Lung cancer is the leading cause of cancer-related death. In particular, non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. Due to tumor resistance and the toxicity of chemotherapeutic agents, it is increasingly critical to discover novel, potent antitumorigenic drugs for treating NSCLC. Lutein, a carotenoid, has been reported to exert toxic effects on cells in several tumor types. However, the detailed functions and underlying mechanisms of lutein in NSCLC remain elusive. The present study showed that lutein significantly and dose-dependently inhibited cell proliferation, arrested the cell cycle at the G0/G1 phase, and induced apoptosis in NSCLC cells. RNA-sequencing analysis revealed that the p53 signaling pathway was the most significantly upregulated in lutein-treated A549 cells. Mechanistically, lutein exerted antitumorigenic effects by inducing DNA damage and subsequently activating the ATR/Chk1/p53 signaling pathway in A549 cells. In vivo, lutein impeded tumor growth in mice and prolonged their survival. In conclusion, our findings demonstrate the antitumorigenic potential of lutein and reveal its molecular mechanism of action, suggesting that lutein is a promising candidate for clinical NSCLC treatment.

Chemokines are chemotactic-competent molecules composed of a family of small cytokines, playing a key role in regulating tumor progression. The roles of chemokines in antitumor immune responses are of great interest. CXCL9, CXCL10, and CXCL11 are important members of chemokines. It has been widely investigated that these three chemokines can bind to their common receptor CXCR3 and regulate the differentiation, migration, and tumor infiltration of immune cells, directly or indirectly affecting tumor growth and metastasis. Here, we summarize the mechanism of how the CXCL9/10/11-CXCR3 axis affects the tumor microenvironment, and list the latest researches to find out how this axis predicts the prognosis of different cancers. In addition, immunotherapy improves the survival of tumor patients, but some patients show drug resistance. Studies have found that the regulation of CXCL9/10/11-CXCR3 on the tumor microenvironment is involved in the process of changing immunotherapy resistance. Here we also describe new approaches to restoring sensitivity to immune checkpoint inhibitors through the CXCL9/10/11-CXCR3 axis.

Macrophages, a type of myeloid immune cell, play essential roles in fighting against pathogenic invasion and activating T cell-mediated adaptive immune responses. As a major constituent of the tumor microenvironment (TME), macrophages play a complex role in tumorigenesis and tumor progression. They can inhibit tumor growth by releasing proinflammatory cytokines and exerting cytotoxic activities but principally contribute to tumor progression by promoting tumor proliferation, angiogenesis, and metastasis. The tumor-promoting hall-marks of macrophages have aroused widespread interest in targeting tumor-associated macrophages (TAMs) for cancer immunotherapy. Increasing preclinical and clinical studies suggest that TAMs are a promising target for cancer immunotherapy. To date, TAM-targeted therapeutic strategies have mainly been divided into two kinds: inhibiting pro-tumor TAMs and activating anti-tumor TAMs. We reviewed the heterogeneous and plastic characteristics of macrophages in the TME and the feasible strategies to target TAMs in cancer immunotherapy and summarized the complementary effect of TAM-targeted therapy with traditional treatments or other immunotherapies.

Macrophages, a type of myeloid immune cell, play essential roles in fighting against pathogenic invasion and activating T cell-mediated adaptive immune responses. As a major constituent of the tumor microenvironment (TME), macrophages play a complex role in tumorigenesis and tumor progression. They can inhibit tumor growth by releasing proinflammatory cytokines and exerting cytotoxic activities but principally contribute to tumor progression by promoting tumor proliferation, angiogenesis, and metastasis. The tumor-promoting hallmarks of macrophages have aroused widespread interest in targeting tumor-associated macrophages (TAMs) for cancer immunotherapy. Increasing preclinical and clinical studies suggest that TAMs are a promising target for cancer immunotherapy. To date, TAM-targeted therapeutic strategies have mainly been divided into two kinds: inhibiting pro-tumor TAMs and activating anti-tumor TAMs. We reviewed the heterogeneous and plastic characteristics of macrophages in the TME and the feasible strategies to target TAMs in cancer immunotherapy and summarized the complementary effect of TAM-targeted therapy with traditional treatments or other immunotherapies.

BACKGROUND:The current outbreak of coronavirus disease 2019 (COVID-19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, Hubei, China, spreads across national and international borders.METHODS:We prospectively collected medical records of 14 health care workers (HCWs) who were infected with SARS-CoV-2, in neurosurgery department of Wuhan Union Hospital, China.RESULTS:Among the 14 HCWs, 12 were conformed cases, the other 2 were suspected cases. Most of them were either exposed to the two index patients or infected coworkers, without knowing they were COVID-19 patients. There were 4 male and 10 female infected HCWs in this cohort, whose mean age was 36 years (SD, 6 years). The main symptoms included myalgia or fatigue (100%), fever (86%) and dry cough (71%). On admission, 79% of infected HCWs showed leucopenia and 43% lymphopenia. Reduced complement C3 could be seen in 57% of the infected HCWs and IL-6 was significantly elevated in 86% of them. The proportion of lymphocytes subsets, concentrations of immunoglobulins, complement C4, IL-2, IL-4, IL-10, TNF-α and IFN-γ were within normal range in these 14 infected HCWs. The most frequent findings on pulmonary computed tomographic images were bilateral multifocal ground-glass opacifications (86%).CONCLUSIONS:Human-to-human transmission of COVID-19 pneumonia has occurred among HCWs, and most of these infected HCWs with confirmed COVID-19 are mild cases. Our data suggest that in the epidemic area of COVID-19, stringent and urgent surveillance and infection-control measures should be implemented to protect doctors and nurses from COVID-19 infection.

BACKGROUND & AIMS: We compared clinical, laboratory, radiological, and outcome features of patients with SARS-CoV-2 infection (COVID-19) with pneumonia, with vs without diarrhea. METHODS: We performed a retrospective, single-center analysis of 84 patients with SARS-CoV-2 pneumonia in Wuhan Union Hospital, China, from January 19 through February 7, 2020. Cases were confirmed by real-time reverse-transcriptase PCR of nasal and pharyngeal swab specimens for SARS-CoV-2 RNA. Blood samples were analyzed for white blood cell count, lymphocyte count, alanine aminotransferase, creatine kinase, lactate dehydrogenase, D-dimer, C-reactive protein, and in some cases, immunoglobulins, complement, lymphocyte subsets, and cytokines. Virus RNA was detected in stool samples by real-time PCR. RESULTS: Of the 84 patients with SARS-CoV-2 pneumonia, 26 (31%) had diarrhea. The duration of fever and dyspnea in patients with diarrhea was significantly longer than those without diarrhea (all P <.05). Stool samples from a higher proportion of patients with diarrhea tested positive for virus RNA (69%) than from patients without diarrhea (17%) (P <.001). As of February 19, a lower proportion of patients with diarrhea had a negative result from the latest throat swab for SARS-CoV-2 (77%) than patients without diarrhea (97%) (P = .010), during these patients' hospitalization. Of 76 patients with a negative result from their latest throat swab test during hospitalization, a significantly higher proportion of patients with diarrhea had a positive result from the retest for SARS-CoV-2 in stool (45%) than patients without diarrhea (20%) (P = .039). CONCLUSIONS: At a single center in Wuhan, China, 31% of patients with SARS-CoV-2 pneumonia had diarrhea. A significantly higher proportion of patients with diarrhea have virus RNA in stool than patients without diarrhea. Elimination of SARS-CoV-2 from stool takes longer than elimination from the nose and throat.

Background: The pneumonia associated with the novel coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2) is breaking out in Wuhan, China. We aimed to clarify the differences of clinical, laboratory, radiological, and outcome characteristics between SARS-CoV-2 infective pneumonia (Corona Virus Disease 2019, COVID-19) patients with diarrhea and those without. Methods: In this retrospective, single-center study, we included 84 confirmed patients of SARS-CoV-2 pneumonia in Wuhan Union Hospital from Jan 19 to Feb 7. Patients were confirmed by Real-Time Reverse-Transcriptase–Polymerase-Chain-Reaction Testing in pharyngeal swab. The clinical manifestations, laboratory examinations, imaging manifestations and outcomes of patients with diarrhea and those without diarrhea were compared. Findings: Of 84 patients with SARS-CoV-2 pneumonia, diarrhea occurred in 26 (31%) patients. Patients with diarrhea, compared to those without diarrhea, were more likely to have headache (57.7% vs 22.4%, p = 0.003), myalgia or fatigue (94.4% vs 50.0%,p = 0.010), cough(84.6% vs 44.8%, p < 0.001), sputum production(53.8% vs 20.7%, p = 0.0004), nausea(38.5% vs 10.3, p < 0.005) and vomiting(19.2% vs 1.7%, p = 0.010). The duration of fever and dyspnea in patients with diarrhea was significantly longer than those without diarrhea (10.5±4.7 vs 7.6±3.4(day), p = 0.005; 8.1±3.2 vs 4.7±2.3(day), p = 0.002; respectively). There are no differences in most of the laboratory findings between these two groups, including lymphocyte count, creatinine, lactate dehydrogenase and D-Dimer. The positive rate of testing SARS-CoV-2 from stool of COVID-19 patients with diarrhea was much higher than that of patients without (69.2% vs 17.2%, p < 0.001). As of Feb 19, the negative rate in retesting SARS-CoV-2 from throat swab of diarrhea group was significantly lower, as compared with non-diarrhea group (76.9% vs 96.6%, p = 0.010). Of 76 COVID-19 patients whose throat swab test have turn to be negative for SARS-CoV-2, the positive rate in retesting SARS-CoV-2 from stool was significantly higher in diarrhea group, as compared to non-diarrhea group (45.0% vs 19.6%, p = 0.039). Interpretation: COVID-19 patients with diarrhea suffered discomfort longer, as compared with COVID-19 pneumonia patients without diarrhea. The elimination of SARS-CoV-2 from digestive system took much more time than that from respiratory system, in some COVID-19 patients with diarrhea.Funding Statement: The authors stated: "None."Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: Data collection and analysis of cases and close contacts were determined by the National Health Commission of the People's Republic of China to be part of a continuing public health outbreak investigation and were thus considered exempt from institutional review board approval.

BAckground Severe COVID-19 patients account for most of the mortality of this disease. Early detection of severe cases of the disease remains a major challenge. Here, we performed clinical and laboratory profiling of COVID-19 to explore the early warning indicators of severe cases. Methods An analysis of the evolution during the hospitalization of clinical and laboratory findings from 78 confirmed COVID-19 patients and the associated risk factors. Results Of the 78 patients who were classified as un-severe at admission, 60 patients(stable group) were stable as mild cases until discharge, and the remaining 18 patients progressed to severe cases(exacerbated group) during hospitalization. Compared with stable patients, exacerbated patients exhibited older, higher BMI values and higher proportion of smokers. In the exacerbated patients, the median time from onset to deterioration was 7.5 days. Before the time point(days 0–7 from onset), we observed higher-levels of White blood cells(WBC), neutrophil, Neutrophi-Lymphocyte-Ratio(NLR), Lactose-dehydrogenase(LDH), D-dimer, and lower-levels of albumin in the exacerbated group, compared with the stable group. In the second week after the time point, the exacerbated patients displayed lower numbers of lymphocytes, CD3 + , and CD8 + T-cells, and higher-levels of C-reactive protein(CRP), erythrocyte-sedimentation-rate(ESR), Alanine-aminotransferase(ALT),Aspartate-aminotransferase(AST), and Interleukin-6. In the third week, the highest temperature and the proportion of febrile patients declined. All of the laboratory indicators gradually improved. Conclusions Advanced age and smoking history could be risk factors for COVID-19 progression. In the early stage, high-levels of WBC and neutrophils, with noticeably increased LDH and D-dimer, could be early indicators of the disease’s conversion from mild to severe, followed by elevated inflammatory markers, liver enzymes, and decreased T-lymphocytes in the next week.

An increasing number of studies have reported that exosomes released from various cells can serve as mediators of information exchange between different cells. With further exploration of exosome content, a more accurate molecular mechanism involved in the process of cell-to-cell communication has been revealed; specifically, microRNAs (miRNAs) and long noncoding RNAs (lncRNAs) are shuttled by exosomes. In addition, exosomal miRNAs and lncRNAs may play vital roles in the pathogenesis of several respiratory diseases, such as chronic obstructive pulmonary disease (COPD), lung cancer, and asthma. Consequently, exosomal miRNAs and lncRNAs show promise as diagnostic biomarkers and therapeutic targets in several lung diseases. This review will summarize recent knowledge about the roles of exosomal miRNAs and lncRNAs in lung diseases, which has shed light on the discovery of novel diagnostic methods and treatments for these disorders. Because there is almost no published literature about exosomal lncRNAs in COPD, asthma, interstitial lung disease, or tuberculosis, we summarize the roles of exosomal lncRNAs only in lung cancer in the second section. This may inspire some new ideas for researchers who are interested in whether lncRNAs shuttled by exosomes may play roles in other lung diseases.

The lungs are one of the most common organs to which cancer metastasizes, but are a location not common for uterine sarcoma. A malignant mixed Mullerian tumor (MMMT) of the uterus is an extremely rare and aggressive sarcoma, characterized by a mixture of epithelial and mesenchymal components. There are few reports regarding the pulmonary metastasis from MMMTs. The present study presents the case of a 58-year-old woman with hemoptysis and post-menopausal vaginal bleeding. The woman was initially diagnosed with invasive aspergillosis based on a chest computed tomography (CT) scan showing multiple pulmonary nodular opacities surrounded by a ground-glass attenuation halo (halo-sign). Diagnostic curettage and a percutaneous CT-guided lung biopsy were conducted for the pathological diagnosis. Finally, the diagnosis was confirmed as MMMT with lung metastasis based on the histopathological examination of cervical canals, uterus and lung specimens, which showed a mixture of carcinomatous and sarcomatous elements, and morphology exhibiting hyperchromatic nuclei and necrosis. Immunohistochemical staining was positive for vimentin, focally positive for p16, and negative for napsin, cytokeratin 7 (CK7), CK20, carcinoembryonic antigen, carbohydrate antigen 125, homeobox protein CDX2 and villin in the lung specimens. This case highlights that pulmonary metastatic tumor from uterine sarcoma can present as halo-sign, which is commonly observed in pulmonary aspergillosis. Therefore, it needs to be considered in the differential diagnosis of such lesions, and pathological confirmation is required.

目的：探讨顺铂联合重组人血管内皮抑素（恩度）对老年恶性胸腔积液患者血管内皮生长因子（ VEGF）、基质金属蛋白酶（ MMP）－9及生活质量（ QOL）的影响。方法老年恶性胸腔积液患者56例，随机分为实验组和对照组，每组28例，各组患者在进行胸腔闭式引流后，给予对照组患者含有恩度的生理盐水进行胸腔局部灌注治疗，给予实验组患者含有顺铂联合恩度的生理盐水进行局部灌注治疗。两组患者均以2w为1个疗程，连续治疗2个疗程。观察两组患者VEGF、MMP－9水平变化，观察治疗后两组患者的临床疗效、不良反应发生情况，并对两组患者的生活质量进行评分。结果治疗结束后与对照组相比，实验组患者VEGF、MMP－9水平较低（P＜0．05）；临床总有效率较高（P＜0．05）；KPS评分较高（P＜0．05）；不良反应发生率无统计学差异（ P＞0．05）。结论顺铂联合恩度能够积极有效的提高老年恶性胸腔积液患者的生活质量，且安全性高。

Toll-like receptor (TLR) 2 has a well-known role in sensing multiple ligands that include microbial products, endotoxin, and some extracellular matrix molecules; however, its role in the development of malignant pleural effusion (MPE) remains unknown. We performed the present study to explore the impact of TLR2 signaling on the development of MPE and to define the underlying mechanisms by which TLR2 works. Development of MPE was compared between TLR2-/- and wild-type (WT) mice. The effect of TLR2 on differentiation of T helper type 17 (Th17), Th9, and Th2 cells in MPE was explored. The mechanisms of TLR2 on survival of mice bearing MPE were also investigated. MPE volume in TLR2-/- mice was lower than that in WT mice, and the survival of TLR2-/- mice bearing MPE was longer than that of WT mice. TLR2 deficiency increased, and TLR2 activation decreased, Th17 cells in MPE, whereas TLR2 signaling showed the contrary effects on Th2 cells. Th9 cells were increased in MPE of TLR2-/- mice but were not influenced by TLR2 signaling. Intraperitoneal injection of anti-IL-17 monoclonal antibody (mAb), anti-IL-9 mAb, or recombinant mouse IL-4 accelerated the death of TLR2-/- mice bearing MPE, and intraperitoneal injection anti-IL-17 mAb in TLR2-/- mice was associated with a significantly shorter survival time than in WT mice. We have demonstrated, for the first time, that TLR2 signaling promotes the development of MPE and accelerates the death of mice bearing MPE by directly suppressing Th17 cell differentiation and directly promoting Th2 cell differentiation, and also by indirectly suppressing Th9 cell differentiation via an IL-17-dependent mechanism.

探讨两种不同剂量恩度联合顺铂腔内灌注治疗非小细胞肺癌(NSCLC)恶性胸腔积液(MPE)患者疗效及不良反应的差异.将42例NSCLC合并MPE患者分为低剂量组(A组)20例、高剂量组(B组)22例,A组每周予顺铂35mg/m2/d1+恩度30mg/d2,B组每周予顺铂35mg/m2/d1+恩度30mg/d2、d4,均连续行胸腔内灌注治疗2周,比较两组疗效、生活质量及不良反应.B组缓解率及疾病控制率为72.73％及95.45％,均显著优于A组的40.00％及70.00％ (P＜0.05).两组患者治疗后KPS、QLICP-LU总分、心理功能、咳喘、胸闷痛等领域评分均较治疗前显著增加(P＜0.05),B组基本生理功能亦得以改善(P＜0.05).除认知功能外,两组治疗后KPS及QLICP-LU评分差异无统计学意义(P＞0.05).B组药物毒副反应较A组稍大,差异无统计学意义(P＞0.05).高剂量组近期疗效显著优于低剂量组.两种方案均使生活质量获益,高剂量组在基本生理功能及认知方面较低剂量组有一定改善趋势.高剂量组毒副反应较低剂量组稍大,但均可耐受.

目的 比较伊立替康(CPT-11)联合洛铂或顺铂(DDP)二线治疗经治后6个月内复发或转移的晚期小细胞肺癌,观察近期疗效和毒副反应.方法 收集41例经治复发及进展的广泛期小细胞肺癌病例,以抽签方式随机分为实验组和对照组.实验组21例,采用洛铂(LBP) 30mg/m2,d1,伊立替康(CPT-11)65mg/m2,d1、8,21d为1周期;对照组20例,采用CPT-11 65mg/m2,d1、8,DDP 25 mg/m2,d1 ～3,21d为1周期.病例至少完成2周期化疗.结果 两组间客观缓解率、疾病控制率、生存时间无差异(P＞0.05);实验组平均无进展生存时间有所延长(P=0.04);毒副反应中,实验组治疗后Ⅲ～Ⅳ度血小板减少发生率38.1％,对照组为20％,差异具有统计学意义(P=0.03);实验组治疗后Ⅲ～Ⅳ度恶心呕吐发生率为9.5％,对照组为35％,差异也具有统计学意义(P=0.049).结论 CPT-11联合LBP方案二线治疗复发或转移小细胞肺癌(SCLC)在控制肿瘤进展方面较CPT-11联合DDP方案有一定优势,而且毒副反应可耐受.

Malignant pleural effusion ( MPE ) is a common complication of advanced non -small cell lung cancer ( NSCLC) and has seriously impacts on patient's quality of life.Recombinant human endostatin injection ( Endostar) , SF-DA approved since 2006, combined with cisplatin intrapleural perfusion showed good effectivity and good safety for the treatment of NSCLC patients with MPE.The recent clinical research of Endostar combined with cisplatin intrapleural perfu-sion for the treatment of NSCLC MPE are reviewed.

目的：探讨斑蝥酸钠维生素B6注射液联合化疗治疗非小细胞肺癌（ NSCLC）的疗效及对患者免疫功能的影响。方法选择2011年1月至2014年12月在该院就诊的NSCLC患者106例，随机分成对照组和观察组各53例。对照组给予GP化疗方案治疗，观察组给予 GP化疗方案联合静脉滴注斑蝥酸钠维生素B6注射液治疗。结果观察组总有效率高于对照组（ P＜0．05）。治疗后，两组 CD3＋、CD3＋CD4＋、CD16＋CD56＋、CD4／CD8水平与治疗前相比均有所下降，且观察组均高于对照组（均P＜0．01）。治疗后，观察组躯体功能（67．2±16．6）分、情绪功能（73．8±17．2）分、社会功能（66．7±20．4）分、整体生活质量（83．5±25．7）分均高于对照组躯体功能（55．7±14．5）分、情绪功能（62．9±15．1）分、社会功能（54．6±19．2）分、整体生活质量（72．7±22．6）分（P＜0．05或P＜0．01）。观察组患者的血红蛋白下降、白细胞下降、肝肾功能损伤以及恶心呕吐等不良反应的发生率均低于对照组（P＜0．05或P＜0．01）。结论斑蝥酸钠维生素B6注射液联合化疗治疗NSCLC，能够调节患者的免疫功能、提高患者的生活质量，降低化疗期间患者的不良反应。

Objective:To determine the effect of DC-CIK maintenance therapy on the quality of life in advanced non-small cell lung cancer (NSCLC)patients.Methods:Fifty patients with stage Ⅲb or IV NSCLC who achieved com-plete remission,partial remission or stable disease after standard treatment were divided into two groups equally and ran-domly.Group A was treated with a course of autologous DC-CIK maintenance treatment,and group B was treated with im-munosuppressive drugs (Kang Aizhen)for 10 days.The quality of life of patient was measured by QLICP-LU scale at the time of hospitalized and two months after treatment.Scores of quality of life pre-and post-treatment and factors related to therapeutic effect were analyzed ,furthmore,the safety of treatment was also evaluated.Results:The qualities of life in NSCLC patients were improved after DC-CIK maintence therapy(P <0.05).The qualities of life were improved significant-ly in squamous cell cancer,stage IV,aged over 60 years male patients after DC-CIK maintenance treatment.Total inci-dence of adverse reaction was 4% and no severe bone marrow suppression,liver and kidney toxicity and gastrointestinal tract reaction were observed during treatment period.Conclusion:Autologous DC-CIK treatment has potential benefit for the qualities of life of male patients who age over 60 years and with stage IV squamous cell lung cancer with acceptable side effects.It is a safe and effective method for maintenance ther-apy.

Tuberculous pleural effusions (TPEs) and malignant pleural effusions (MPEs) are difficult to differentiate between in certain clinical situations. Interleukin (IL)-33 is a cytokine that participates in inflammatory responses and may have a role in pleural effusions. The present study aimed to investigate the concentrations and potential differential significance of IL-33 in patients with TPE and MPE. IL-33 levels in pleural effusion and serum samples were detected using sandwich enzyme-linked immunosorbent assay in 23 patients with TPE and 21 patients with MPE. The concentration of IL-33 (mean ± standard deviation) in the TPE patients (22.962±0.976 ng/l) was significantly higher than that in the MPE patients (12.603±5.153 ng/l; P<0.001; z=-4.572); however, there was no significant difference in the serum level of IL-33 in the patients with TPE compared with those with MPE (P>0.05). The concentration of IL-33 in the pleural effusions was positively correlated with that in the serum samples in each group (TPE: r=0.563, P=0.05; MPE: r=0.535, P<0.05). The cut-off value of pleural IL-33 for TPE was 19.86 ng/l, which yielded a sensitivity of 0.869, a specificity of 0.905 and an area under the corresponding receiver operating characteristic curve of 0.903. The present study identified that the level of pleural IL-33 is significantly increased in TPEs and may serve as a novel biomarker to differentiate between patients with TPE and MPE.

目的 探讨联合检测外周血CEA、CA125、VEGF、MT及MMP-9与晚期非小细胞肺癌病理类型和临床分期的相关性.方法 分晚期非小细胞肺癌组(40例)和对照组(36例健康者),采用采用RT-PCR检测五种标记物外周血mRNA的表达情况.结果 肺癌组五项标志物mRNA表达化疗前明显高于对照组(P＜0.05),其表达与NSCLC病理类型、临床分期均无相关性.联合检测五种标记物灵敏度上升至90％.结论 联合检测五项肿瘤标记物可提高对晚期非小细胞肺癌诊断的敏感性,但与晚期非小细胞肺癌患者病理类型及分级之间差异均无统计学意义.

非小细胞肺癌已成为癌症死亡的第一病因，目前非小细胞肺癌的早期诊断尚有困难，大多数患者在诊断时已是局部晚期或者有远处转移。晚期患者常合并恶性胸腔积液，大量胸腔积液易导致肺容量下降，引起肺不张及肺部感染，导致胸闷气促呼吸困难等，严重影响肿瘤患者生活质量［1］。