chemotherapy response

化疗反应
  • 文章类型: Journal Article
    小细胞肺癌(SCLC)是一种高度恶性和异质性的癌症,其治疗选择和预后预测模型有限。这里,我们分析了福尔马林固定,通过蛋白质组学分析进行手术切除的石蜡包埋(FFPE)样品,并将SCLC分层为三种蛋白质组亚型(S-I,S-II,和S-III)具有不同的临床结果和化疗反应。蛋白质组分型是一个独立的预后因素,比目前的肿瘤淋巴结转移或退伍军人管理局肺研究组分期方法表现更好。亚型分型结果可以使用来自独立队列的FFPE活检样本进一步验证。将分析扩展到手术和活检样本。S-II亚型的特征特别表明免疫疗法的潜在益处。S-III中的差异过表达蛋白,预后最差的亚型,允许我们提名潜在的治疗靶点,这表明患者选择可能为以前失败的临床试验带来新的希望。最后,对接受免疫治疗的SCLC患者的独立队列的分析验证了S-II患者在一线免疫治疗后的无进展生存期和总生存期的预测.总的来说,我们的研究为未来的临床研究提供了理论基础,以验证当前的研究结果,从而更准确地预测预后和进行精确的治疗.
    Small cell lung cancer (SCLC) is a highly malignant and heterogeneous cancer with limited therapeutic options and prognosis prediction models. Here, we analyzed formalin-fixed, paraffin-embedded (FFPE) samples of surgical resections by proteomic profiling, and stratified SCLC into three proteomic subtypes (S-I, S-II, and S-III) with distinct clinical outcomes and chemotherapy responses. The proteomic subtyping was an independent prognostic factor and performed better than current tumor-node-metastasis or Veterans Administration Lung Study Group staging methods. The subtyping results could be further validated using FFPE biopsy samples from an independent cohort, extending the analysis to both surgical and biopsy samples. The signatures of the S-II subtype in particular suggested potential benefits from immunotherapy. Differentially overexpressed proteins in S-III, the worst prognostic subtype, allowed us to nominate potential therapeutic targets, indicating that patient selection may bring new hope for previously failed clinical trials. Finally, analysis of an independent cohort of SCLC patients who had received immunotherapy validated the prediction that the S-II patients had better progression-free survival and overall survival after first-line immunotherapy. Collectively, our study provides the rationale for future clinical investigations to validate the current findings for more accurate prognosis prediction and precise treatments.
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  • 文章类型: Journal Article
    背景:膀胱癌是一种常见的恶性肿瘤,具有重要的临床意义。小泛素样修饰蛋白(SUMO)通路相关基因(SPRG)与癌症的发生和发展有关。方法:在本研究中,我们对膀胱癌中的SPRG进行了全面分析。我们分析了SPRG的基因表达和预后价值,并基于膀胱癌中的四个基因(HDAC4,TRIM27,EGR2和UBE2I)开发了SPRG特征(SPRGS)预后模型。此外,我们调查了SPRGS和基因组改变之间的关系,肿瘤微环境,化疗反应,和免疫疗法。此外,我们确定EGR2是膀胱癌的关键SPRG。免疫组化法检测EGR2在膀胱癌中的表达,细胞功能实验阐明了敲低EGR2对细胞增殖的影响,入侵,和膀胱癌细胞的迁移。结果:我们的研究结果表明,SPRGS有望作为膀胱癌化疗反应和免疫治疗疗效的预后标志物和预测生物标志物。SPRGS预后模型对膀胱癌患者的生存率显示出高预测准确性。我们还观察到SPRG和基因组改变之间的相关性,肿瘤微环境,和对化疗的反应。免疫组织化学结果显示EGR2在膀胱癌组织中高表达,其过度表达与不良预后相关。EGR2敲除抑制膀胱癌细胞增殖,入侵,和移民。结论:这项研究为膀胱癌中SPRGS的前景及其对个性化治疗策略的潜在影响提供了有价值的见解。EGR2作为关键SPRG的鉴定及其对膀胱癌细胞的功能影响进一步突出了其在膀胱癌发生发展中的意义。总的来说,SPRGS可能作为膀胱癌患者的重要预后标志物和预测生物标志物。指导治疗决策并改善患者预后。
    Background: Bladder cancer is a prevalent malignancy with significant clinical implications. Small Ubiquitin-like Modifier (SUMO) pathway related genes (SPRG) have been implicated in the development and progression of cancer. Methods: In this study, we conducted a comprehensive analysis of SPRG in bladder cancer. We analyzed gene expression and prognostic value of SPRG and developed a SPRG signature (SPRGS) prognostic model based on four genes (HDAC4, TRIM27, EGR2, and UBE2I) in bladder cancer. Furthermore, we investigated the relationship between SPRGS and genomic alterations, tumor microenvironment, chemotherapy response, and immunotherapy. Additionally, we identified EGR2 as a key SPRG in bladder cancer. The expression of EGR2 in bladder cancer was detected by immunohistochemistry, and the cell function experiment clarified the effect of knocking down EGR2 on the proliferation, invasion, and migration of bladder cancer cells. Results: Our findings suggest that SPRGS hold promise as prognostic markers and predictive biomarkers for chemotherapy response and immunotherapy efficacy in bladder cancer. The SPRGS prognostic model exhibited high predictive accuracy for bladder cancer patient survival. We also observed correlations between SPRG and genomic alterations, tumor microenvironment, and response to chemotherapy. Immunohistochemical results showed that EGR2 was highly expressed in bladder cancer tissues, and its overexpression was associated with poor prognosis. Knockdown of EGR2 inhibited bladder cancer cell proliferation, invasion, and migration. Conclusion: This study provides valuable insights into the landscape of SPRGS in bladder cancer and their potential implications for personalized treatment strategies. The identification of EGR2 as a key SPRG and its functional impact on bladder cancer cells further highlights its significance in bladder cancer development and progression. Overall, SPRGS may serve as important prognostic markers and predictive biomarkers for bladder cancer patients, guiding treatment decisions and improving patient outcomes.
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  • 文章类型: Journal Article
    这项研究调查了身体质量指数(BMI)对乳腺癌(BC)患者生活质量(QoL)和治疗结果的影响。特别是关注营养状况受损的体重不足的人。一项非随机前瞻性研究包括121名不同BMI类别的新诊断患者,使用FACT-B和FACIT-Sp-12问卷。随访发生在基线,在(第三和第六)期间,在(12个月)蒽环类-紫杉烷化疗后,顺序地或伴随地。低BMI患者(<18.5kg/m2;53.7%)表现出明显较差的QoL,以营养指标受损(低MUAC和SFT)为标志。重复测量方差分析确定了BMI组间在功能、社会,和情绪QoL方面(p<0.05),在其他领域没有显著差异。卡方(2)检验强调了BMI与治疗反应之间的显着联系(p<0.0001),在体重过轻的患者中显示出较高的无应答率(p=4.259e-14)。该研究提倡与营养师进行预处理咨询,作为印度BC患者的标准护理,提供免费营养支持,以改善QoL结果和治疗反应。
    This study investigates the impact of Body Mass Index (BMI) on Quality of Life (QoL) and treatment outcomes in breast cancer (BC) patients, particularly focusing on underweight individuals with compromised nutritional status. A nonrandomized prospective study comprising 121 newly diagnosed patients across various BMI categories utilized FACT-B & FACIT-Sp-12 questionnaires. Follow-ups occurred at baseline, during (3rd and 6th), and after (12th month) anthracycline-taxane chemotherapy, either sequentially or concomitantly. Patients with low BMI (<18.5 kg/m2; 53.7%) exhibited significantly poorer QoL, marked by compromised nutritional indicators (low MUAC and SFT). Repeated measures ANOVA identified significant correlations between BMI groups in functional, social, and emotional QoL aspects (p < 0.05), with no notable differences in other domains. A Chi-square (ꭓ2) test underscored a significant link between BMI and treatment response (p < 0.0001), showing higher rates of non-responders among underweight patients (p = 4.259e-14). The study advocates pretreatment consultation with a dietitian as standard care for Indian BC patients, offering complimentary nutritional support for improved QoL outcomes and treatment responses.
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  • 文章类型: Journal Article
    神经母细胞瘤是儿童中最具破坏性的颅外实体恶性肿瘤。尽管有严格的治疗方案,高危神经母细胞瘤患者的预后仍然很差,存活率不到40%。到目前为止,MYCN扩增状态被认为是最预后的因素,但仅对应于~25%的神经母细胞瘤患者。因此,在神经母细胞瘤患者中确定更好的预后和治疗反应标志物至关重要.我们应用了强大的生物信息学数据挖掘工具,如加权基因共表达网络分析,cisTarget,以及两个神经母细胞瘤患者数据集上的单细胞调控网络推断和聚类。我们发现Sin3A相关蛋白30(SAP30),与高风险呈正相关的驱动转录因子,programming,第4阶段,以及神经母细胞瘤患者队列中的低生存率。高风险神经母细胞瘤患者和复发特异性患者来源的异种移植物的肿瘤显示较高的SAP30水平。先进的药物基因组学分析和CRISPR-Cas9筛选表明SAP30的必要性与顺铂耐药性相关,并且在顺铂耐药性患者来源的异种移植肿瘤细胞系中进一步显示出更高的水平。SAP30的沉默在体外诱导细胞死亡,并导致体内肿瘤负荷和大小降低。总之,这些结果表明,SAP30是更好的预后和顺铂耐药标志物,因此是高危神经母细胞瘤的潜在药物靶点.
    Neuroblastoma is the most devastating extracranial solid malignancy in children. Despite an intense treatment regimen, the prognosis for high-risk neuroblastoma patients remains poor, with less than 40% survival. So far, MYCN amplification status is considered the most prognostic factor but corresponds to only ∼25% of neuroblastoma patients. Therefore, it is essential to identify a better prognosis and therapy response marker in neuroblastoma patients. We applied robust bioinformatic data mining tools, such as weighted gene co-expression network analysis, cisTarget, and single-cell regulatory network inference and clustering on two neuroblastoma patient datasets. We found Sin3A-associated protein 30 (SAP30), a driver transcription factor positively associated with high-risk, progression, stage 4, and poor survival in neuroblastoma patient cohorts. Tumors of high-risk neuroblastoma patients and relapse-specific patient-derived xenografts showed higher SAP30 levels. The advanced pharmacogenomic analysis and CRISPR-Cas9 screens indicated that SAP30 essentiality is associated with cisplatin resistance and further showed higher levels in cisplatin-resistant patient-derived xenograft tumor cell lines. Silencing of SAP30 induced cell death in vitro and led to a reduced tumor burden and size in vivo. Altogether, these results indicate that SAP30 is a better prognostic and cisplatin-resistance marker and thus a potential drug target in high-risk neuroblastoma.
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  • 文章类型: Journal Article
    背景:必须监测浸润性乳腺癌(IBC)患者对新辅助化疗(NC)的反应,和生物标志物是必要的。NC可以在其微环境中激活抗肿瘤免疫反应,称为肿瘤浸润淋巴细胞(TIL)。TIL成分被认为具有很大的潜力作为预测因子是CD4+,CD8+,和FOXP3+TIL。这项研究旨在探索TIL成分,这些成分可能是NC病理反应的预测生物标志物。
    方法:根据CD4+、CD8+,和FOXP3+TIL表达与Miller-Payne(MP)分级系统。年龄,肿瘤分级,PR,ER,还评估了Ki-67和HER2。CD4+,CD8+,和FOXP3+TIL表达通过IHC染色进行分析,而其他数据是从档案馆收集的。使用单变量和多变量分析对数据进行分析。
    结果:单因素分析显示CD4+TIL和MP之间存在显著关系(p<0.001),CD8+和MP(p=0.004),和FOXP3与MP(p<0.001)。三种生物标志物在一个模型中的同时整合不足以成为预测模型。因此,本研究通过测试结合现有3种生物标志物中2种的几种替代模型进行了探索性分析.结果表明,模型2中的CD4TIL(CD4CD8)和模型4中的FOXP3TIL(CD8FOXP3)显示出明显的系数值。此外,模型4中的所有阈值系数都很重要。
    结论:这项研究表明,CD4+,CD8+,和FOXP3+TIL具有作为预测生物标志物的潜力。特别是,FOXP3+在IBC患者病理反应的预测模型中占主导地位。
    BACKGROUND: Response to neoadjuvant chemotherapy (NC) in individuals with invasive breast cancer (IBC) must be monitored, and biomarkers are needed. NC can activate an anti-tumour immune response in its microenvironment, known as Tumor-infiltrating Lymphocytes (TIL). TIL components believed to have great potential as predictors are CD4+, CD8+, and FOXP3+ TIL. This study aims to explore TIL components that can potentially be predictive biomarkers of NC pathological responses.
    METHODS: A sample size of 40 were analyzed based on the relationship between CD4+, CD8+, and FOXP3+ TIL expression with the Miller-Payne (MP) grading system. Age, tumour grade, PR, ER, Ki-67, and HER2 were also evaluated. CD4+, CD8+, and FOXP3+ TIL expressions were analayzed by IHC staining, while other data were collected from archives. Data was analyzed using univariate and multivariate analysis.
    RESULTS: Univariate analysis showed a significant relationship between CD4+ TIL and MP (p<0.001), CD8+ and MP (p=0.004), and FOXP3 with MP (p<0.001). The simultaneous integration of the three biomarkers in one model was not good enough to be a predictive model. Therefore, an exploratory analysis was conducted by testing several alternative models that combined two of the three existing biomarkers. It turned out that CD4+ TIL in model 2 (CD4+CD8+) and FOXP3+ TIL in model 4 (CD8+FOXP3+) showed significant coefficient values. Moreover, all of the threshold coefficients in model 4 are significant.
    CONCLUSIONS: This study shows that CD4+, CD8+, and FOXP3+ TIL have promising potential as predictive biomarkers. In particular, FOXP3+ is dominant in predictive models of pathological response in patients with IBC.
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  • 文章类型: Journal Article
    肠道菌群在抗癌治疗中的参与越来越受到关注。肠道细菌结构和功能的改变是癌症发展以及化疗疗效的重要因素。最近的研究已经证实,肠道菌群和相关代谢产物通过与免疫系统的相互作用影响化疗药物的药理活性。这篇综述旨在总结目前有关恶性肿瘤和化疗如何影响肠道菌群的知识。肠道微生物群如何调节宿主免疫反应,以及肠道菌群和宿主免疫反应之间的相互作用如何影响化疗的疗效。还描述了基于肠道微生物群提高化疗效率的策略的最新进展。破译由肠道微生物群和宿主免疫维持的复杂稳态为化疗中的细菌干预提供了坚实的科学依据。
    The involvement of the gut microbiota in anti-cancer treatment has gained increasing attention. Alterations to the structure and function of the gut bacteria are important factors in the development of cancer as well as the efficacy of chemotherapy. Recent studies have confirmed that the gut microbiota and related metabolites influence the pharmacological activity of chemotherapeutic agents through interactions with the immune system. This review aims to summarize the current knowledge of how malignant tumor and chemotherapy affect the gut microbiota, how the gut microbiota regulates host immune response, and how interactions between the gut microbiota and host immune response influence the efficacy of chemotherapy. Recent advances in strategies for increasing the efficiency of chemotherapy based on the gut microbiota are also described. Deciphering the complex homeostasis maintained by the gut microbiota and host immunity provides a solid scientific basis for bacterial intervention in chemotherapy.
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  • 文章类型: Case Reports
    骨肉瘤是最常见的原发性骨癌,通常出现在股骨远端。这种情况的诊断通常涉及高级成像和组织活检,以及考虑到特征性的临床和影像学指标。股骨远端骨肉瘤的治疗方法是多学科的,涉及初始化疗,接着是保肢手术,骨和软组织重建,以及随后的辅助化疗。我们提供了一个案例研究,该案例研究涉及一名25岁的男性,该男性在股骨远端患有疱疹性病变,通过开放活检证实是成骨细胞骨肉瘤。进一步评估显示肺部多发结节病变,用化疗管理。四个月后,观察到病变的消退。由于恶性的临床和影像学特征,切除病变并随后进行重建,利用定制的全膝关节置换术。切除包括去除股骨远端14厘米,组织学检查证实中央成骨细胞骨肉瘤。在一年的随访中观察到满意的结果,表明有希望的结果。警惕至关重要,尤其是年轻的表面型骨肿瘤患者,因为这个肿瘤需要考虑。
    Osteosarcoma is the most common type of primary bone cancer, which usually appears in the distal femur. The diagnosis of this condition typically involves advanced imaging and tissue biopsy, as well as taking into account characteristic clinical and radiographic indicators. The treatment approach for distal femoral osteosarcoma is multidisciplinary and involves initial chemotherapy, followed by limb-sparing surgery, reconstruction of bone and soft tissue, and subsequent adjuvant chemotherapy. We present a case study of a 25-year-old male admitted with a blastic lesion in the distal femur, confirmed via open biopsy to be osteoblastic osteosarcoma. Further evaluation revealed multiple pulmonary nodular lesions, managed with chemotherapy. After four months, regression of the lesion was observed. Due to malignant clinical and imaging features, excision of the lesion and subsequent reconstruction were performed, utilizing a custom-made total knee arthroplasty. The excision encompassed the removal of the distal 14 cm of the femur, with histological examination confirming central osteoblastic osteosarcoma. Satisfactory outcomes were observed during a one-year follow-up, indicating promising results. Vigilance is crucial, especially in young patients with surface-type bone tumors, as this neoplasm requires consideration.
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  • 文章类型: Journal Article
    随着免疫检查点抑制剂(ICIs)的兴起,评估食管鳞状细胞癌(ESCC)中程序性死亡配体1(PD-L1)的表达变得越来越重要。然而,挑战依然存在,包括主观解释和染色强度的不明确意义,以及在肿瘤和基质区域的对比作用。我们的研究通过分析PD-L1在肿瘤和基质中的表达与H评分,增强了对ESCCs中PD-L1的理解。突出了其独特的临床病理影响。在来自手术切除的194例ESCC标本的回顾性队列中,我们使用H评分量化肿瘤和基质区室中的PD-L1表达,用数字病理分析软件分析整个幻灯片图像。Kaplan-Meier分析表明,较高的PD-L1表达与肿瘤和基质区域的术后总生存期(OS)和无复发生存期(RFS)的改善显着相关。多变量分析确定肿瘤PD-L1高表达是OS和RFS延长的独立预后因素(分别为HR=0.47,p=0.007;HR=0.54,p=0.022)。在单独的分析中,发现高基质PD-L1表达与较不晚期的病理阶段和对细胞毒性化疗的长期反应相关,与ICI治疗反应没有类似的相关性。本研究揭示了PD-L1在ESCC肿瘤免疫微环境中的对比作用,影响预后,肿瘤分期,和治疗反应。
    The assessment of programmed death-ligand 1 (PD-L1) expression in esophageal squamous cell carcinoma (ESCC) has become increasingly important with the rise of immune checkpoint inhibitors (ICIs). However, challenges persist, including subjective interpretation and the unclear significance of staining intensity, as well as contrasting roles in tumoral and stromal regions. Our study enhances the understanding of PD-L1 in ESCCs by analyzing its expression in tumors and stroma with H-scores, highlighting its distinct clinicopathological impacts. In a retrospective cohort of 194 ESCC specimens from surgical resection, we quantified PD-L1 expression in tumoral and stromal compartments using H-scores, analyzing whole slide images with digital pathology analysis software. Kaplan-Meier analysis demonstrated that higher PD-L1 expression is significantly associated with improved postoperative overall survival (OS) and recurrence-free survival (RFS) in both tumoral and stromal areas. Multivariable analysis identified high tumoral PD-L1 expression as an independent prognostic factor for prolonged OS and RFS (HR = 0.47, p = 0.007; HR = 0.54, p = 0.022, respectively). In a separate analysis, high stromal PD-L1 expression was found to correlate with less advanced pathological stages and a prolonged response to cytotoxic chemotherapy, with no similar correlation found for ICI treatment response. This study reveals PD-L1\'s contrasting role in the ESCC tumor immune microenvironment, impacting prognosis, tumor stage, and treatment response.
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  • 文章类型: Journal Article
    背景:目前尚不清楚提取肿瘤周体积(PTV)影像组学特征是否是评估上皮性卵巢癌(EOC)化疗反应的有用工具。
    目的:评估捕获PTV细微变化的MRI影像组学特征(RS)及其对整个肿瘤体积(WTV)的评估性能,以评估EOC患者对化疗的反应。
    方法:回顾性。
    方法:纳入219例患者,年龄从15岁到79岁。
    3.0或1.5T,轴向脂肪抑制T2加权成像(FS-T2WI),弥散加权成像(DWI),和对比增强T1加权成像(CE-T1WI)。
    结果:从四个轴向序列和六个不同的感兴趣体积(VOIs)(WTV和WTVPTV(WPTV))中提取了MRI特征,其周围大小(PS)范围从1到5毫米。这些特征经过了预处理,使用最小冗余最大相关性和最小绝对收缩和选择算子选择信息最多的特征来构建RS。最优RS,然后,通过多变量逻辑回归将受试者工作特征曲线下面积(AUC)最高的受试者工作特征与独立临床特征整合,构建影像组学-临床模型(RCM).
    方法:Mann-WhitneyU检验,卡方检验,DeLong测试,对数秩检验。P<0.05表示差异显著。
    结果:在WPTV上构建的所有RS表现出比WTV(0.671)更高的AUC(0.720-0.756)。其中,PS=2mm的RS表现出显著更好的性能(AUC=0.756)。国际妇产科联合会(FIGO)分期被确定为独家独立临床评价特征,RCM的AUC(0.790)高于RS,但无统计学意义(P=0.261)。
    结论:从PTV中提取的影像组学特征可以提高WTV影像组学评估EOC化疗反应的效率。2mmPTV的截止值是获得有效评估效率的合理值。
    方法:4技术效果:阶段2。
    BACKGROUND: It remains unclear whether extracting peritumoral volume (PTV) radiomics features are useful tools for evaluating response to chemotherapy of epithelial ovarian cancer (EOC).
    OBJECTIVE: To evaluate MRI radiomics signatures (RS) capturing subtle changes of PTV and their added evaluation performance to whole tumor volume (WTV) for response to chemotherapy in patients with EOC.
    METHODS: Retrospective.
    METHODS: 219 patients aged from 15 to 79 years were enrolled.
    UNASSIGNED: 3.0 or 1.5T, axial fat-suppressed T2-weighted imaging (FS-T2WI), diffusion-weighted imaging (DWI), and contrast enhanced T1-weighted imaging (CE-T1WI).
    RESULTS: MRI features were extracted from the four axial sequences and six different volumes of interest (VOIs) (WTV and WTV + PTV (WPTV)) with different peritumor sizes (PS) ranging from 1 to 5 mm. Those features underwent preprocessing, and the most informative features were selected using minimum redundancy maximum relevance and least absolute shrinkage and selection operator to construct the RS. The optimal RS, with the highest area under the curve (AUC) of receiver operating characteristic was then integrated with independent clinical characteristics through multivariable logistic regression to construct the radiomics-clinical model (RCM).
    METHODS: Mann-Whitney U test, chi-squared test, DeLong test, log-rank test. P < 0.05 indicated a significant difference.
    RESULTS: All the RSs constructed on WPTV exhibited higher AUCs (0.720-0.756) than WTV (0.671). Of which, RS with PS = 2 mm displayed a significantly better performance (AUC = 0.756). International Federation of Gynecology and Obstetrics (FIGO) stage was identified as the exclusive independent clinical evaluation characteristic, and the RCM demonstrated higher AUC (0.790) than the RS, but without statistical significance (P = 0.261).
    CONCLUSIONS: The radiomics features extracted from PTV could increase the efficiency of WTV radiomics for evaluating the chemotherapy response of EOC. The cut-off of 2 mm PTV was a reasonable value to obtain effective evaluation efficiency.
    METHODS: 4 TECHNICAL EFFICACY: Stage 2.
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  • 文章类型: Case Reports
    肺肉瘤样癌(SC)是一类异质性散发性的非小细胞肺癌(NSCLCs),诊断和治疗具有挑战性。梭形细胞癌(SpCC)是该组中非常罕见的子集。因此,由于文献有限,预后和治疗尚不清楚.这种癌症的表现根据肿瘤的部位以及诊断时观察到的并发症和转移而变化。这里,我们报道了一名73岁的男性,他在呼吸困难和疲劳恶化两个月后到急诊室就诊.胸部X线显示广泛的左侧胸腔积液。胸部计算机断层扫描(CT)扫描显示胸膜肿块,返回为SpCC,为此他被转诊到一所大学医院。
    The lung\'s sarcomatoid carcinomas (SC) are a heterogeneous sporadic group of non-small cell lung carcinomas (NSCLCs) and are very challenging to diagnose and treat. Spindle cell carcinoma (SpCC) is a very rare subset of this group. Hence, the prognosis and treatments are unclear due to the limited literature available. The presentation of this cancer varies based on the site of the neoplasm and the complications and metastases observed at the time of diagnosis. Here, we report a 73-year-old man who presented to the emergency room after two months of worsening dyspnea and fatigue. Chest X-ray showed an extensive left-sided pleural effusion. A computed tomography (CT) scan of the chest showed a pleural-based mass that came back as SpCC, for which he was referred to a university hospital.
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