Background Inflammatory myofibroblastic tumor (IMT) remains a rare and challenging disease, for which current diagnostic and therapeutic strategies are still limited. This study aims to investigate the clinical characteristics and treatment strategies for inflammatory myofibroblastic tumor of the chest, and to summarize diagnostic and therapeutic experiences. Methods A retrospective analysis was conducted on the clinical data of 55 patients diagnosed with IMTC treated at our institution between January 2016 and January 2025. Of these cases, 35 (63.6%) involved lung tumors, 13 (23.6%) tracheal tumors, 6 cases (10.9%) mediastinal tumors, and 1 (1.8%) an esophageal tumor. All patients underwent surgical resection, and there were no perioperative deaths. The follow-up period ranged from 8 to 104 months. Results Patients were categorized into two groups: a lung tissue group and a non-lung tissue group (trachea, esophagus, mediastinum). Within the lung tissue group, patients were further subdivided according to the type of surgery: sublobar resection (wedge or segmentectomy) versus lobectomy/combined lobectomy (standard lobectomy, extended lobectomy, or sleeve resection). There was no significant difference in overall survival between the sublobar resection group and the lobectomy/combined lobectomy group; however, the sublobar group had a shorter postoperative hospital stay. Conclusions Complete surgical resection remains the primary and most effective treatment, and routine lymph node dissection appears unnecessary. Sublobar resection achieves comparable survival outcomes to lobectomy while offering shorter hospital stays, making it a viable option for selected patients. Given the potential for recurrence, vigilant long-term follow-up is strongly recommended to ensure early detection and management of relapse.

Intratumoral microbiota has been found to be a crucial component of hepatocellular carcinoma (HCC). Due to insufficient recognition, technical limitations, and low biomass of intratumoral microbiota, it is poorly understood. Intratumoral microbiota exhibit significant diversity in HCC tissues. It is involved in the development of HCC through several mechanisms, such as remodeling the immunosuppressive microenvironment, metabolic reprogramming, and genetic alterations. Moreover, intratumoral microbiota is associated with the metastasis of HCC cells. Herein, we reviewed the history of intratumoral microbiota, applied biotechnology to depict the signatures of intratumoral microbiota, investigated the potential sources of intratumoral microbiota, and assessed their functions, mechanisms, and heterogeneity. Furthermore, in this review, we summarized the development of therapeutics that can be used in the treatment of HCC and proposed future perspectives for research in this field.

Cholangiocarcinoma (CCA) is a highly aggressive type of adenocarcinoma distinguished by its invasiveness. Depending on specific anatomical positioning within the biliary tree, CCA can be categorized into intrahepatic CCA (ICCA), perihilar CCA (pCCA) and distal CCA (dCCA). In recent years, there has been a significant increase in the global prevalence of CCA. Unfortunately, many CCA patients are diagnosed at an advanced stage, which makes surgical resection impossible. Although systemic chemotherapy is frequently used as the primary treatment for advanced or recurrent CCA, its effectiveness is relatively low. Therefore, immunotherapy has emerged as a promising avenue for advancing cancer treatment research. CCA exhibits a complex immune environment within the stromal tumor microenvironment (TME), comprising a multifaceted immune landscape and a tumor-reactive stroma. A deeper understanding of this complex TME is indispensable for identifying potential therapeutic targets. Thus, targeting tumor immune microenvironment holds promise as an effective therapeutic strategy.

Programmed cell death protein-1 (PD-1), also called CD279, is coded by the PDCD1 gene and is constitutively expressed on the surface of immune cells. As a receptor and immune checkpoint, PD-1 can bind to programmed death ligand-1/programmed death ligand-2 (PD-L1/PD-L2) in tumor cells, leading to tumor immune evasion. Anti-PD-1 and anti-PD-L1 are important components in tumor immune therapy. PD-1 is also expressed as an intrinsic variant (iPD-1) in cancer cells where it plays important roles in malignant progression as proposed by recent studies. However, iPD-1 has received much less attention compared to PD-1 expressed on immune cells although there is an unmet medical need for fully elucidating the mechanisms of actions to achieve the best response in tumor immunotherapy. iPD-1 suppresses tumorigenesis in non-small cell lung cancer (NSCLC) and colon cancer, whereas it promotes tumorigenesis in melanoma, hepatocellular carcinoma (HCC), pancreatic ductal adenocarcinoma (PDAC), thyroid cancer (TC), glioblastoma (GBM), and triple-negative breast cancer (TNBC). In this review, we focus on the role of iPD-1 in tumorigenesis and development and its molecular mechanisms. We also deeply discuss nivolumab-based combined therapy in common tumor therapy. iPD-1 may explain the different therapeutic effects of anti-PD-1 treatment and provide critical information for use in combined anti-tumor approaches.

Abstract Background There is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (≥2). Whether it is safe and feasible to have bilateral simultaneous surgical resection remains unknown. The purpose of this study is to summarize the experience of surgical resection of patients with multiple GGOs in our Hospital in recent years, and to discuss the above questions. Methods Clinical datas of patients who underwent one-stage bilateral uni-portal VATS resections of multiple pulmonary ground glass opacities and had routine pathological examination were collected from May 2016 to May 2019 in our hospital. Results A total of 34 patients underwent simultaneous bilateral surgical resection of multiple GGO lesions, 28 were women,6 were men, the average age of total patients was 57.9 ± 6.7 years. All patients underwent bilateral uni-portal video-assisted thoracoscopic surgery (Uni-portal VATS), the average intraoperative blood loss was 100.9 ± 67.7 ml, the average operation time was 140 ± 74.8 min, the average thoracic drainage time was 2.8 ± 3.1 days, and the average postoperative hospital stay was 4.2 ± 4.3 days. Postoperative complications including: 2 cases of infection, 3 cases of atrial fibrillation, and 5 cases of persistent air leakage for more than 3 days. All of them improved after treatment, and there were no serious complications and deaths in perioperative period. A total of 76 GGO lesions were resected, with a total malignancy rate of 81.6%, including 40 were pure GGO, of which 28 were malignant (70%), and the average diameter of them were 9.6 ± 3.8 mm; 36 were mixed GGO, of which 34 were malignant (94.4%), the average diameter of them were 15.6 ± 6.6 mm.Mean postoperative follow-up was 28.4 (range, 3–39) months. There was neither recurrence nor deaths at final follow-up. Conclusion The malignancy rate of multiple GGOs is high. Therefore, when the lung function is allowed,one-stage bilateral uni-portal VATS can be considered. According to experience of main surgeon and the frozen biopsy, either sub-lobar resection or lobectomy was acceptable. The risk of postoperative complications and the prognosis were optimal.

目的 总结多发肺磨玻璃影(ground-glass opacity,GGO)患者同期手术切除的技术要点.方法 回顾性分析2015年11月至2019年5月65例在武汉同济医院胸外科同期行多发肺GGO切除患者的临床资料,其中男13例、女52例,平均年龄(56.0±9.4)岁,分析患者手术情况及肺GGO相关信息.结果 患者发现GGO至手术时间间隔8～ 1447(236.5±362.4)d.同期单侧手术48例,同期双侧手术17例,除2例患者因全胸腔粘连中转开胸外,其余均为胸腔镜手术,无围手术期严重并发症及死亡病例,术后平均住院时间(12.2±4.3)d.共切除GGO病灶156个,纯GGO 80个,其中恶性58个(72.5％),平均直径(7.7±3.3)mm,良性22个(27.5％),平均直径(5.5±2.6)mm;混合GGO 76个,其中恶性69个(90.8％),平均直径(13.6±6.6)mm,良性7个(9.2％),平均直径(7.7±3.5)mm.结论 患者发现肺多发GGO时应进行规范抗炎治疗,当保守治疗无效且经观察后无良性转归者应考虑外科手术治疗.此类患者病灶为恶性可能性大,在肺功能允许时可考虑同期单侧或双侧胸腔镜多病灶切除,根据病灶临床特征及术中快速病理结果可灵活采取亚肺叶及(或)肺叶切除方法,不会增加患者术后并发症风险;如评估患者无法耐受同期多病灶切除,直径＞7.7 mm的GGO病灶应优先考虑手术切除.

目的 探究pT1期非小细胞肺癌N2淋巴结转移特点及其影响因素,为术中更加准确地行系统的淋巴结清扫以及术后准确的病理分期提供依据.方法 回顾性分析2013年5月到2018年12月在华中科技大学同济医学院附属同济医院胸外科行肺癌根治术的48例患者的临床资料,其中男性32例,女性16例,年龄38～70 (57.8±7.2)岁.依据术后病理结果,将N2淋巴结转移的患者分为跳跃转移组和非跳跃转移组,其中跳跃转移组15例,非跳跃转移组33例,分析N2淋巴结转移特点和跳跃转移特点及其影响因素.结果 pT1期N2淋巴结转移以腺癌(87.5％)、外周型病灶(70.8％)及pT1c(64.6％)期多见,主要手术方式为肺叶切除,所有患者N2淋巴结转移率为16.3,N1淋巴结转移率为11.7％,N2淋巴结转移更多发生在隆突下(27.8％)及上纵隔淋巴结(47.5％),发生下纵隔淋巴结转移概率极低(1.6％);上叶肺癌以上纵隔及隆突下淋巴结转移为主,下叶肺癌以隆突下淋巴结转移为主;右肺癌主要是2/3/4/7组淋巴结转移,左肺癌主要是6/7组淋巴结转移;对比两组临床资料,在术后病理分化程度上有显著性差异(P＜0.01),然而在年龄、性别、吸烟史、家族史、肿瘤大小、肿瘤位置、术前癌胚抗原(CEA)水平及肿瘤病理类型上均无差异性.结论 pT1期肺腺癌及外周型病灶较容易发生N2淋巴结转移,在行肺癌根治术时,应重点清扫隆突下及上纵隔淋巴结;对于pT1期非小细胞肺癌,肿瘤直径越大,越容易发生N2淋巴结转移;年龄、性别、吸烟史、家族史、肿瘤大小、肿瘤位置、术前CEA水平及肿瘤病理类型与早期非小细胞肺癌是否发生N2淋巴结跳跃转移无明显的相关性,肿瘤分化程度的高低可能是早期非小细胞肺癌发生N2淋巴结跳跃转移的影响因素.

男,53岁,胸部隐痛不适1个月余.无呼吸困难、心慌、胸闷、咳嗽、咳痰、四肢乏力等不适.无慢性基础疾病史,体格检查未见明显异常.既往体健.入院查心电图、甲状腺B超及甲状腺功能(TSH、fT3、fT4)均未见明显异常.胸部增强CT及MRI检查提示:左心房上方,升主动脉后方见一大小约53 mm× 36mm的不规则混杂密度肿块,考虑心包内肿瘤(图1,图2).然而,心脏彩超检查显示此肿块并未造成右心室流出道受阻以及肺动脉受压,心脏内未见结构异常.为进一步的临床及病理诊断,完善术前检查后,于2015年9月1日在全麻下行右后外侧切口开胸心包内肿瘤切除术,切开心包,见肿块位于升主动脉后方,左心房上方,大小约60 mm×36 mm,包膜完整,质韧硬,与升主动脉外膜粘连,与左心房无明显粘连,5ml注射器穿刺肿瘤无液体抽出,排除血管瘤可能,逐步分离粘连,完整切除肿瘤.

孤立性纤维瘤(solitary fibrous tumor,SFT)临床上相对少见,以往认为是间皮瘤的一个类型,发病率低,好发于胸腹腔,临床表现为局部生长缓慢的无痛性肿块,随着肿瘤的增大会出现相应部位的压迫症状,如咳嗽、疼痛、呼吸困难、肺性骨关节病等[1].