No abstract

Background Synchronous bilateral lung lesions are emerging as a common but tricky disease for surgical management. Whether one or two-stage surgery should be taken remains in debate. We retrospectively analysed 151 patients who underwent one and two-stage Video Assisted Thoracic Surgery (VATS) to investigate the safety and feasibility of the two surgical approaches. Methods A total of 151 patients were included in the study. Propensity score matching was performed to minimize the baseline characteristics difference between one and two-stage groups. Clinical factors including in-hospital days after surgery, chest tube drainage days, types and severity of post-operative complications were compared between the two groups. Logistic univariate and multivariate analyses were used to find the risk factors for post-operative complications. Nomogram was built to select the low risk candidates for the one-stage VATS. Results After propensity score matching, 36 one-stage and 23 two-stage patients were enrolled. The age (p = 0.669), gender (p = 0.3655), smoking status (p = 0.5555), pre-operative comorbidity (p = 0.8162), surgical resection (p = 0.798) and lymph node dissection (p = 9036) were balanced between the two groups. There was no difference in post-surgery hospital days (8.67 ± 2.68 versus 8.46 ± 2.92, p = 0.7711) and chest tube retaining days (5.47 ± 2.20 versus 5.46 ± 1.95, p = 0.9772). Moreover, post-operative complications also showed no difference between one-stage and two-stage groups (p = 0.3627). Univariate and multivariate analysis revealed that advanced age (p = 0.0495), pre-surgical low haemoglobin (p = 0.045) and blood loss (p = 0.002) were risk factors for post-operative complications. Nomogram built with the three risk factors showed reasonable predictive value. Conclusions One-stage VATS for synchronous bilateral lung lesion patients was proved to be a safety procedure. Advanced age, pre-surgical low haemoglobin and blood loss may predict complications after surgery.

It has been reported that chromatin regulators (CRs), as one of the essential upstream regulators of tumor development, were screened to construct a prognostic model for predicting the outcome of tumor patients. However, the prognostic model based on CRs-related long noncoding RNAs (lncRNAs) in esophageal cancer (EC) has never been researched. This study aims to construct a novel CRs-related lncRNA signature to evaluate the prognostic ability of EC patients. We obtained the transcriptome data and clinical information of patients with EC from the Cancer Genome Atlas database, 870 CRs-related genes from previous topic research. Univariate, multivariate Cox, the least absolute shrinkage and selection operator regression analyses were used to establish the risk model. The receiver operating characteristic curve, principal component analysis, nomogram, quantitative real-time PCR were performed to evaluate the independence and accuracy of the model. The biological functions and immune microenvironment of the risk model were analyzed by gene set enrichment analyses and R softwares. A novel 3 CRs-related lncRNAs risk model composed of AC079684.1, TMEM75, LINC00365, as an independent and superior factor, was established for prognosis prediction of EC patients. Quantitative real-time PCR analysis verified upregulated AC079684.1 and TMEM75 mRNA levels and downregulated LINC00365 mRNA level in EC tissues compared with normal tissues. Gene set enrichment analysis analysis displayed Kyoto encyclopedia of genes and genomes and gene ontology pathways enriched in risk groups, such as focal adhesion, pathways in cancer, epidermal cell differentiation. Immune cells and immune checkpoints were more likely to be activated in the high-risk group. Finally, we found most of the compounds in the high-risk group exhibited higher sensitivity through therapeutic drug screening. The 3 CRs-related lncRNAs risk model could independently predict the prognosis of EC and provide immunotherapy guidance for patients with EC.

Background: To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing neutropenia during multiple cycles of chemotherapy in patients with non-small cell lung cancer (NSCLC). Method: In a multicenter, prospective, randomized trial, patients with NSCLC were randomly assigned in a 2:1 ratio to treatment group (PEG-rhG-CSF as primary prophylactic therapy) or control group. Patients in the control group were administered rhG-CSF when white blood cell count was <2.0 Â 10 9 /L or absolute neutrophil count <1.0 Â 10 9 /L. The primary endpoint was the incidence of grade 3/4 neutropenia. Secondary endpoints included the incidence and duration of grade 3/4 neutropenia in each cycle, the incidence of febrile neutropenia (FN), delay rate of chemotherapy, prolonged time of chemotherapy, and safety. Results: Between January 2019 and July 2021, 130 patients were enrolled (treatment group: n = 87, control group: n = 43). The incidence of grade 3/4 neutropenia in the treatment group was significantly lower than that in the control group (1.15% vs. 11.63%, p < 0.05). The mean duration of grade 3/4 neutropenia for the treatment and control group was 2.00 and 3.75 days, respectively. There were no statistical differences in the incidence of FN, delay rate of chemotherapy, prolonged time of chemotherapy, and antibiotic use between the two groups (all p > 0.05). Adverse events were reported in 47.13% of patients in the treatment group and 48.84% patients in the control group. Conclusions: Primary prophylactic treatment with PEG-rhG-CSF could reduce the incidence of neutropenia in patients with NSCLC during multiple cycles of chemotherapy, with acceptable safety and tolerability.