The possible role of Epstein-Barr virus (EBV) in the pathogenesis of thymic epithelial tumors (TET) remains controversial. This study aimed to determine the prevalence of EBV in TET. We conducted a systematic review of relevant English-language studies published between January 1980 and December 2013. Effect size was calculated as event rates (95% confidence interval [CI]) by homogeneity testing using Cochran’s Q and I2 statistics for benign TET, benign TET with myasthenia gravis (MG), and thymic carcinoma (TC). Among 136 potentially relevant studies, 22 met the inclusion criteria. Despite a considerable degree of heterogeneity, the pooled estimated incidences were 9% (95% CI, 1–23%), 20% (95% CI, 0–54%), and 6% (95% CI, 0–21%) for benign TET, benign TET with MG, and TC, respectively. There was significant heterogeneity among studies that used in situ hybridization (ISH) for both benign TET and benign TET with MG. According to the random-effects model, studies employing ISH yielded lower point estimates of EBV prevalence (5%) than those employing other methods (33%). Using the random-effects model, we found a lack of significant heterogeneity among studies from different geographic regions (p = 0.0848). Further, 12 of 23 lymphoepithelioma-like carcinoma (LELC) cases tested EBV-positive. The prevalence of EBV in benign TET with or without MG was lower than in nasopharyngeal carcinoma, suggesting that EBV plays a minor role in TET pathogenesis. Although the prevalence of EBV in TC was also low, EBV may play an important causal role in LELC. Further research is needed to clarify these associations.

This case series demonstrates the successful use of autogenous rib grafts in the reconstruction of the manubrium after resection. We consider that the reconstruction technique is a safe and effective alternative to a complex problem.

Although several surgical approaches exist for lower thoracic oesophageal cancer, standardized techniques for minimally invasive oesophageal resection and intrathoracic anastomosis have not yet been established. Thus, optimization of the approach and identification of the ideal anastomosis technique are needed. Seven consecutive patients with lower thoracic oesophageal cancer were treated using a single-position, minimally invasive surgical technique with laparoscopy and thoracoscopy. In the present article, we describe this technique in detail and discuss the outcomes of these patients. No adverse events occurred intraoperatively, no failures in the intrathoracic oesophagogastrostomy were detected and favourable short-term outcomes were obtained. Thus, the procedure described is safe and technically feasible and appears to be promising as an alternative approach for the treatment of patients with lower thoracic oesophageal cancer.

Background Although postoperative chylothorax following lung cancer surgery is rare, it is a recognized complication in 0.25–3% of patients. However, cases of cardiac tamponade caused by chylopericardium after lung cancer surgery are extremely rare. Case presentation We describe hitherto unreported sequelae of chyle leak following lobectomy and systematic mediastinal lymph node dissection (SLND) causing pericardial tamponade and cardiovascular compromise. The patient was successfully treated with minimally invasive surgical repair and ligation. We also discuss the development of chylopericardium as a potential complication of lobectomy and SLND. Conclusions The anatomical characteristics of the thoracic duct warrant special attention in postoperative chyle leak management in patients who undergo definitive mediastinal lymph node dissection. Surgeons should be aware that chylopericardium is a rare but potential complication of lobectomy and SLND as it may help with early diagnosis, management, and prevention of cardiac tamponade.

BackgroundEvidence suggests that long non-coding RNAs (lncRNAs) are involved in various cancers. Here, we developed and evaluated an autophagy-related prognostic lncRNA signature for lung adenocarcinoma (LUAD). ResultsUsing a publicly available microarray dataset from The Cancer Genome Atlas, we analyzed the lncRNA expression profile in a cohort of 439 LUAD patients. The lncRNA-mRNA co-expression network along with univariate and multivariate Cox regression analyses were used to determine 15 autophagy-related lncRNA signatures that were significantly correlated with patient overall survival. Autophagy-related lncRNA signatures stratified patients into high- and low-risk groups with significantly different survival (hazard ratio = 3.256, 95% confidence interval = 2.858–4.101, P < 0.001). The lncRNA signature was further confirmed in other independent datasets. Moreover, the lncRNA signature had prognostic value independent of routine clinical factors. Functional analysis indicated that autophagy-related lncRNA signatures may be involved in LUAD via known autophagy-related pathways. ConclusionsThis newly identified autophagy-related lncRNA signature is a more powerful prognostic tool than the clinicopathological factors routinely used to predict patient survival, and can provide further insights into the molecular mechanisms underlying LUAD.