Yunlang She
Tongji University
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Yunlang She.
Oncotarget | 2016
Yijiu Ren; Chenyang Dai; Hui Zheng; Fangyu Zhou; Yunlang She; Gening Jiang; Ke Fei; Ping Yang; Dong Xie; Chang Chen
Because the need of clinical prognostic evaluation by specific metastatic organ, we aim to analyze the prognostic factors in lung cancer patients with M1b disease with Surveillance Epidemiology and End-Results database (SEER). This retrospective study evaluated lung cancer patients of adenocarcinoma (AD), squamous cell carcinoma (SQCC), and small cell lung cancer (SCLC) selected from SEER. We provided the prognostic correlates of overall survival (OS) and lung cancer-specific survival (LCSS) in this population. 23,679 eligible patients were included. Bone was the most common metastatic site in AD (63.1%) and SQCC (61.1%), while liver was the most prevalent site (61.9%) in SCLC. Single site metastasis was significantly associated with better outcome compared to multiple sites metastases in all patients. Among patients with single site metastasis, OS and LCSS were longer for AD and SCLC if involving brain or bone, with median survival time of 5 to 7 months, comparing to 3 months if invloving liver (all p-values < 0.001). Similarly, among patients with multiple metastases, better outcomes were observed in AD patients (4 vs 3 months; OS and LCSS, p < 0.001) and SCLC patients (6 vs 4 months; OS, p = 0.017; LCSS, p = 0.023) without liver metastasis compared to those with liver metastasis. In conclusion, we estimated multiple survival outcomes by histology of primary tumor and sites of metastasis. Liver metastasis is found to be the worst prognostic factor for AD and SCLC patients with distant metastasis. More in-depth research is warranted to identify patients who are prone to develop distance metastasis, especially to liver.
Journal of Thoracic Oncology | 2017
Chenyang Dai; Huikang Xie; Hang Su; Yunlang She; Erjia Zhu; Ziwen Fan; Fangyu Zhou; Yijiu Ren; Dong Xie; Hui Zheng; Xiermaimaiti Kadeer; Donglai Chen; Liping Zhang; Gening Jiang; Chunyan Wu; Chang Chen
Objectives: Tumor spread through air spaces (STAS) is a novel invasive pattern in lung adenocarcinoma (ADC). The effects of the combination of STAS and tumor size on survival have not been well studied. Methods: A total of 383 patients with ADC 3 cm or smaller (stage IA) and 161 patients with stage IB ADC were identified from 2009 to 2010. Recurrence‐free survival (RFS) and overall survival (OS) were compared between patients as stratified by STAS and tumor size. A validation cohort was included in this study. Results: STAS was observed in 116 ADCs 3 cm or smaller (30.3%). In cases involving ADCs 3 cm or smaller, patients with STAS had worse RFS (p = 0.006) and OS rates (p < 0.001) than those without STAS. Furthermore, comparable RFS (p = 0.091) and OS (p = 0.443) rates were observed in patients with ADCs 3 cm or smaller with STAS present and those with stage IB ADC. Multivariate analysis revealed STAS to be an independent prognostic factor in ADCs 3 cm or smaller (RFS, p = 0.043; OS, p = 0.009). Among patients with ADCs larger than 2 to 3 cm, STAS still stratified the prognosis. Moreover, the unfavorable prognosis of patients with ADCs larger than 2 to 3 cm with STAS present was similar to that of patients with stage IB ADC. Among patients with ADCs 2 cm or smaller, STAS failed to stratify the prognosis significantly. Similar results were obtained in the validation cohort. Conclusions: These results provide preliminary evidence that STAS could be considered as a factor in a staging system to predict prognosis more precisely, especially in ADCs larger than 2 to 3 cm.
Oncotarget | 2017
Yunlang She; Lilan Zhao; Chenyang Dai; Yijiu Ren; Junyan Zha; Huikang Xie; Sen Jiang; Jingyun Shi; Shunbin Shi; Weirong Shi; Bing Yu; Gening Jiang; Ke Fei; Yongbing Chen; Chang Chen
Purpose To construct a preoperative nomogram to differentiate invasive pulmonary adenocarcinomas (IPAs) from preinvasive lesions in patients with solitary pure ground-glass nodules (GGN). Methods A primary cohort of patients with pathologically confirmed pulmonary solitary pure GGN after surgery were retrospectively studied at five institutions from January 2009 to September 2015. Half of the patients were randomly selected and assigned to a model-development cohort, and the remaining patients were assigned to a validation cohort. A nomogram predicting the invasive extent of the solitary GGNs was constructed based on the independent risk factors. Predictive performance was evaluated by concordance index (C-index) and calibration curve. Results Out of 898 cases included in the study, 501 (55.8%) were preinvasive lesions and 397 (44.2%) were IPAs. In the univariate analysis, lesion size (p < 0.001), lesion margin (p = 0.041), lesion shape (p < 0.001), mean computed tomography (CT) value (p = 0.018), presence of pleural indentation (p = 0.017), and smoking status (p = 0.014) were significantly associated with invasive extent. In multivariate analysis, lesion size (p < 0.001), lesion margin (p = 0.042), lesion shape (p < 0.001), mean CT value (p = 0.014), presence of pleural indentation (p = 0.026), and smoking status (p = 0.004) remained the predictive factors of invasive extent. A nomogram was developed and validation results showed a C-index of 0.94, demonstrating excellent concordance between predicted and observed results. Conclusions We established and validated a novel nomogram that can identify IPAs from preinvasive lesions in patients with solitary pure GGN.
Journal of Thoracic Oncology | 2016
Chenyang Dai; Yijiu Ren; Dong Xie; Hui Zheng; Yunlang She; Ke Fei; Gening Jiang; Chang Chen
Objectives: Patients with NSCLC with M1a disease regardless of lymph node status were categorized as stage IV. This study aims to investigate whether the N descriptors in M1a patients could provide clinical information. Methods: Overall, 39,731 patients with NSCLC with M1a disease were identified from the Surveillance, Epidemiology, and End Results database during 2005–2012. Lung cancer–specific survival (LCSS) was compared among M1a patients stratified by N stage. A Cox proportional hazards regression model was applied to evaluate the prognostic factors. Statistical analyses were performed in all subgroups. Results: M1a patients without lymph node involvement had the best LCSS, followed by patients with N1 disease; no difference in LCSS was observed between N2 and N3 disease (N0 versus N1, p < 0.001; N1 versus N2, p < 0.001; and N2 versus N3, p = 0.478). Similarly, this trend was observed when patients were subdivided into two temporal cohorts (2005–2008 and 2009–2012) and also when M1a disease was subdivided into contralateral pulmonary nodules and pleural dissemination (malignant pleural effusion [or pericardial effusion] and pleural nodules). In addition, a difference in LCSS between N2 and N3 disease was observed in patients with malignant pleural nodules (p = 0.003). Multivariate analysis showed that lymph node involvement was an independent prognostic factor for M1a patients, and this result was also noticed in all subgroups. Conclusions: These results provide preliminary evidence that lymph node stage may have clinical significance among patients with NSCLC with M1a disease, adding prognostic information.
The American Journal of Surgical Pathology | 2017
Chenyang Dai; Huikang Xie; Xiermaimaiti Kadeer; Hang Su; Dong Xie; Yijiu Ren; Yunlang She; Erjia Zhu; Ziwen Fan; Tao Chen; Linlin Qin; Hui Zheng; Liping Zhang; Gening Jiang; Chunyan Wu; Chang Chen
This study aimed to investigate the relationship between lymph node micrometastasis and histologic patterns of adenocarcinoma, with a particular focus on their joint effect on prognosis. We retrospectively reviewed 235 patients with stage I adenocarcinoma from January 2009 to December 2009. Lymph node micrometastasis was evaluated by immunohistochemical staining for cytokeratin (AE1/AE3) and thyroid transcription factor-1. A logistic regression model was applied to confirm the predictive factors of micrometastasis. Survival analysis was performed to evaluate the effect of micrometastasis on prognosis. Lymph node micrometastasis was observed in 35 patients (15%). Patients with micrometastasis had significantly worse recurrence-free survival (P<0.001) and overall survival (P<0.001) compared with those without micrometastasis. Micropapillary component was confirmed as an independent predictor of increased frequency of micrometastasis (P<0.001). Among 62 patients with adenocarcinoma with a micropapillary component, 23 (37%) had lymph node micrometastasis. Micropapillary-positive/micrometastasis-positive patients had significantly worse survival compared with micropapillary-positive/micrometastasis-negative patients (RFS, P=0.039; OS, P=0.002) and micropapillary-negative patients (recurrence-free survival, P<0.001; overall survival, P<0.001). Moreover, the presence of micrometastasis correlated with a higher risk of locoregional recurrence (P=0.031) rather than distant recurrence (P=0.456) in micropapillary-positive patients. In summary, lymph node micrometastasis was more frequently observed in adenocarcinoma with a micropapillary component. Moreover, lymph node micrometastasis could provide helpful prognostic information in patients with resected stage I lung adenocarcinoma with a micropapillary component; thus, immunohistochemical detection of micrometastatic tumor cells in lymph nodes should be recommended.
European Radiology | 2018
Yunlang She; Lei Zhang; Huiyuan Zhu; Chenyang Dai; Dong Xie; Huikang Xie; Wei Zhang; Lilan Zhao; Liling Zou; Ke Fei; Xiwen Sun; Chang Chen
ObjectivesAdenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) are assumed to be indolent lung adenocarcinoma with excellent prognosis. We aim to identify these lesions from invasive adenocarcinoma (IA) by a radiomics approach.MethodsThis retrospective study was approved by institutional review board with a waiver of informed consent. Pathologically confirmed lung adenocarcinomas manifested as lung nodules less than 3 cm were retrospectively identified. In-house software was used to quantitatively extract 60 CT-based radiomics features quantifying nodule’s volume, intensity and texture property through manual segmentation. In order to differentiate AIS/MIA from IA, least absolute shrinkage and selection operator (LASSO) logistic regression was used for feature selection and developing radiomics signatures. The predictive performance of the signature was evaluated via receiver operating curve (ROC) and calibration curve, and validated using an independent cohort.Results402 eligible patients were included and divided into the primary cohort (n = 207) and the validation cohort (n = 195). Using the primary cohort, we developed a radiomics signature based on five radiomics features. The signature showed good discrimination between MIA/AIS and IA in both the primary and validation cohort, with AUCs of 0.95 (95% CI, 0.91–0.98) and 0.89 (95% CI, 0.84–0.93), respectively. Multivariate logistic analysis revealed that the signature (OR, 13.3; 95% CI, 6.2–28.5; p < 0.001) and gender (OR, 3.5; 95% CI, 1.2–10.9; p = 0.03) were independent predictors of indolent lung adenocarcinoma.ConclusionThe signature based on radiomics features helps to differentiate indolent from invasive lung adenocarcinoma, which might be useful in guiding the intervention choice for patients with pulmonary nodules.Key points• Based on radiomics features, a signature is established to differentiate adenocarcinoma in situ and minimally invasive adenocarcinoma from invasive lung adenocarcinoma.
Annals of Surgical Oncology | 2018
Yijiu Ren; Liyan Zhang; Huikang Xie; Yunlang She; Hang Su; Dong Xie; Hui Zheng; Liping Zhang; Gening Jiang; Chunyan Wu; Chenyang Dai; Chang Chen
BackgroundThis study aimed to investigate the significance of lymph node micrometastasis (LNMM) in the lung cancer nodal categories.MethodsBetween 1 January 2009 and 31 December 2013, 589 patients with suspected c-stage 1 and p-T1-2aN0-1M0 lung adenocarcinoma were enrolled in this study. The study evaluated LNMM with cytokeratin (AE1/AE3) and transcription factor-1 (TTF1) (8G7G3/1) expression by immunohistochemistry. Recurrence-free survival (RFS) and overall survival (OS) were compared among the T1-2aN0-1M0 patients stratified by the new N categories.ResultsFrom 589 patients, 7892 removed lymph nodes were examined, and LNMM was observed in 55 (9.3%) of the patients. The patients without LNMM or N1 had the best RFS (5-year rate: 80% vs 25%; P < 0.001) and OS (5-year rate: 87% vs 43%; P < 0.001), followed by the patients with LNMM, compared with those in the N1 category (RFS: 5-year rate, 25% vs 8%; P = 0.010; OS: 5-year rate, 43% vs 20%; P = 0.009). Similarly, this trend was observed when patients were subdivided into the T1 and T2a categories. Multivariate analysis showed that the new N categories with the addition of LNMM were an independent prognostic factor. This result also was noticed in all subgroups.ConclusionsThe findings showed LNMM to be clinically significant as a risk factor for lung cancer. Clinicians should consider LNMM when estimating N categories to determine prognosis and the best treatment strategy.
Journal of Surgical Oncology | 2017
Yunlang She; Lilan Zhao; Chenyang Dai; Yijiu Ren; Gening Jiang; Huikang Xie; Huiyuan Zhu; Xiwen Sun; Ping Yang; Yongbing Chen; Shunbin Shi; Weirong Shi; Bing Yu; Dong Xie; Chang Chen
To develop and validate a nomogram to estimate the pretest probability of malignancy in Chinese patients with solid solitary pulmonary nodule (SPN).
Lung Cancer | 2018
Hang Su; Huikang Xie; Chenyang Dai; Yijiu Ren; Yunlang She; Long Xu; Donglai Chen; Dong Xie; Liping Zhang; Gening Jiang; Chang Chen
OBJECTIVES T-cell immunoglobulin and mucin-domain containing-3 (TIM-3) is a promising checkpoint. However, its features and prognostic value in lung adenocarcinoma remain undetermined. In this study, we aimed to characterize TIM-3 expression and its prognostic significance in patients with surgically resected lung adenocarcinoma. MATERIALS AND METHODS Expression of TIM-3 and programmed cell death 1 (PD-1), and density of CD8+ tumor infiltrating lymphocytes (TILs) were evaluated by immunohistochemistry in resected lung adenocarcinoma. The association between clinicopathological features or clinical outcomes and TIM-3 expression was analyzed. RESULTS A total of 223 patients were enrolled. TIM-3 expression was observed in 107 (48.0%) samples. Positive TIM-3 expression significantly correlated with positive PD-1 expression (p < 0.001) and high CD8+ TILs density (p = 0.014). TIM-3 positivity was significantly associated with worse recurrence-free survival (RFS) (hazard ratio [HR], 2.32; 95% confidence interval [CI], 1.44-3.73, p = 0.001) and overall survival (OS) (HR, 2.04; 95% CI, 1.29-3.20, p = 0.002). Subgroup analysis revealed that TIM-3+/PD-1+/CD8 low group had the worst RFS (5-year rate: 39.5%, p = 0.002) and OS (5-year rate: 50.0%, p = 0.035), while TIM-3-/PD-1-/CD8 high group had the best RFS (5-year rate: 93.8%, p = 0.002) and OS (5-year rate: 100%, p = 0.035). CONCLUSION TIM-3 had a relatively high positive expression rate and special clinicopathological features in patients with lung adenocarcinoma. A combination of TIM-3 and/or PD-1 expression or CD8+ TILs density could further stratify patients into different groups with distinct prognosis.
Journal of Thoracic Disease | 2018
Yijiu Ren; Chenyang Dai; Huikang Xie; Yunlang She; Hang Su; Chang Chen
We would like to thank Dr. Chen and his colleagues for their interest in and positive comments about our work (1). In lung cancer, even patients with pathological stage I non-small cell lung cancer (NSCLC), who have undergone a radical operation, including total tumor resection and systematic lymphadenectomy, may have recurrence rates between 25% and 40% and 5-year survival rates between 57% and 85% (2). These findings suggest that lymph node micrometastasis (LNMM) (3), consisting of metastases <2 mm that are difficult to detect using routine pathological examination methods, may positively correlate with post-operative recurrence and patient survival.