein expression in IB lung adenocarcinoma. Using univariate and multivariate survival analyses, we found that CUGBP1 and VI were independent prognostic factors for IB stage adenocarcinoma individuals postsurgically. CONCLUSIONS High expression of CUGBP1 could enhance the recurrence rate of adenocarcinoma and predicts an adverse postsurgical survival of TTP. Combination of CUGBP1 and VI detecting could be considered as indication to predict prognosis of IB stage adenocarcinoma in the clinical trial.