［Abstract］　Objective　To explore the efficacy and safety of first-line systemic therapy combined with local intensive therapy for stage Ⅳ lung adenocarcinoma patients. Methods　The clinical data of 152 patients with stage Ⅳ lung adenocarcinoma who were admitted to Chinese PLA General Hospital from January 2022 to June 2023 were retrospectively analyzed. Seventy-four patients who received first-line systemic therapy combined with local intensive therapy were enrolled as group A, and 78 patients who received first-line systemic therapy alone were enrolled as group B. The primary endpoints were progression-free survival(PFS), and the secondary endpoints were overall survival(OS) and treatment-related adverse events. Results　The median follow-up time was 30.1 months, and the median PFS of the overall population was 28.0 months, of which the median PFS of the group A was 42.0 months, and the median PFS of the group A was significantly higher than that of the group B(20.7 months), and the difference was statistically significant(P<0.05). The results of multivariate Cox regression analysis showed that female and local intensive therapy were protective factors for better prognosis of PFS in the patients(P<0.05), while lymph node metastases(N stages of N₁, N₂ and N₃) were risk factors for poor prognosis of PFS(P<0.05), and smoking history and lymph node metastases(N stages of N₁, N₂ and N₃) were risk factors for poor OS prognosis(P<0.05), and chemotherapy combined with immunotherapy was a risk factor for poor OS prognosis(P<0.05). Conclusion　First-line systemic therapy combined with local intensive therapy can significantly improve PFS in patients with stage Ⅳ lung adenocarcinoma, in which radiotherapy and ablative therapy play a key role. The adverse events associated with the combination therapy are generally controllable.]]> 2025/1/6 10:33:01 1,2, MAO Yunye^1,2, LIN Liyan^1,2, WANG Jinliang¹]]> JIA Yangyang^1,2, MAO Yunye^1,2, LIN Liyan^1,2, WANG Jinliang¹ 4true ［Abstract］　Objective　To explore the correlation of TP53 mutations and their different variant forms with the efficacy of first-line treatment of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) in patients with advanced EGFR-sensitive mutant lung adenocarcinoma. Methods　The data from The Cancer Genome Atlas(TCGA) database was collected for bioinformatics analysis. The clinical data of 152 patients with advanced EGFR-sensitive mutant(19 Del or 21 L858R) lung adenocarcinoma who were admitted to Department of Medical Oncology, Affiliated Hospital of Hebei University from December 2017 to December 2022 were retrospectively analyzed. All the patients were treated with EGFR-TKIs. The correlation of TP53 mutations and their different variant forms with the efficacy of EGFR-TKIs was analyzed. Results　Of the 152 patients included in the analysis, 105 patients had EGFR-TP53 co-mutations. The patients with TP53 mutations had shorter progression-free survival(PFS) than those with TP53 wild-type. The patients with missense mutations, mutations in exons 5-8, disruptive mutations, and non-disruptive mutations had shorter PFS than those with TP53 wild-type. In the patients with EGFR-TP53 co-mutations, the patients with TP53 missense mutations had shorter PFS than those with non-missense mutations, and the patients with non-disruptive TP53 mutations had shorter PFS than those with disruptive TP53 mutations, and the patients with mutations in exons 5-8 had shorter PFS than those with mutations in exon 4/9/10. Conclusion　The advanced EGFR-sensitive mutant lung adenocarcinoma patients with TP53 mutations who receive first-line treatment have shorter PFS than those with TP53 wild-type, suggesting that TP53 mutations are negative predictor of efficacy of EGFR-TKIs in the advanced EGFR-sensitive mutant lung adenocarcinoma patients. In the patients with EGFR-TP53 co-mutations, the patients with TP53 missense mutations, non-disruptive mutations, and mutations in exons 5-8 have shorter PFS.]]> 2025/1/6 10:33:01 LI Xiaofang, XI Chenglin, HUO Ran, FANG Guotao, SHANG Yanhong 3true ［Abstract］　Objective　To explore whether puncture can cause tumor cells to enter the bloodstream by comparing the changes in peripheral blood circulating tumor cells(CTCs) before and after percutaneous transthoracic needle biopsy for lung tumors. Methods　A total of 46 patients with suspected lung cancer who were admitted to Xuanwu Hospital Capital Medical University from December 2019 to December 2023 were recruited, all of whom receiving percutaneous transthoracic needle biopsy. The patients received CTCs testing(immunomagnetic bead-based negative enrichment+targeted polymerase chain reaction) before and after puncture, and the changes in CTCs before and after puncture were compared. Results　In all the enrolled patients, their levels of CTCs were significantly increased after puncture compared with those before puncture(P<0.05). In the benign tumor group, there were no significant changes in CTCs levels before and after puncture in 11 patients(P>0.05), while in the malignant tumor group, 35 patients had significant increases in CTCs levels after puncture compared with those before puncture(P<0.05), and in the malignant tumor group, there were no significant changes in CTCs levels before and after puncture in 24 patients of the stage Ⅰ-Ⅲ non-small-cell lung cancer and limited-stage small-cell lung cancer group(P>0.05), while CTCs levels after puncture in 11 patients of the stage Ⅳ non-small-cell lung cancer and extensive-stage small-cell lung cancer group were significantly increased compared with those before puncture(P<0.05). Conclusion　Percutaneous transthoracic needle biopsy can cause the increased levels of CTCs in patients with stage Ⅳ non-small-cell lung cancer and extensive-stage small-cell lung cancer, but has no significant effect on patients with stage Ⅰ-Ⅲ non-small-cell lung cancer and limited-stage small-cell lung cancer.]]> 2025/1/6 10:33:01 XUE Hanjiang, ZHANG Yi, LU Gaojun, QIAN Kun 2true ［Abstract］　Objective　To explore the B7-H3 expression level in small-cell lung cancer(SCLC) and its correlation with the small-cell lung cancer patients′ prognosis. Methods　Thirty-four SCLC tissue specimens surgically resected in Beijing Chest Hospital, Capital Medical University from January 2010 to July 2019 were collected, and the medical records and follow-up data of the patients from whom the specimens were obtained were collected. The expression of B7-H3 in the SCLC tissues was detected by using immunohistochemical method, and the correlation between the expression level of B7-H3 in the SCLC tissues and the patients′ clinical characteristics was analyzed. Results　There were 14 patients(41.18%) with high expression of B7-H3 and 20 patients(58.82%) with low expression of B7-H3. The expression of B7-H3 was positive in 26 cases(76.47%) and negative in 8 cases(23.53%). The proportion of lymph node metastasis and the number of lymph node metastasis in the high B7-H3 expression group were higher than those in the low B7-H3 expression group, and the differences were statistically significant(P<0.05). However, there were no statistically significant differences in gender, age and smoking ratio between the two groups(P>0.05). Expression of B7-H3 was consistent with score of micro vessel density(MVD)(Kappa=0.339, P=0.048). The MVD scores of the high B7-H3 expression group were higher than those of the low B7-H3 expression group, and the differences were statistically significant(t=3.784, P=0.001). The median overall survival(OS) of the high B7-H3 expression group was shorter than that of the low B7-H3 expression group(13.8 months vs 23.5 months), and the difference in survival prognosis between the two groups was statistically significant(log-rank test: χ²=3.873, P=0.049). Conclusion　B7-H3 is expressed to varying degrees in SCLC tissues, and high expression of B7-H3 is associated with lymph node metastasis and poor prognosis, which may become a potential target for treatment of SCLC.]]> 2025/1/6 10:33:01 1, LI Hongxia¹, LIN Haifeng², WANG Shouzheng¹, ZHANG Quan¹, LYU Jialin¹, LI Jie¹, ZHENG Hua¹, HU Ying¹]]> LI Xi¹, LI Hongxia¹, LIN Haifeng², WANG Shouzheng¹, ZHANG Quan¹, LYU Jialin¹, LI Jie¹, ZHENG Hua¹, HU Ying¹ 1true