BMC Pulmonary Medicine最新文献

{"title":"Predictors of occult lymph node metastasis in clinical T1 lung adenocarcinoma: a retrospective dual-center study.","authors":"Xiaoxin Huang, Xiaoxiao Huang, Kui Wang, Lijuan Liu, Guanqiao Jin","doi":"10.1186/s12890-025-03559-3","DOIUrl":"10.1186/s12890-025-03559-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical strategy for lymph node dissection in lung adenocarcinoma remains controversial. Accurate predicting occult lymph node metastasis (OLNM) in patients with clinical T1 lung adenocarcinoma is essential for optimizing treatment decisions and improving patient outcomes. This study analyzes the relationship between anaplastic lymphoma kinase (ALK) status, clinicopathological characteristics, computed tomography (CT) features, and OLNM in patients with clinical T1 lung adenocarcinoma.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from patients with clinical T1 lung adenocarcinoma who showed no lymph node metastasis on preoperative CT and underwent surgical resection with lymph node dissection at two centers from January 2016 to December 2023. Univariate and multivariate logistic regression analyses were performed to identify factors associated with OLNM.</p><p><strong>Results: </strong>Among 1138 patients with clinical T1 lung adenocarcinoma, 167 (14.6%) were found to have OLNM, including 55 (4.8%) with pathological N1 status and 112 (9.8%) with pathological N2 status. Multivariate logistic regression analysis identified lobulation, spiculation, solid density, lymphovascular invasion, spread through air spaces (STAS), micropapillary pattern, solid pattern, and carcinoembryonic antigen (CEA) levels as independent positive predictors of OLNM. Furthermore, lobulation, lymphovascular invasion, STAS, micropapillary pattern, solid pattern, CEA levels, and ALK were independent positive predictors of occult N2 lymph node metastasis. The lepidic pattern, however, was identified as an independent negative predictor for OLNM and occult N2 lymph node metastasis.</p><p><strong>Conclusion: </strong>The identified predictors may assist clinicians in evaluating the risk of OLNM in patients with clinical T1 lung adenocarcinoma, potentially guiding more targeted intervention strategies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"99"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536625","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":"PCR array analysis reveals a novel expression profile of ferroptosis-related genes in idiopathic pulmonary fibrosis.","authors":"Chenyou Shen, Wei Wang, Dong Wei, Xusheng Yang, Cheng Jiang, Yating Sheng, Yuan Chen, Jie Sun, Xiaoshan Li, Guirong Li, Shugao Ye, Jingyu Chen","doi":"10.1186/s12890-025-03555-7","DOIUrl":"10.1186/s12890-025-03555-7","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic, irreversible, and fatal disease characterized by progressive interstitial lung fibrosis. Given its insidious onset and poor outcome, there is an urgent need to elucidate the molecular mechanisms underlying IPF and identify effective therapeutic targets and diagnosis and prognosis biomarkers. Ferroptosis is an iron-dependent form of programmed cell death that occurs as lipid peroxides accumulate. Growing evidence suggests that ferroptosis is important in IPF.</p><p><strong>Methods: </strong>Human ferroptosis PCR array was performed on IPF and control lung tissue. The differentially expressed ferroptosis-related genes (DE-FRGs) were identified, underwent functional enrichment analyses, protein-protein interaction network construction, and potential drug target prediction. The DE-FRGs were validated and their value as diagnostic and prognostic blood biomarkers were evaluated using the Gene Expression Omnibus dataset GSE28042.</p><p><strong>Results: </strong>The array identified 13 DE-FRGs. Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analyses revealed that the DE-FRGs were mainly related to iron ion transport, blood microparticles, and oxidoreductase activity, and were involved in porphyrin metabolism, necroptosis, and the p53 signaling pathway in addition to ferroptosis. The 13 DE-FRGs were analyzed using the Drug-Gene Interaction Database to explore novel IPF therapeutic agents, yielding 42 potential drugs. Four DE-FRGs (BBC3, STEAP3, EPRS, SLC39A8) in the peripheral blood of IPF patients from the GSE28042 dataset demonstrated the same expression pattern as that observed in the lung tissue array. The receiver operating characteristic analysis demonstrated that the area under the curve of STEAP3 and EPRS were > 0.75. The survival analysis demonstrated that STEAP3 and EPRS were significantly different between the IPF and control groups.</p><p><strong>Conclusions: </strong>The FRG expression profiles in IPF and control lung tissue were characterized. The findings provided valuable ideas to elucidate the role of ferroptosis in IPF and aided the identification of novel IPF therapeutic targets and biomarkers.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"98"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530893","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":"β-elemene inhibits tumor-promoting in small cell lung cancer by affecting M2 macrophages and TGF-β.","authors":"Wenhui Huang, Bing Fu, Haoran Xu","doi":"10.1186/s12890-025-03533-z","DOIUrl":"10.1186/s12890-025-03533-z","url":null,"abstract":"<p><strong>Objective: </strong>M2 macrophages have been implicated in promoting tumor growth and metastasis in various cancers, including small cell lung cancer (SCLC). This study investigated the role of M2 macrophages in SCLC progression and explored the therapeutic potential of β-elemene, a natural compound, in modulating M2 macrophage-mediated tumor promotion.</p><p><strong>Methods: </strong>We differentiated THP-1 monocytes into M2 macrophages using PMA (phorbol 12-myristate 13-acetate), IL-4 (interleukin-4), and IL-13 (interleukin-13). M2 macrophages were co-cultured with the SCLC cell line NCI-H209, and CCK-8, Transwell, and flow cytometry assays were performed. TGF-β expression levels were detected by ELISA. M2 macrophages and NCI-H209 co-cultured cells were treated with β-elemene, or M2 macrophages were transfected with TGF-β shRNA lentivirus, and then co-cultured with NCI-H209 cells. Flow cytometry was used to analyze cell apoptosis. Immunofluorescence staining was performed to assess TGF-β expression.</p><p><strong>Results: </strong>Our findings demonstrate that M2 macrophages significantly enhance the viability, proliferation, and migration of SCLC cells, and this effect is associated with increased TGF-β expression in SCLC cells co-cultured with M2 macrophages. Furthermore, β-elemene treatment significantly reduced the migration and viability of SCLC cells co-cultured with M2 macrophages. Silencing TGF-β expression in M2 macrophages also suppressed SCLC cell proliferation and migration, suggesting that β-elemene may inhibit the pro-tumorigenic effects of M2 macrophages in SCLC by modulating TGF-β signaling. Immunofluorescence staining revealed that β-elemene treatment significantly reduced TGF-β levels in SCLC cells co-cultured with M2 macrophages, supporting the hypothesis that β-elemene exerts its antitumor activity by modulating the TGF-β pathway.</p><p><strong>Conclusions: </strong>Our results suggest that β-elemene has the potential to suppress SCLC development by modulating M2 macrophages and the TGF-β, offering a new therapeutic avenue and potential drug candidate for SCLC treatment.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"97"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530905","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":"Clinical characteristics of acquired anti-IFN-γ autoantibodies in patients infected with non-tuberculous mycobacteria: a prospective cohort study.","authors":"Hanlin Liang, Siqiao Liang, Yan Ning, Xuemei Huang, Ruiling Ning, Ni Chen, Limei Hong, Xiaona Liang, Siyao Wu, Ping Yan, Hongyu Wei, Zengtao Luo, Qiangxiu Zeng, Dongming Qu, Zhiyi He","doi":"10.1186/s12890-025-03566-4","DOIUrl":"10.1186/s12890-025-03566-4","url":null,"abstract":"<p><strong>Background: </strong>Patients with positive anti-IFN-γ autoantibodies (AIGAs) are characterized by susceptibility to disseminated infection by multiple pathogens. The clinical characteristics of non-tuberculous mycobacterial (NTM) infection with AIGAs positivity remain unclear.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at the First Affiliated Hospital of Guangxi Medical University from January 2021 to January 2024. A total of 93 patients diagnosed with NTM infection were divided into two groups: AIGAs-positive with NTM infection and AIGAs-negative with NTM infection. The clinical manifestations, laboratory data, imaging examination, and pathogens were analyzed to characterize the disease.</p><p><strong>Results: </strong>A total of 44 AIGAs-positive and 49 AIGAs-negative patients with NTM infection were enrolled. Disseminated infections were significantly more common among AIGAs-positive patients (P < 0.001), with frequent co-infections involving Talaromyces marneffei (TM) and viruses. Additionally, AIGAs-positive patients exhibited elevated inflammatory markers and immunoglobulins. In the AIGAs-positive group, lymph nodes, bones, skin, and blood were the most frequently affected sites. Chest CT scans exhibited a range of findings. Over a mean follow-up period of 36 months, 56.82% of patients with AIGAs positivity experienced exacerbations despite undergoing regular anti-NTM therapy.</p><p><strong>Conclusions: </strong>AIGAs-positive patients with NTM infection exhibit elevated inflammatory markers, abnormal immune indicators, and coagulation function. Disseminated infections involving multiple organs are common, with frequent co-infection with TM and viruses. These patients may have unique symptoms, signs, and imaging findings compared to AIGAs-negative patients. Recurrence is common among these patients, highlighting the need for timely identification and intervention.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"95"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522713","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":"Factors associated with low adherence to inhaled therapy in patients with chronic respiratory diseases: a cross-sectional study.","authors":"Esther Ribes Murillo, Josep Ramon Marsal Mora, Marta Micol Bachiller, Leonardo Galván Santiago, Núria Nadal Braqué, Marta Ortega Bravo","doi":"10.1186/s12890-025-03563-7","DOIUrl":"10.1186/s12890-025-03563-7","url":null,"abstract":"<p><strong>Background: </strong>Because of their high prevalence, chronic respiratory diseases, like asthma and chronic obstructive pulmonary disease, represent main public health problems. They are mainly treated through inhaled therapy. There is low adherence to such therapy, resulting in poor control of chronic respiratory diseases. However, more research is needed on the association of several factors with low adherence. The purpose of this study was to estimate the association of age, sex, type of drug, and frequency of administration with low adherence to inhaled therapy. In order to do this, we performed a cross-sectional study.</p><p><strong>Methods: </strong>We selected all patients treated with long-acting anticholinergics (LAMA), long-acting β2-adrenergics (LABA), LAMA/LABA, or inhaled corticosteroid (ICS)/LABA in the Health Area of Lleida on 16 March 2017. For each treatment, we determined the percentage of patients showing low adherence to therapy (less than 50%), calculated as drug boxes collected from the pharmacy with respect to the prescribed ones. Then, we analysed the association of age, sex, type of drug, and frequency of administration, with low adherence to therapy through a multivariate linear model.</p><p><strong>Results: </strong>11,128 people had electronic prescriptions for one of the inhaled therapy; of them, 24.6% (2,741) showed low adherence. The highest percentage of people with low adherence was found among young patients and women. Women 25-34 years of age included the highest percentage of patients with low adherence. As for drugs, the highest percentage of patients with low adherence was found among the ones treated with LABA and ICS/LABA. Finally, a higher percentage of patients with an administration frequency of 12 h presented low adherence, in comparison with patients treated every 24 h, in general and in the LABA and ICS/LABA groups.</p><p><strong>Conclusions: </strong>The differences that we observed in adherence to inhaled therapy according to the different factors analysed should be considered when managing chronic respiratory diseases and their impact on patients' clinical burden, quality of life, and costs for the health system.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"94"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522714","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":"Rapid and intense onset of granulation tissue formation following walnut aspiration: a case report.","authors":"Gökhan Aykun, Handan İnönü Köseoğlu","doi":"10.1186/s12890-024-03426-7","DOIUrl":"10.1186/s12890-024-03426-7","url":null,"abstract":"<p><p>Foreign body aspiration can affect individuals of all ages and lead to symptoms such as dyspnea, coughing, and wheezing. Complications may arise from the physical and chemical properties of the aspirated material as well as the duration of retention. This case study reports the early bronchoscopic and pathological findings of a 38-year-old male patient who aspirated walnuts. The patient underwent flexible bronchoscopy 14 h after aspiration, and a piece of walnut was successfully removed from the intermediate bronchus. During the procedure, the bronchial mucosa appeared extremely irregular and yellowish-green in color. Follow-up bronchoscopy one month later revealed regression of the previously observed granulation tissue. This case highlights the importance of early intervention in foreign body aspiration cases, especially with substances that can rapidly and intensely react with mucous membranes such as walnuts.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"96"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522715","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":"Quantitative CT and COPD: cluster analysis reveals five distinct subtypes with varying exacerbation risks.","authors":"Chusheng Peng, Zizheng Chen, Haobin Zhou, Chaoyue Dai, Haolei Yuan, Yuan Gao, Fengyan Wang, Zhenyu Liang","doi":"10.1186/s12890-025-03562-8","DOIUrl":"10.1186/s12890-025-03562-8","url":null,"abstract":"<p><strong>Background: </strong>The heterogeneity of chronic obstructive pulmonary disease (COPD) is increasingly recognized. To characterize the heterogeneity of COPD, we aimed to identify subtypes related to quantitative CT by using principal component analysis (PCA) and cluster analysis.</p><p><strong>Methods: </strong>The data of 1879 participants in the SPIROMICS study were obtained from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center. A combination of PCA and k-means clustering was used to analyze the data from these participants in the SPIROMICS study. We randomly split the samples into training and validation sets. Clusters were evaluated for their relationship with acute exacerbation risk throughout the entire follow-up period. The results of the training set were confirmed in the validation set. To avoid sampling errors, we conducted 10 random sampling cycles. Normalized mutual information (NMI) was applied in every cycle to evaluate the stability of clustering.</p><p><strong>Results: </strong>We identified five clusters related to quantitative CT characterized as follows: (1) male-dominated low disease impact cluster, (2) obesity with relatively high symptom burden cluster, (3) airway wall lesion cluster, (4) lung upper region zone-predominant emphysema cluster, (5) severe emphysema cluster. There are significant differences in acute exacerbation risk among these five clusters.</p><p><strong>Conclusions: </strong>Cluster analysis identified 5 clusters related to quantitative CT of all participants in the SPIROMICS cohort with significant differences in baseline characteristics and acute exacerbation risk. The stability of clustering results was validated through NMI in 10 sampling cycles. In addition, dimensionality reduction results showed high reproducibility in different studies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"92"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514672","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":"Relationship between lung consolidation size measured by ultrasound and outcome in ICU patients with respiratory failure.","authors":"Na Wang, Yi Chi, Qianling Wang, Yun Long, Dawei Liu, Zhanqi Zhao, Huaiwu He","doi":"10.1186/s12890-025-03564-6","DOIUrl":"10.1186/s12890-025-03564-6","url":null,"abstract":"<p><strong>Background: </strong>Lung ultrasound has been extensively used to assess the etiology of respiratory failure. Additionally, lung ultrasound-based scoring systems have been proposed to semi-quantify the loss of lung aeration in the ICU. The one most frequently used distinguishes four steps of progressive loss of aeration (scores from 0 to 3) and 3 scores mean tissue-like pattern. However, the burden of consolidation is not considered as tissue-like pattern is defined as 3 scores independently of its dimension. In this study, we present an ultrasound method for quantitative measurement of consolidation size and investigate the relationship between consolidation size and outcome in ICU patients with respiratory failure.</p><p><strong>Methods: </strong>A total of 124 patients in ICU were prospectively enrolled and 13 patients were excluded due to failure to obtain LUS measurements. Among the remaining 111 patients, 17 patients were non-intubated, and 94 patients under sedation and analgesia were intubated. All patients underwent lung ultrasound examination for the measurement of lung consolidation size between 24 and 48 h after ICU admission. Lung consolidation size was assessed by consolidation area index (CA), which was determined by tracing the maximum cross-sectional area of the region of consolidation. The Cox-regression model was constructed for 28- and 90-day mortality.</p><p><strong>Results: </strong>Consolidation size was successfully evaluated in all patients. The CA was 24.2cm²[15.9-36.6] (median [25th -75th percentiles]). CA was negatively correlated with PaO₂/FiO₂ ratio (r=-0.26, P < 0.0001). Upon univariate and multivariate analysis, only CA [Odds ratio (OR) 1.04, 95% CI 1.01-1.08, P = 0.004] and APACHEII (OR 1.14, 95% CI 1.05-1.25, P = 0.002) were the risk factors for ICU mortality. Patients with substantial CA (> 29.4cm²) had a higher risk of death in 28-day [Hazard ratio (HR) 4.35, 95%CI 1.70-11.11; Log-rank P = 0.017] and 90-day mortality (HR 4.10, 95%CI 1.62-10.39; Log-rank P < 0.01).</p><p><strong>Conclusions: </strong>The proposed CA parameter, determined by lung ultrasound, was readily accessible at the bedside. It is noteworthy that a larger CA was correlated with impaired oxygenation and increased mortality rates among ICU patients. Further investigation is required to establish the merits of incorporating CA into lung ultrasound assessments in the ICU.</p><p><strong>Trial registration: </strong>ClinicalTrial.gov, Identifier NCT05647967, Date: Dec 13, 2022, retrospectively registered.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"91"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514675","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 systemic inflammation response index as risks factor for all-cause and cardiovascular mortality among individuals with respiratory sarcopenia.","authors":"Ying Liu, Xuejun Yin, Yutong Guo, Jixiong Xu, Ruitai Shao, Yunyuan Kong","doi":"10.1186/s12890-025-03525-z","DOIUrl":"10.1186/s12890-025-03525-z","url":null,"abstract":"<p><strong>Background: </strong>Respiratory sarcopenia is associated with poor outcomes, yet effective biomarkers for risk stratification remain limited. This study investigates the associations between complete blood count (CBC)-derived inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), neutrophil-monocyte-to-lymphocyte ratio (NMLR), and systemic inflammation response index (SIRI) and both all-cause and cardiovascular mortality in patients with respiratory sarcopenia.</p><p><strong>Methods: </strong>We conducted a cohort analysis of 1,673 adults with possible respiratory sarcopenia using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012, with mortality follow-up through December 31, 2019. Possible respiratory sarcopenia was assessed via peak expiratory flow rate (PEFR). Multivariable Cox regression models evaluated associations between NLR, NMLR, SIRI, and mortality outcomes, adjusted for demographic, socioeconomic, and health-related covariates. Additional CBC-derived biomarkers (PLR, dNLR, MLR, SII) were analysed, and mediation analysis assessed albumin's role as a partial mediator of mortality.</p><p><strong>Results: </strong>Over a median follow-up of 116 months, 263 deaths occurred, including 68 from cardiovascular causes. Elevated NLR, NMLR, and SIRI were significantly associated with increased risks of all-cause and cardiovascular mortality. SIRI emerged as the strongest predictor, with adjusted hazard ratios (HRs) of 1.65 (95% CI, 1.23-2.22) for all-cause mortality and 3.18 (95% CI, 1.83-5.53) for cardiovascular mortality. Albumin partially mediated the relationship between SIRI and all-cause mortality (12.1%).</p><p><strong>Conclusion: </strong>Elevated NLR, NMLR, and SIRI are associated with increased mortality risks in respiratory sarcopenia, with SIRI demonstrating the highest predictive power. Integrating SIRI into clinical assessments may aid in identifying high-risk patients, allowing for targeted interventions.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"90"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514579","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":"Middle lobe tumors and lymphovascular invasion as independent predictors of recurrence-free survival in stage I NSCLC.","authors":"Mustafa Akyıl, Serkan Bayram","doi":"10.1186/s12890-025-03560-w","DOIUrl":"10.1186/s12890-025-03560-w","url":null,"abstract":"<p><strong>Background: </strong>Recurrence and metastases are prevalent in lung cancer, contributing to a concerning rate of treatment failure. As a result, there is a pressing need for multivariate analyses of prognostic utility in non-small cell lung cancer (NSCLC). This study reports on the factors influencing metastasis and recurrence-free survival (RFS) in patients with clinical stage I NSCLC who have undergone anatomic lung resection.</p><p><strong>Methods: </strong>This study included patients diagnosed with stage I NSCLC who received surgical treatment at our institution between January 2016 and December 2022. A careful examination was conducted of the patients' demographic, clinical, radiological, and histopathological data. The prognostic value of the recorded parameters was assessed according to recurrence and/or metastasis, considering RFS during follow-up assessments.</p><p><strong>Results: </strong>Among the 616 patients included in this study, the average age was 63 ± 8.9 years, with 506 (82.1%) of patients being male. During a median follow-up period of 50.4 ± 23.7 months (ranging from 1 to 89 months), 79 patients (12.8%) experienced recurrence or metastasis, while 41 patients (6.7%) died. Multivariate analysis showed no significant differences (p > 0.05) regarding recurrence or metastasis development when considering demographic characteristics, tumor size, operation forms, histopathologic types involved, perineural and visceral pleural invasion status, and aspects of oncological treatment. Conversely, the presence of lymphovascular invasion (p < 0.003) and tumor localization in the middle node (p < 0.045) emerged as significant predictors of RFS.</p><p><strong>Conclusion: </strong>In patients with early-stage NSCLC, the presence of lymphovascular invasion and localization of the tumor in the middle lobe are independent predictors of RFS.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"93"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514657","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}