Lung cancer : journal of the International Association for the Study of Lung Cancer
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We developed a bronchoscope insertion guidance system that produces virtual images by extracting the bronchi by automatic threshold adjustment, and searching for the bronchial route to the determined target. We used this system in combination with a thin bronchoscope and endobronchial ultrasonography with a guide sheath (EBUS-GS), and evaluated its practicability, usefulness and safety. The subjects were 31 patients with 32 peripheral pulmonary lesions. ⋯ The median total examination time was 22.3 (9.8-41.5) min. In summary, using the bronchoscope insertion guidance system, virtual images can be readily produced, and the bronchoscope can be successfully guided to the target. This method is promising as a routine examination method in the biopsy of peripheral pulmonary lesions.
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The epidermal growth factor receptor (EGFR) has been implicated in the pathophysiology of various cancers, including non-small cell lung cancer (NSCLC). Inhibitors targeting the tyrosine kinase domain of this receptor have been seen to elicit favourable responses in a subset of NSCLC patients. Mutational analysis of the EGFR has revealed that the response to reversible tyrosine kinase inhibitors (TKIs) is a result of the presence of activating mutations present between exons 18 and 21, most frequently the exon 19 deletion and the L858R mutations. ⋯ In addition to the predominant mutations in the EGFR gene, alternative genetic changes between exons 18 and 21 have been observed. Experimental models have demonstrated that TKIs exhibit differential efficacy depending on which mutations are present. Such information may result in the design of highly specific agents that target specific mutations, which could result in more efficacious treatments.
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Numerous studies indicate that smoking is associated with many factors that contribute to poorer outcomes in patients with lung cancer and may limit the efficacy of treatment, especially in advanced non-small cell lung cancer (NSCLC), but little is known about its effect on treatment of resected NSCLC. The aim of this study was to determine the impact of smoking on adjuvant chemotherapy in patients with NSCLC. Another objective of our study was to investigate the relationship between smoking status and the clinical characteristics of patients with NSCLC. ⋯ A patient with PY>22.75 is more likely to develop squamous cell lung cancer. In non-smokers and patients with PY< or=10, adjuvant chemotherapy has a survival benefit.
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Functional genomics has emerged over the past 10 years as a novel technology to study genetic alterations. Gene expression arrays are one genomic technique employed to discover changes in the DNA expression that occur in neoplastic transformation. Microarrays have been applied to investigating lung cancer. ⋯ Microarrays can also be applied to improve diagnosis, staging and discover prognostic markers. The eventual goal of this technology is to discover new markers for therapy and to customize therapy based on an individual tumor genetic composition. In this review, we present the current state of gene expression array technology in its application to lung cancer.
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The natural history of lung adenocarcinoma with ground-glass opacity (GGO) remains undetermined. We describe a lung adenocarcinoma in which GGO transformed through a scar-like lesion over the long term into a solid nodule of poorly differentiated adenocarcinoma. Whether poorly differentiated lung adenocarcinoma can evolve from GGO-type adenocarcinoma is an important issue that requires clarification.