Yue Cheng

Introduction: Pulmonary endometriosis (PE) is an unusual cause of catamenial hemoptysis, with only a small proportion of endometriosis cases involving the thorax. Standard management often involves surgical resection combined with hormonal therapy; however, recurrence rates remain high and long-term hormonal suppression can be challenging for patients. Multiple thoracic surgical interventions may be required for these patients during their reproductive age. A more minimally intervention alternative to surgery is expected, especially those who would like to preserve lung function and warrant quality of life. Case Presentation: We report two PE cases diagnosed clinically based on periodical hemoptysis and radiological changes relevant to menstrual cycles. Both patients were successfully treated with percutaneous radiofrequency ablation (RFA), with complete resolution of cyclical hemoptysis and a 3-year symptom-free follow-up. Conclusion: Percutaneous RFA may be a promising alternative to surgical resection for solitary PE lesions and could serve as part of a multidisciplinary management strategy for endometriosis, especially in young patients at risk of recurrence who wish to preserve lung function and maintain quality of life.

Lung cancer, with high morbidity and mortality rates, requires tailored treatment based on pathological subtypes, clinical staging, and individual performance scores. multidisciplinary treatment (MDT) is supposed to improve patient prognosis, making the treatment generation process a multiattribute multiexpert decision-making (MAMEDM) problem. Traditional MAMEDM models often necessitate experts with differing opinions to conform to group consensus, neglecting experts’ willingness to adjust opinions. To address this issue, this study proposes an MAMEDM framework which can maximize experts’ willingness for opinion transformation. Initially, a linguistic scale function is used to preprocess linguistic evaluations. A fuzzy clustering algorithm is introduced to cluster experts. The weights of subgroups are determined based on the network centrality and the professional titles of experts. Expert opinions within subgroups are aggregated based on the principle of maximizing the willingness of experts for opinion transformation, and then the ORESTE method is implemented to rank treatment options. A case study on lung cancer treatment option generation demonstrates the effectiveness of the proposed framework. Results show that considering experts’ willingness to revise evaluations significantly enhances decision acceptance and reduces the impact of noncooperative behaviors.

Background: Accumulating evidence indicates inherited risk in the aetiology of lung cancer, although smoking exposure is the major attributing factor. Family history is a simple substitute for inherited susceptibility. Previous studies have shown some possible yet conflicting links between family history of cancer and EGFR mutation in lung cancer. As EGFR-mutated lung cancer favours female, never-smoker, adenocarcinoma and Asians, it may be argued that there may be some underlying genetic modifiers responsible for the pathogenesis of EGFR mutation. Methods: We searched four databases for all original articles on family history of malignancy and EGFR mutation status in lung cancer published up to July 2018. We performed a meta-analysis by using a random-effects model and odds ratio estimates. Heterogeneity and sensitivity were also investigated. Then we conducted a second literature research to curate case reports of familial lung cancers who studied both germline cancer predisposing genes and their somatic EGFR mutation status; and explored the possible links between cancer predisposing genes and EGFR mutation. Results: Eleven studies have been included in the meta-analysis. There is a significantly higher likelihood of EGFR mutation in lung cancer patients with family history of cancer than their counterparts without family history, preferentially in Asians (OR = 1.35[1.06–1.71], P = 0.01), those diagnosed with adenocarcinomas ((OR = 1.47[1.14–1.89], P = 0.003) and those with lung cancer-affected relatives (first and second-degree: OR = 1.53[1.18–1.99], P = 0.001; first-degree: OR = 1.76[1.36–2.28, P < 0.0001]). Familial lung cancers more likely have concurrent EGFR mutations along with mutations in their germline cancer predisposition genes including EGFR T790 M, BRCA2 and TP53. Certain mechanisms may contribute to the combination preferences between inherited mutations and somatic ones. Conclusions: Potential genetic modifiers may contribute to somatic EGFR mutation in lung cancer, although current data is limited. Further studies on this topic are needed, which may help to unveil lung carcinogenesis pathways. However, caution is warranted in data interpretation due to limited cases available for the current study.

Lung cancer is the leading cause of cancer-related deaths in China, with over 690 000 lung cancer deaths estimated in 2018. The mortality has increased about five-fold from the mid-1970s to the 2000s. Lung cancer low-dose computerized tomography (LDCT) screening in smokers was shown to improve survival in the US National Lung Screening Trial, and more recently in the European NELSON trial. However, although the predominant risk factor, smoking contributes to a lower fraction of lung cancers in China than in the UK and USA. Therefore, it is necessary to establish Chinese-specific screening strategies. There have been 23 associated programmes completed or still ongoing in China since the 1980s, mainly after 2000; and one has recently been planned. Generally, their entry criteria are not smoking-stringent. Most of the Chinese programmes have reported preliminary results only, which demonstrated a different high-risk subpopulation of lung cancer in China. Evidence concerning LDCT screening implementation is based on results of randomized controlled trials outside China. LDCT screening programmes combining tobacco control would produce more benefits. Population recruitment (e.g. risk-based selection), screening protocol, nodule management and cost-effectiveness are discussed in detail. In China, the high-risk subpopulation eligible for lung cancer screening has not as yet been confirmed, as all the risk parameters have not as yet been determined. Although evidence on best practice for implementation of lung cancer screening has been accumulating in other countries, further research in China is urgently required, as China is now facing a lung cancer epidemic.

Purpose: We established a CT-derived approach to achieve accurate progression-free survival (PFS) prediction to EGFR tyrosine kinase inhibitors (TKI) therapy in multicenter, stage IV EGFR-mutated non–small cell lung cancer (NSCLC) patients. Experimental Design: A total of 1,032 CT-based phenotypic characteristics were extracted according to the intensity, shape, and texture of NSCLC pretherapy images. On the basis of these CT features extracted from 117 stage IV EGFR-mutant NSCLC patients, a CT-based phenotypic signature was proposed using a Cox regression model with LASSO penalty for the survival risk stratification of EGFR-TKI therapy. The signature was validated using two independent cohorts (101 and 96 patients, respectively). The benefit of EGFR-TKIs in stratified patients was then compared with another stage-IV EGFR-mutant NSCLC cohort only treated with standard chemotherapy (56 patients). Furthermore, an individualized prediction model incorporating the phenotypic signature and clinicopathologic risk characteristics was proposed for PFS prediction, and also validated by multicenter cohorts. Results: The signature consisted of 12 CT features demonstrated good accuracy for discriminating patients with rapid and slow progression to EGFR-TKI therapy in three cohorts (HR: 3.61, 3.77, and 3.67, respectively). Rapid progression patients received EGFR TKIs did not show significant difference with patients underwent chemotherapy for progression-free survival benefit (P = 0.682). Decision curve analysis revealed that the proposed model significantly improved the clinical benefit compared with the clinicopathologic-based characteristics model (P < 0.0001). Conclusions: The proposed CT-based predictive strategy can achieve individualized prediction of PFS probability to EGFR-TKI therapy in NSCLCs, which holds promise of improving the pretherapy personalized management of TKIs. Clin Cancer Res; 24(15); 3583–92. ©2018 AACR.

// <![CDATA[ $('.header-date').hide();$('#titleAuthors').hide();$('#abstractHeader').hide(); // ]]> Wenxin Luo1, *, Wangdong Xu2, *, Lin Xia3, Dan Xie3, Lin Wang4, Zaipei Guo5, Yue Cheng1, Yi Liu2 and Weimin Li1 1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China 2Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China 3State Key Laboratory of Biotherapy and Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China 4Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China 5Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China *Wenxin Luo and Wangdong Xu contributed equally to this work, and should be considered as the co-first author Correspondence to: Weimin Li, email: [email protected] Keywords: atopic dermatitis, cataracts, mutation Received: November 07, 2016 Accepted: June 02, 2017 Published: July 31, 2017 ABSTRACT Background: Atopic dermatitis (AD) is a common skin disorder with elevated prevalence. Cataract induced by AD rarely occurs in adolescent and young adult patients, which is also called atopic cataract. Using whole exome sequencing, we aimed to explore genetic alterations among AD and atopic cataract. Result: We recruited a 19 year-old Chinese male with AD accompanied with cataracts, his father with AD and his mother without AD or cataract. Through analysis of the exomic sequence of the 3 individuals from the same family, we identified that with respect to AD, there were 162 genes mutated in both this patient and his father but not in his mother. In addition, we found 10 genes mutated in this patient only without in his parents according to cataract. Conclusion: This research suggests that coinheritance of mutations in these genes may correlate with AD, and the pathogenesis of AD complicated with cataracts was related to genetic factors.

Lung cancer is the leading cause of cancer-related death on a global scale. This study aimed to review the clinicopathological featuresof primary lung cancer and the practice in diagnoses and treatments. Medical record of patients diagnosed with primary lung cancer in West China Hospital of Sichuan University from 2008 to 2014 were retrospectively reviewed. Clinical characteristics of the patients, including pathological type, age, gender, and TNM stage were analyzed. A total of 6 458 patients were diagnosed with primary lung cancer, with male patients comprising the majority (male: 66.5%, n=4 291 vs. female: 33.5%, n=2 167). The patients had an average age of 59.22 yr., mostly (61.1%) between 50 and 70 yr. and 5.1% (n=335) under 40 yr. More than half (53.3%) of the patients were at stage IV at diagnosis, compared with 10.5% at stage I. The most common histological type was adenocarcinoma (ADC, n=3 523, 54.44%), followed by squamous cell carcinoma (SCC, n=1 637, 25.35%) and small cell lung cancer (SCLC, n=916, 14.18%). The majority of patients were confirmed with fibrobronchoscopy and surgery, and treated with surgery and chemotherapy. Patients diagnosed with primary lung cancer in West China Hospital of Sichuan University are primarily elderly men. Adenocarcinoma is the main type. Fibrobronchoscopyis the main method for diagnosis, and chemotherapy and surgery are the main treatments for lung cancer.