Journal of thoracic disease最新文献

{"title":"Association of CT characteristics of osteosarcoma lung metastases with spontaneous pneumothorax: a retrospective analysis.","authors":"Jianqi Li, Chengfen Deng, Jun Yuan, Haolin Jia, Lin Peng","doi":"10.21037/jtd-24-1015","DOIUrl":"https://doi.org/10.21037/jtd-24-1015","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous pneumothorax (SP) has been reported to be associated with osteosarcoma lung metastases, but the computed tomography (CT) characteristics of lung metastases in patients with pneumothorax have not been comprehensively described. The study aimed to describe the CT characteristics of lung metastases in patients with osteosarcoma and to identify factors associated with SP.</p><p><strong>Methods: </strong>This study comprised 123 patients diagnosed with osteosarcoma lung metastasis at our hospital between January 2016 and December 2021. Demographics, tumor characteristics at initial diagnosis, the time interval between diagnosis of lung metastases and pneumothorax, and features of lung metastases on chest CT were documented.</p><p><strong>Results: </strong>A total of 31 patients experienced SP (20 unilateral and 11 bilateral cases). Lung metastases were identified as multiple nodules or masses (39/42 <i>vs.</i> 123/204, P<0.001), with higher rates of cavitation and pleural involvement (23/42 <i>vs.</i> 19/178, P<0.001 and 38/42 <i>vs.</i> 63/178, P<0.001, respectively) in patients with pneumothorax. A considerable prevalence of calcification (123/220) was observed in lung metastases. However, no statistically significant difference was found between patients with and without pneumothorax. The duration of detection of lung metastases was shorter in patients with pneumothorax than in those without it (6 <i>vs.</i> 11 months, P=0.039). Binary logistic regression analysis revealed that only the presence of cavitation and pleural involvement of lung metastases were significantly associated with pneumothorax, with odds ratios of 12.430 [95% confidence interval (CI): 3.011-51.320; P<0.001] and 15.480 (95% CI: 4.038-59.348; P<0.001), respectively.</p><p><strong>Conclusions: </strong>SP can occur in the region of lung metastases near the pleura following the formation and bursting of cavities. Regular follow-up of these patients has the potential to ensure early detection and treatment of pneumothorax.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8417-8423"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive bioinformatics analysis of prognosis and immunotherapy in lung adenocarcinoma.","authors":"Ling Peng, Luping Xia, Meiyu Yang, Yali Wen, Qinghua Zeng","doi":"10.21037/jtd-24-1530","DOIUrl":"https://doi.org/10.21037/jtd-24-1530","url":null,"abstract":"<p><strong>Background: </strong>Research has shown that genetic mutations play an important role in the prognosis of lung adenocarcinoma (LUAD). However, the genes that influence the prognosis and immunotherapy of lung cancer patients have not yet been thoroughly studied. In this study, data from The Cancer Genome Atlas (TCGA) Program and other databases were used to identify the survival-related genes in LUAD.</p><p><strong>Methods: </strong>First, the TCGA database was used to screen key LUAD genes. Second, the Gene Expression Profiling Interactive Analysis 2 (GEPIA2), University of ALabama at Birmingham CANcer (UALCAN), Tumor IMmune Estimation Resource (TIMER), Kaplan-Meier plotter, and cBioPortal databases, and a univariate Cox analysis combined with a random forest (RF) model were used to estimate gene expression, patient prognosis, and gene mutations, respectively. TIMER was also used to predict the immune function of the genes.</p><p><strong>Results: </strong>A total of 2,138 up-regulated and 2,559 down-regulated differentially expressed genes (DEGs) were identified from TCGA-LUAD dataset. Next, four prognostic genes (i.e., <i>CENPH</i>, <i>SLC35F4</i>, <i>TESMIN</i>, and <i>TERT</i>) were identified as the key genes. The expression levels of all four genes were higher in LUAD tissues than those in the normal lung tissues, but only <i>CENPH</i> and <i>TESMIN</i> were correlated with poor overall survival (OS). The four genes were also found to be associated with immunoinfiltration.</p><p><strong>Conclusions: </strong>Of the four key genes identified, <i>CENPH</i> and <i>TESMIN</i> would not only contribute to the diagnosis and prognosis of LUAD but could also serve as potential immunotherapy targets for LUAD.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8633-8647"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoplasmic reticulum stress-MMRN1 positive feedback contributes to cisplatin resistance in small cell lung cancer.","authors":"Mingxin Liu, Peihong Hu, Bo Tang, Qi Yang, Run Xiang, Yiqiang Liu, Juan Li, Binghuo Wu, Hong Wu, Bo Tian, Chuan Xu, Qiang Li","doi":"10.21037/jtd-24-1477","DOIUrl":"10.21037/jtd-24-1477","url":null,"abstract":"<p><strong>Background: </strong>Small cell lung cancer (SCLC) accounts for 15% of all lung cancers and presents early metastasis and poor prognosis. Chemotherapy with cisplatin (CDDP) remains one of the standards of care in first-line treatment. However, the emergence of acquired resistance to CDDP causes disease progression and cancer recurrence. A comprehensive understanding of the CDDP-resistant mechanisms aids in defining accurate biomarkers and developing potential strategies.</p><p><strong>Methods: </strong>The liquid chromatograph mass spectrometer (LC-MS/MS) was conducted to analyze the differential exosomal proteins from plasma samples of SCLC patients with non-treatment or resistance to CDDP. The online RNA-seq data with clinicopathological information on SCLC patients were downloaded from the Gene Expression Omnibus (GEO) database for further prognostic analysis. The SCLC cell line model of acquired CDDP resistance was established to investigate the role of platelet protein multimerin-1 (MMRN1) in CDDP resistance.</p><p><strong>Results: </strong>MMRN1 was increased in CDDP-resistant SCLC patients and cell line models. Reduction of MMRN1 recovered the sensitivity to CDDP while overexpression of MMRN1 conferred CDDP resistance. The CDDP-resistant SCLC cells disseminated resistant to the CDDP-sensitive SCLC cells via the exosomal MMRN1. Additionally, CDDP treatment induces endoplasmic reticulum (ER) stress and subsequent upregulation of MMRN1. Increasing MMRN1 interacted with binding immunoglobulin protein (BiP) in the ER, maintaining the ER stress in SCLC cells.</p><p><strong>Conclusions: </strong>The present study identified exosomal MMRN1 as a potential biomarker for CDDP resistance in SCLC. MMRN1 sustains ER stress via interaction with BiP and subsequently facilitates CDDP resistance, which might be a promising therapeutic target to overcome CDDP resistance.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8363-8378"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of causal associations between cerebral cortical structure and Barrett's esophagus: insights from Mendelian randomization and meta-analysis.","authors":"Qiong Liu, Xiaofang Liu, Mengge Gao, Bo Yang, Miaoqing Luo, Biying Yang, Guojun Liang","doi":"10.21037/jtd-24-698","DOIUrl":"10.21037/jtd-24-698","url":null,"abstract":"<p><strong>Background: </strong>Barrett's esophagus (BE) is a precancerous condition often associated with esophageal adenocarcinoma, influenced by both genetic and environmental factors. However, there is controversy regarding the causal relationship between cerebral cortical structures and BE, with recent studies suggesting a potential neurobiological component to its multifactorial etiology. This study aims to clarify this relationship by utilizing Mendelian randomization (MR) analysis to investigate the potential causal effects of cortical structure variations on BE risk.</p><p><strong>Methods: </strong>Comprehensive MR analyses was utilized to examine the potential causal associations between variations in cerebral cortical structure, specifically cortical thickness (TH) and surface area (SA), and the susceptibility to developing BE. Data were obtained from two genome-wide association study (GWAS) repositories. Instrumental variables were chosen using rigorous criteria, and the analysis was enhanced by employing inverse variance weighting and three additional methods, as well as conducting sensitivity analyses to evaluate the reliability of our results. In the validation stage, we used meta-analysis to combine the effect sizes to obtain robust causal relationships.</p><p><strong>Results: </strong>Initial MR findings indicated significant associations between cortical structural features in several specific regions and BE. The meta-analysis confirmed a consistent negative correlation with BE for increased cortical TH in the supramarginal and pars orbitalis regions, and a positive correlation for increased SA in the middle temporal region. Additional initial positive findings did not maintain significance in the meta-analysis, suggesting the need for cautious interpretation and further validation.</p><p><strong>Conclusions: </strong>Our study underscores the gastrointestinal-brain axis hypothesis, identifying cortical structure integrity as a potential modifier of BE risk, highlighting the importance of considering neurobiological factors in its pathogenesis. Understanding these associations could have significant clinical implications, particularly in developing targeted interventions to modify BE risk based on neurological pathways.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8582-8601"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining cardiac and renal biomarkers to establish a clinical early prediction model for cardiac surgery-associated acute kidney injury: a prospective observational study.","authors":"Jiaxin Li, Jinlin Wu, Liming Lei, Bowen Gu, Han Wang, Yusheng Xu, Chunbo Chen, Miaoxian Fang","doi":"10.21037/jtd-24-1185","DOIUrl":"https://doi.org/10.21037/jtd-24-1185","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery-associated acute kidney injury (CSA-AKI) is a prevalent complication with poor outcomes, and its early prediction remains a challenging task. Currently available biomarkers for acute kidney injury (AKI) include serum cystatin C (sCysC) and urinary N-acetyl-β-D-glucosaminidase (uNAG). Widely used biomarkers for assessing cardiac function and injury are N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). In light of this, our study aimed to evaluate the effectiveness of these four biomarkers in predicting CSA-AKI.</p><p><strong>Methods: </strong>This prospective observational study enrolled adult patients who had undergone cardiac surgery. The clinical prediction model for CSA-AKI was developed using the least absolute shrinkage and selection operator (LASSO) regression method. The model's performance was assessed using the area under the curve of the receiver operating characteristic (ROC-AUC), decision curve analysis (DCA), and calibration curves. Furthermore, a separate validation cohort was constructed to externally validate the prediction model. Additionally, a risk nomogram was created to facilitate risk assessment and prediction.</p><p><strong>Results: </strong>In the modeling cohort consisting of 689 patients and the validation cohort consisting of 313 patients, the total incidence of CSA-AKI was 33.4%. The LASSO regression identified several predictors, including age, history of hypertension, baseline serum creatinine (sCr), coronary artery bypass grafting combined with valve surgery, cardiopulmonary bypass duration, preoperative albumin, hemoglobin, postoperative NT-proBNP, cTnI, sCysC, and uNAG. The constructed clinical prediction model demonstrated robust performance, with a ROC-AUC of 0.830 (0.800-0.860) in the modeling cohort and 0.840 (0.790-0.880) in the validation cohort. Furthermore, both calibration and DCA indicated good model fit and clinical benefit.</p><p><strong>Conclusions: </strong>This study demonstrates that incorporating the immediately postoperative renal biomarkers, sCysC and uNAG, along with the cardiac biomarkers, NT-proBNP and cTnI, into a clinical early prediction model can significantly enhance the accuracy of predicting CSA-AKI. These findings suggest that a comprehensive approach combining both renal and cardiac biomarkers holds promise for improving the early detection and prediction of CSA-AKI.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8399-8416"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term success of cardiovascular surgery in Takayasu arteritis: 48 years of experience in Mexico, beyond forefront techniques.","authors":"María Elena Soto, Victor Gabriel Gómez-Saviñón, Cuauhtémoc Vásquez-Jiménez, Rodolfo Barragán-Garcia, Iván Hernandez-Mejia, Solange Gabriela Koretzky, Verónica Guarner-Lans, Israel Perez-Torres, Humberto Jorge Martínez-Hernández, Valentín Herrera-Alarcón","doi":"10.21037/jtd-24-709","DOIUrl":"https://doi.org/10.21037/jtd-24-709","url":null,"abstract":"<p><strong>Background: </strong>Takayasu arteritis (TA) affects medium and large caliber arteries causing stenosis, occlusion, or aneurysms. It has great predilection for the aortic arch, subclavian and extracranial arteries. The global prevalence is of 1% to 2% per million inhabitants, which varies by geographical region. The main cause of death in TA of cardiovascular origin and includes ischemic cardiomyopathy and valvular disease. The aim of this study was to evaluate the surgical experience according to the type of surgery in subjects with TA and with and without long-term inflammatory activity.</p><p><strong>Methods: </strong>This was a retrospective and descriptive, cross-sectional study, between 1969 and 2017. Patients with TA with more than 3 classification criteria according to the American College of Rheumatology were included. The type of surgery was classified as: organ preservation, cardiac, bypass, exclusion, and replacement. Inflammatory activity was evaluated.</p><p><strong>Results: </strong>A total of 41 patients were included, out of which 31 (76%) were women. The age at diagnosis was 29±10 years. The long-term survival rate according to the surgical procedure was in cardiac surgery of 15 years in 90% of cases, in organ preservation surgery of 35 years in 90%. Bypass, replacement, exclusion and other surgeries had a 100% survival at a follow-up of 48 years.</p><p><strong>Conclusions: </strong>There are different types of surgical approaches to treat the complexity of each TA patient. The surgical technique well selected by experts in cardiothoracic surgery offers an excellent long-term prognosis. Interventional management successfully resolves some arterial occlusive aspects. It is necessary to evaluate the appropriate use of surgical, interventional, and hybrid management through randomized clinical trials to evaluate their comparison with transparency.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8482-8492"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic duct identification using three-dimensional thoracoscope versus indocyanine green fluorescence during minimally invasive esophagectomy: a retrospective cohort study.","authors":"Saiguang Ji, Fuchen Xing, Hai Zhou, Jian Xu, Chenyan Wang, Hong Liu","doi":"10.21037/jtd-24-947","DOIUrl":"https://doi.org/10.21037/jtd-24-947","url":null,"abstract":"<p><strong>Background: </strong>Chylothorax following esophagectomy is a frustrating complication with considerable morbidity. In addition, recognizing the morphological patterns of the thoracic duct (TD) holds great significance. This study was aimed at explore the safety and efficacy of three-dimensional (3D) thoracoscope in comparison with indocyanine green (ICG) fluorescence to identify TD during minimally invasive esophagectomy (MIE) for esophageal cancer.</p><p><strong>Methods: </strong>A totally 354 esophageal cancer patients undergoing MIE in a single center between January 2019 and August 2023 were retrospectively analyzed, including 179 cases using fluorescent laparoscopy (the ICG group) and 175 cases with 3D laparoscopy (the 3D group). The baseline and perioperative parameters such as operation time and the TD-related complications were compared.</p><p><strong>Results: </strong>Intraoperative recognition rate of the TD in the ICG group was higher than that of the 3D group (98.9% <i>vs.</i> 96.0%), although without a significant difference. Both groups demonstrated similar operation time, estimated blood loss, chest tube drainage, the incidence of postoperative complications and the length of postoperative hospital stay, with P>0.05, respectively. Meanwhile, the ICG group showed better prevention efficacy of the TD ligation. Furthermore, the incidence of complications was not significantly different between the two groups. ICG-specified side effect was not found in this cohort.</p><p><strong>Conclusions: </strong>The ICG-guided fluorescent laparoscopy as well as the 3D thoracoscope as a simple and safe method is probably sufficient to identify the TD in real-time, which can serve as a potent tool for preventing TD injuries during MIE.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8262-8270"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of common carotid artery cannulation for elective aortic surgery-a follow-up study.","authors":"Kiril Penov, Patrick Kohnle, Matz Andreas Haugen, Dejan Radakovic, Nodir Madrahimov, Khaled Machwart, Khaled Hamouda, Rainer Leyh, Constanze Bening","doi":"10.21037/jtd-24-735","DOIUrl":"https://doi.org/10.21037/jtd-24-735","url":null,"abstract":"<p><strong>Background: </strong>The selection of the cannulation site for elective aortic surgery is mostly an individual choice based on the surgeon's experience and the surgical strategy. We evaluated the long-term outcomes of right common carotid artery (CCA) cannulation using a side graft to establish unilateral selective antegrade cerebral perfusion (uSACP).</p><p><strong>Methods: </strong>We reviewed the records of 343 patients who underwent elective ascending aortic or aortic arch surgery between 2013 and 2020. One hundred aortic procedures were performed using the right CCA as the sole arterial cannulation site under moderate hypothermic circulatory arrest (MHCA). Cross-validated least absolute shrinkage and selection operator (LASSO) and stepwise Cox regression were applied to model the effects of cannulation sites on adverse outcomes. Kaplan-Meier analysis compared mortality in the treatment group with that in the general population.</p><p><strong>Results: </strong>The mean patient age was 65.9±9.5 years (81% male). The mean MHCA temperature was 27.1±5.1 ℃, and the average uSACP duration was 13.6±7.7 minutes. The early mortality and stroke rates were 1% and 4%, respectively. After a median of 5.4 follow-up years, seven patients suffered stroke, with 92% survival at 6 years, similar to an age- and gender-matched general population (log-rank P=0.50). Multivariable analysis revealed that age at surgery was the only significant predictor of late stroke or death [hazard ratio (HR) =1.083; P=0.01; c-index 0.683). Control Doppler ultrasound examination after a median of 2.3 years found no evidence of injury or dissection of the right CCA.</p><p><strong>Conclusions: </strong>Cannulation of the right carotid artery is a safe, feasible, and practical adjunct technique for proximal aortic surgery that generates comparable short- and long-term results. Careful patient selection and techniques are essential to minimize risk.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8173-8183"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-infectious pulmonary complications after haematopoietic progenitor transplantation: a diagnostic approach.","authors":"Ana Casal, Vanessa Riveiro, Juan Suárez-Antelo, Lucía Ferreiro, Nuria Rodríguez-Núñez, María E Toubes, Luis Valdés","doi":"10.21037/jtd-24-1063","DOIUrl":"https://doi.org/10.21037/jtd-24-1063","url":null,"abstract":"<p><p>Haematopoietic stem cell transplantation (HCT) is an established treatment for a wide variety of haematological diseases, both malignant and non-malignant. Infectious and non-infectious post-HCT pulmonary complications are a major cause of morbidity and mortality, with non-infectious complications becoming more prominent in recent decades as prophylaxis has led to a decrease in infectious complications. Globally, these complications can be divided into three phases (neutropenic, early and late phase) depending on their time of onset in relation to the graft. There is a growing awareness that the assessment of the patient undergoing HCT should start before the transplantation itself. It is known that total body irradiation dose, the source of HCT, myeloablative regimens or lower baseline lung function are key risk factors in the development of pulmonary complications. In general, the treatment of these entities consists of administration of corticosteroids with variable response, which highlights the need to better understand the underlying biology in order to have new drugs with more directed targets to improve the prognosis of post-HCT non-infectious pulmonary complications. In view of the limited therapeutic response mentioned above, preventive measures for patients undergoing HCT, such as conditioning of less ablative regimens or pre-selection of high-risk cases, are of paramount importance in order to mitigate the severity of these devastating pulmonary complications.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8771-8781"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current landscape of immunotherapy in esophageal cancer: a literature review.","authors":"Mohamad M Moughnyeh, Mary Green, Binit Katuwal, Zane T Hammoud","doi":"10.21037/jtd-24-1145","DOIUrl":"10.21037/jtd-24-1145","url":null,"abstract":"<p><strong>Background and objective: </strong>Esophageal cancer has witnessed a significant shift in its epidemiology within the United States. Adenocarcinoma of the esophagus is now the fastest-growing solid malignancy, surpassing esophageal squamous cell carcinoma (ESCC) in frequency. There has been a concentrated effort to establish new therapies for dealing with this malignancy including immunotherapy in conjunction with surgery and radiotherapy. Our objective is to provide a comprehensive review of the current therapeutic strategies for esophageal cancer, with a particular focus on the emerging role of immunotherapy in combination with surgery and radiotherapy, and its impact on treatment outcomes.</p><p><strong>Methods: </strong>A thorough search was done using keywords of \"esophageal cancer\", \"immunotherapy in esophageal cancer\", and \"immunotherapy\" in PubMed, MEDLINE, and Google Scholar databases. All studies that were identified in this search were analyzed for relevance and content.</p><p><strong>Key content and findings: </strong>A total of 1,555 studies were identified which were checked for relevance and content. Fifteen articles were reviewed which focused on esophageal cancer and the immunotherapy directed towards this condition. This review article summarizes the most recent and available evidence on immunotherapy directed towards the treatment of esophageal cancer.</p><p><strong>Conclusions: </strong>Esophageal cancer treatment is undergoing a paradigm shift with the advent of immunotherapy, particularly programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors. These therapies hold promise for both second-line and first-line settings, with evolving biomarkers guiding treatment decisions. Combination strategies and personalized approaches are actively investigated to overcome resistance mechanisms and enhance treatment outcomes in this challenging cancer type.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8807-8814"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}