［Abstract］　Objective　To explore the regularity and clinical characteristics of segmental lymph node metastasis in lung adenocarcinoma, and the indications of segmentectomy of lung. Methods　Two hundred patients with cT₁N₀M₀ lung adenocarcinoma who were admitted to the First Affiliated Hospital of China Medical University from January 2014 to April 2020 were selected, and all the patients received standard lung lobectomy and mediastinal lymph node dissection. The lymph nodes were sampled in each group, and then the metastatic status of isolated segmental lymph nodes(iLSN) and its influencing factors were analyzed by combining with the clinical features. Results　The results of univariate analysis showed that there were significant differences in maximum tumor diameter, maximum standardized uptake value(SUV_max), serum carcinoembryonic antigen(CEA), nodule type, pathological subtype and N₁ lymph node metastasis between the non-iLSN metastasis group and the iLSN metastasis group(P<0.05). The results of multivariate regression analysis showed that the maximum tumor diameter of 2.1-3.0 cm, SUV_max≥2.5, CEA>4.5 ng/ml, nodule type of non-simple ground glass nodule and N₁ lymph node metastasis were the independent risk factors for the occurrence of iLSN metastasis(P<0.05), while the pathological subtypes of adenocarcinoma in situ(AIS), microinvasive adenocarcinoma(MIA) and lepidic adenocarcinoma(LPA) were the independent protective factors for iLSN metastasis. Conclusion　Segmentectomy of lung might be a better choice for patients with CEA≤4.5 ng/ml, SUV_max<2.5 and the largest tumor diameter of simple ground glass nodules not more than 1 cm, and the tumors confirmed by frozen pathology as AIS/MIA/LPA. However, when intraoperative pathology confirms that N₁ lymph nodes are positive, lobectomy of lung should be added.]]> 2022/6/10 17:57:15 SUN Guang-hao, XU Shun 7true ［Abstract］　Objective　To evaluate the effect of sugammadex sodium on postoperative pulmonary complications(PPCs) after thoracoscopic radical resection of lung cancer in elderly patients. Methods　One hundred elderly patients who underwent elective thoracoscopic radical resection of lung cancer in Henan Provincial Chest Hospital from February 2020 to July 2020 were selected and divided into sugammadex sodium group and neostigmine group by random number table method, with 50 cases in each group. At the end of the operation, the sugammadex sodium group was given intravenous injection of sugammadex sodium 2 mg/kg when the counts of train-of-four stimulation(TOF) were more than or equal to 2 and the neostigmine group was given neostigmine 40 μg/kg+atropine 10 μg/kg intravenously when the patients had spontaneous breathing. The incidence of PPCs within 72 h after surgery was compared between the two groups. The 15-Quality of Restoration(QoR-15) was used to evaluate the quality of rehabilitation of the patients on the first day and the second day after surgery. The inflammatory indicators of the patients in the two groups were observed on the first day before surgery, and on the first day and the third day after surgery. The operation-related indicators, the stay time in the postanesthesia care unit(PACU), and the postoperative hospital stay were compared between the two groups. Results　There were 15 cases(30.00%) of PPCs in the neostigmine group and 6 cases(12.00%) in the sugammadex sodium group within 72 hours after surgery, and the difference was statistically significant(χ²=4.883, P=0.027). The levels of white blood cell count, neutrophil count and neutrophil percentage showed an upward trend in the two groups after surgery, and the increases in the sugammadex sodium group were smaller than those in the neostigmine group(P<0.05). On the first day and the third day after surgery, the white blood cell count, neutrophil count and neutrophil percentage in the sugammadex sodium group were significantly lower than those in the neostigmine group(P<0.05). The postoperative stay time in PACU and postoperative hospital stay in the sugammadex sodium group were shorter than those in the neostigmine group, and the differences were statistically significant(P<0.05). The incidence rates of sinus bradycardia, dry mouth and nausea and vomiting in the neostigmine group were significantly higher than those in the sugammadex sodium group(P<0.05). The QoR-15 scores of the sugammadex sodium group on the first day and the second day after surgery were higher than those of the neostigmine group, and the differences were statistically significant(P<0.05). Conclusion　Sugammadex sodium can reduce the incidence of PPCs in elderly patients after thoracoscopic radical resection of lung cancer, which is beneficial to their early rehabilitation.]]> 2022/6/10 17:57:16 WANG Xiao-jing, XIE Ya-xian, DANG Xiao-yan, et al. 6true ［Abstract］　Video-assisted thoracoscopic surgery(VATS) has developed rapidly in the past decades as a representative technique of minimally invasive surgery for related lung diseases. Compared with traditional open thoracic surgery, VATS has the advantages of “less trauma via operative approach, better prognosis and higher quality of life after surgery”. As a consequence, it has become the main method of surgical treatment for early stage lung cancer and other lung diseases. The purpose of this paper is to introduce the development history and treatment status of VATS, and to illustrate its great vitality in current treatment, and to explore the promising potential of the integration of VATS technology and robotic technology under the background of the combination of medicine and engineering.]]> 2022/3/31 0:00:00 SHU Wen-bo, ZHOU Zhen-yu, WANG Xin, et al. 5true ［Abstract］　Non-small cell lung cancer(NSCLC) is the leading cause of cancer-related morbidity and mortality in malignant tumors. Immune microenvironment is closely related to the occurrence and development of tumors. NSCLC is usually accompanied by extensive genetic alterations and has a special tumor immune microenvironment. The emergence of immunotherapy has promoted the development of the treatment of NSCLC. However, the majority of patients with NSCLC still fail to respond well to immunotherapy. In-depth study of the immune microenvironment of NSCLC, especially the function of various immune cells, is the key to understand the mechanisms of tumor immunosuppression and improve the clinical prognosis of the patients.]]> 2022/3/31 0:00:00 GUO Guang-ran, ZHANG Lan-jun 4true ［Abstract］　The incidence rate of lung cancer ranks first in the incidence rates of malignant tumours around the world, and despite its progress in treatment, its mortality rate remains high.Fundamentally, the invasion and metastasis of cancer cells are the main reasons for the poor prognosis and low survival rate of lung cancer. The invasion and metastasis of cancer cells include the following stages: epithelial-mesenchymal transition, neovascularization or lymphatics, cancer cell survival, extravasation and proliferation at the distal part. The occurrence and development mechanisms of these stages are not clear at present. This paper summarizes the advances in studies on the invasion and metastasis mechanisms of lung cancer in recent years and the current situation, and makes a review to provide reference for the majority of researchers.]]> 2022/3/31 0:00:00 ZHANG Wen-qian, LI Hui 3true ［Abstract］　Objective　To study the situation of ground-glass nodule(GGN) in predicting the invasion of non-small cell lung cancer(NSCLC). Methods　Two hundred and forty-four NSCLC patients with GGN confirmed by surgery and pathology from January 2014 to June 2019 were retrospectively selected, and their computed tomography(CT) features and pathological examination results were analyzed. The association between GGN and NSCLC invasion was evaluated. Results　The pathological findings of 244 GGN in the 244 cases were adenocarcinoma, including 44 cases of adenocarcinoma in situ(AIS), 53 cases of minimally invasive adenocarcinoma(MIA) and 147 cases of invasive adenocarcinoma(IA). The pathological results of 9 cases with aerated bronchus sign GGN were all IA. Lymph node metastasis was found in 2 cases. There were significant differences among the AIS group, the MIA group and the IA group in density, lobulation, spiculation, vacuole sign, aerated bronchus sign, pleural retraction sign, vascular convergence sign, as well as the size of solid components, the proportion of solid components and the maximum diameter of GGN(P<0.05). The results of receiver operating characteristic(ROC) curve analysis showed that the maximum diameter of GGN, the size of solid components, and the proportion of solid components had the value of predicting whether NSCLC invaded, and the maximum diameter of nodules had the best diagnostic efficiency. Conclusion　The size of GGN can be used to predict whether NSCLC invades.]]> 2022/3/31 0:00:00 LIU Bao-dong, ZHANG Yi, SU Lei, et al. 2true ［Abstract］　Objective　To analyze the effect of marital status on prognosis of patients with non-small cell lung cancer(NSCLC). Methods　The patients diagnosed with NSCLC between 2010 and 2016 were collected from the Surveillance, Epidemiology and End Results(SEER) database and the corresponding characteristic data were extracted. Propensity score matching(PSM) was performed between the married group and the unmarried group to exclude the confounding effects of relevant clinicopathological features. Kaplan-Meier method and log-rank test were used to compare the survival between the married group and the unmarried group, and the survival curves of overall survival(OS) and cancer specific survival(CSS) were plotted. Finally, Cox regression analysis was used to explore the clinicopathological factors affecting the patients′prognosis. Results　In total, the data of 58 424 NSCLC patients were enrolled according to the selection criteria. The samples were divided into two groups using the PSM analysis results, and 20 148 patients in each group were selected for further analysis. The results showed that the median survival time of OS and CSS in the married group was 25 months and 31 months, respectively, while the median survival time of OS and CSS in the unmarried group was 22 months and 27 months, respectively, and the differences were significant(P<0.05). The results of univariate and multivariate Cox regression analyses showed that the prognosis of the married patients was significantly better than that of the unmarried patients. Conclusion　Unmarried patients need not only closer surveillance but also more social and family support than married patients, which may improve the patients′ compliance with treatment, and ultimately improves their survival.]]> 2022/3/31 0:00:00 ZHAO De-chang, ZHANG Ru-si, YANG Long-jun, et al. 1true