Abstract:
Background:Patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations often develop systemic disease progression during treatment with EGFR-tyrosine kinase inhibitors (TKIs). Droplet digital polymerase chain reaction (ddPCR) and amplification refractory mutation system (ARMS)-PCR are routinely applied for detection of EGFR mutations, including T790M, which is associated with TKI sensitivity. We compared the efficiency of ddPCR and ARMS-PCR in detecting T790M and explored the association between T790M abundance and osimertinib efficacy. Methods:Genomic DNA (gDNA) from tissue and cells in hydrothorax and circulating tumor DNA (ctDNA) from peripheral blood (PB), and clinicopathological data were retrospectively collected from 263 patients who visited Sun Yat-sen University Cancer Center for T790M test. Results:Mean T790M abundance and mutant copy number of cases tested positive by both methods, i.e., the ddPCR+ARMS+ group (19.1%, 636.9), were higher than those in the ddPCR+ARMS- group (0.36%, 12.1), suggesting that ddPCR is more sensitive in detecting samples with low mutant abundance than ARMS-PCR. T790M detection rate was comparable for gDNA and ctDNA samples (44.7% vs. 37.6%, P=0.242); however, gDNA sample tended to show more T790M abundance in ddPCR analysis. T790M coexisted with L858R mutation (8/11) more than with deletions in exon 19 (19del) mutation (3/11) in TKI-naive tumors, while 19del co-occurred as often as L858R in post-TKI tumors. T790M+ patients benefited more from osimertinib and showed longer progression-free survival (PFS) (not achieved vs. 10.1 months, P=0.0399), while lower T790M abundance (<1.065%) was associated with longer PFS (not achieved vs. 8.8 months, P=0.0033). Conclusions:ddPCR has a higher sensitivity than ARMS-PCR, especially in detecting the less abundant T790M. Although detection rates were comparable for ctDNA and gDNA samples, the mutation abundance was higher in gDNA sample. Finally, low T790M abundance was associated with longer PFS in NSCLC patients receiving osimertinib treatment.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Li Y,Xu Y,Wu X,He C,Liu Q,Wang Fdoi
10.21037/jtd.2019.07.42subject
Has Abstractpub_date
2019-07-01 00:00:00pages
3004-3014issue
7eissn
2072-1439issn
2077-6624pii
jtd-11-07-3004journal_volume
11pub_type
杂志文章abstract:Background:The incidence of conduction disturbances requiring permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) have remained a common concern. The purpose of this study was to evaluate the impact of postprocedural PPM implantation following TAVR on clinical outcomes. Metho...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.02
更新日期:2019-12-01 00:00:00
abstract::Myocardial ischemia is considered the cornerstone of the treatment of patients with coronary artery disease (CAD). Although the deleterious effects of myocardial infarction, the maximum expression of ischemia, have been extensively studied and described, the clinical effects of chronic, documented myocardial ischemia ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.02.85
更新日期:2019-03-01 00:00:00
abstract::Transbronchial lung biopsy with a cryoprobe, or cryobiopsy, is a promising new bronchoscopic biopsy technique capable of obtaining larger and better-preserved samples than previously possible using traditional biopsy forceps. Over two dozen case series and several small randomized trials are now available describing e...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.06.96
更新日期:2017-07-01 00:00:00
abstract:Background:There has been controversy regarding prognostic factors for surgically resected primary pulmonary sarcomatoid carcinoma (PSC). Recently, several studies have shown that neutrophil-to-lymphocyte ratio (NLR) was a prognostic factor for various types of cancers from multiple organs. Therefore, we performed this...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.02.02
更新日期:2019-03-01 00:00:00
abstract::Kehlet first introduced the notion of enhanced recovery after surgery (ERAS). Moreover, in the last years, the fast-track programmes demonstrated a reduction of complications and the hospital length of stay in general surgery. ERAS involves a multidisciplinary to development the value of care introducing the evidence-...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.01.62
更新日期:2019-09-01 00:00:00
abstract::Along with the progresses that have been made in techniques and instruments, uniportal video-assisted thoracoscopic surgery (VATS) became more and more popular. Here, we present the operation video of a 52-year-old female with early stage lung cancer in the right upper lobe (RUL), who underwent uniportal VATS right up...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.05.26
更新日期:2017-06-01 00:00:00
abstract::Transcatheter procedures offer less invasive approaches allowing rapid recovery and earlier hospital discharge. A number of international guidelines have defined the role of echocardiography spanning diagnosis, detailed anatomical assessment, device sizing and selection, peri-procedure guidance and post device surveil...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.126
更新日期:2018-09-01 00:00:00
abstract::The last decade has seen significant advances in our understanding of lung cancer biology and management. Identification of key driver events in lung carcinogenesis has contributed to the development of targeted lung cancer therapies, heralding the era of personalised medicine for lung cancer. As a result, histologica...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.08.43
更新日期:2013-10-01 00:00:00
abstract::Cardiac amyloidosis is thought to be a rare group of diseases caused by extracellular deposition of misfolded proteins in the extracellular cardiac matrix resulting in heart failure with preserved ejection fraction (HFpEF). This review focuses on the similarities and differences between the pathophysiology, clinical p...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.03.134
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Previously, most studies did not discuss about the characteristics of lung-involved toxocariasis without eosinophilia. However, the patients are not always accompanied by eosinophilia, so it is necessary to learn about the clinical and radiologic features that may predict pulmonary toxocariasis without eosin...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.12.24
更新日期:2014-12-01 00:00:00
abstract::The severity of the clinical condition and co-morbidities of the patients for esophagectomy require a complex assessment and risk stratification before the operation, and most of the cases need complex management. We did a literature search and considered the data on risk stratification and complex management of patie...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.11
更新日期:2019-04-01 00:00:00
abstract::Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree. The exact pathogenesis is unclear, and it has a heterogenous clinical course. Its diagnosis requires the clinician to have a high index of suspicion based on clinical symptoms and radiological features. Computed tomogra...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.01.49
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:The Thoracic Morbidity and Mortality (TM&M) classification system is a method for univocally coding the postoperative adverse events by their complexity of management. The aim of the present study was to compare the distribution of the severity of complications according to the TM&M system versus the distribu...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2013.05.03
更新日期:2013-06-01 00:00:00
abstract:Background:Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small cell lung cancer (NSCLC). Methods:We retrospectively assessed 103 consecutive patients given lo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.123
更新日期:2018-02-01 00:00:00
abstract:Background:In non-small cell lung cancer (NSCLC), circulating tumor cells (CTC) are shed and circulate to the peripheral blood through the pulmonary vein. Previously, CTC count in pulmonary venous blood (pvCTC) was shown to significantly increase after surgical manipulation. Therefore, we assessed the correlation betwe...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.12.56
更新日期:2018-01-01 00:00:00
abstract::Primary pleural myxoid liposarcoma is a rare tumor. Here, we report a primary myxoid liposarcoma occupying the majority of the left thoracic cavity with features suggesting invasion. Computed tomography (CT) at medical check-up incidentally revealed a bulky inhomogeneous fatty mass. The tumor's large size made a predi...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.03.29
更新日期:2017-03-01 00:00:00
abstract::Rituximab, a monoclonal antibody against CD20+ antigen specific B cell, has been increasingly used in the treatment of non-Hodgkin's lymphoma and some other autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. It is noted that Rituximab could enhanced the efficacy of CHOP-based che...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2013.08.35
更新日期:2013-08-01 00:00:00
abstract:Background:To assess the usefulness of the neutrophil/lymphocyte ratio (NLR), a marker of inflammation and/or stress, for predicting weaning failure in patients receiving invasive mechanical ventilation (IMV), compared to levels of leukocytes and C-reactive protein (CRP). Methods:This observational prospective cohort ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.08.68
更新日期:2018-09-01 00:00:00
abstract::Lung cancer continues to be the leading cause of cancer death worldwide. Recently, immunotherapy for non-small cell lung cancer (NSCLC) has emerged as a powerful treatment option for advanced lung cancer. The relative success of programmed death 1 (PD-1) and/or programmed death ligand 1 (PD-L1) antibodies in metastati...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.01.109
更新日期:2018-02-01 00:00:00
abstract::The scientific world is enriched daily with new knowledge, due to new technologies and continuous discoveries. The mathematical functions explain the statistical concepts particularly those of mean, median and mode along with those of frequency and frequency distribution associated to histograms and graphical represen...
journal_title:Journal of thoracic disease
pub_type: 社论
doi:10.21037/jtd.2017.05.81
更新日期:2017-06-01 00:00:00
abstract::Arnold's nerve ear-cough reflex is recognised to occur uncommonly in patients with chronic cough. In these patients, mechanical stimulation of the external auditory meatus can activate the auricular branch of the vagus nerve (Arnold's nerve) and evoke reflex cough. This is an example of hypersensitivity of vagal affer...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.04.22
更新日期:2014-10-01 00:00:00
abstract::The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital i...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.08.44
更新日期:2016-08-01 00:00:00
abstract:Background:To review our experience of transmanubrial osteomuscular sparing approach (TMA) for resection of various lesions involving the thoracic inlet and to prove the feasibility and safety of the approach. Methods:Retrospective review of 58 consecutive cases, from April 2007 to January 2016, with surgical resectio...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.08.99
更新日期:2017-09-01 00:00:00
abstract:Background:Pacing parameters may influence pacing lead life and pacemaker life. This study sought to determine whether different right atrial active-fixation lead implantation parameters are associated with chronic pacing performance. Methods:A retrospective observational study was conducted on all consecutive patient...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.04.04
更新日期:2019-04-01 00:00:00
abstract:Background:To investigate the diagnostic performance of galactomannan (GM) detection in bronchoalveolar lavage fluid (BALF) corrected by urea dilution and modification of the AspICU clinical algorithm. Methods:GM detection in serum and BALF samples was performed in nonneutropenic patients on the day of clinically susp...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.01.07
更新日期:2019-02-01 00:00:00
abstract:Background:The technical concepts of thoracoscopic segmentectomy are still evolving. In this study we present a simple bronchoscopy-based intersegmental demarcation technique with short- and mid-term outcomes compared between thoracoscopic segmentectomy and lobectomy. Methods:All 105 consecutive patients with lung can...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-656
更新日期:2020-06-01 00:00:00
abstract::Response monitoring using fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography (FDG-PET/CT) textural features has potential in targeted treatment with erlotinib in non-small cell lung cancer (NSCLC) patients. Patients with substantial decrease of metabolic activity during...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.02.10
更新日期:2016-03-01 00:00:00
abstract::The bidirectional interaction between sleep-disordered breathing (SDB) and stroke has been the subject of many studies. On the one hand, different forms of SDB, and especially obstructive sleep apnea, increase the risk of stroke either directly or indirectly by influencing other known cardiovascular risk factors such ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.66
更新日期:2018-12-01 00:00:00
abstract:Background:Multimorbidity is increasing common in Brazilian adults. Comorbid chronic lung disease, cardiovascular disease and diabetes are often inaccurately diagnosed or ineffectively treated. The Global Alliance against Chronic Respiratory Diseases (GARD) aims to strengthen health systems to prevent and control non-c...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.34
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Anastomotic leakage after cervical oesophagogastrostomy is a common and difficult problem. Mediastinal manifestation of anastomotic leakage may lead to mediastinitis with dramatic and potentially lethal outcome. Contamination of the mediastinum can be controlled by endoscopic placement of an expandable metal...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2012.10.12
更新日期:2013-04-01 00:00:00