Blood vessel passage on CT exerts a vital part in early diagnosis as well as treatment of carcinoma of the lungs. Intratumoral microvascular density (iMVD) has gradually become the focus of research on biological behavior, appearance, and evolution of malignant tumors nowadays. The aim of this paper was to verify whether there is a correlation between the iMVD and the vascular morphology of ground glass nodules (GGNs). A total of 109 patients with pulmonary GGN were classified into three groups (I,II, and III) according to the vascular morphology on CT, and their expression of CD31-, CD34-, and CD105-labeled iMVD was detected by the streptoavidin–biotin method, statistically analyzing the iMVD values of each group. The expression of CD31, CD34, and CD105 in different lung tissues was significantly different, with remarkably higher iMVD in lung cancer tissues than in adjacent normal lung tissues. In the imaging sort of types I, II, and III according to the means of vascular passage, the iMVD expression of CD31, CD34, and CD105 was significantly different between groups. These data suggest that the presence and the abnormal morphology of vessels seen within GGNs indicate the occurrence and progression of lung cancer in pathology. It offers a strong theoretical foundation for early diagnosis of carcinoma of the lungs, thus providing a more precise clinical diagnosis and prognosis of early-stage lung cancer.
Background: The accurate and safe division of the intersegmental demarcation (ISD) is critical and challenging during thoracoscopic anatomical segmentectomy. Here, we provide an improved technique which emphasizes the application of an electric hook and blunt division of ISD. The technique is termed as the "modified hand-tearing method" (MHT method) with combined application of an electric hook and staplers. The study aimed to review the outcomes of patients who underwent thoracoscopic anatomical segmentectomy, with or without the MHT method in our institute and assess its feasibility and safety. In addition, we compared the feasibility between video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) using the MHT method. Methods: From 2018 July to 2021 June, we retrospectively analyzed 701 patients who underwent segmentectomy. Using propensity score matching, data of two well-matched pairs of 276 cases in the MHT method and non-MHT method groups, and two wellmatched pairs of 40 cases in the VATS and RATS subgroups were obtained. The clinical and perioperative characteristics of patients were compared between groups. Results: Compared with the non-MHT method group, the MHT method group had shorter operation time and shorter postoperative hospital stay. Period of chest tube drainage and postoperative total drainage and postoperative complications had no between-group difference. Compared with VATS, the RATS subgroup had less intraoperative bleeding and shorter postoperative hospital stay. Conclusion: Division of ISD using the MHT method has advantages in precision and ease of operation, so it has the potential to become a feasible and effective method for thoracoscopic anatomical segmentectomy.
Introduction : Esophagogastric junction adenocarcinomas (00000000) are devastating diseases with increasing incidence. The Siewert classification is the well accepted anatomical classification system for EGJA to guide surgical approaches. However, the definition of EGJA and its optimal resection strategy are still debatable. Methods 198 EGJA patients, of which 140 (70.7%) were distal EGJA, 58 (29.3%) were proximal EGJA, 42 gastric adenocarcinoma (GCA) patients and 36 esophageal squammous cell carcinomas (ESCC) patients were enrolled. Targeted next-generation sequencing (NGS) of 450 cancer-related genes was performed to identify the genomic alterations. The molecular characteristics of the above EGJA, GCA and ESCC were analyzed and compared. Results Gene alterations with a high mutation frequency in EGJA in this cohort were identified: TP53 (74%), CCNE1 (14%), ERBB2 (12%), FAT3 (11%), ARID1A (11%), PIK3CA (10%), SPTA1 (10%), CDK6 (9%), FGF3 (9%), LRP1B (9%). Compared with GCA and ESCC, EGJA may better benefit from PIK3CA inhibitors due to high-frequency mutations in PIAK-AKT-related genes. We also found that FRFR2, ZNF127 and MYC mutations maybe biomarkers to distinguish distal EGJA from proximal EGJA. Conclusion Our data identify differences of EGJA from GCA and ESCC, as well as distal/proximal EGJA at the genomic level, suggesting that a unique TNM staging for EGJA may be required.
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