Background The azygos lobe (AL) combined with partial anomalous pulmonary venous return (PAPVR) is comparatively uncommon as well as in radical surgery for right lung cancer. Case presentation We herein present an extremely rare case of lung cancer coexisting with AL and asymptomatic PAPVR, which was diagnosed with preoperative contrast three-dimensional reconstruction and received radical surgery by thoracoscopy. During the surgery, we preserved azygos vein successfully and found a split type of PAPVR in right upper pulmonary vein. Conclusions AL combined with PAPVR may cause confusion on the vascular separation and disconnection of the right pulmonary hilar. However, preoperative 3D reconstruction is more conducive to the correct performing of this type of surgery.

PurposeThe purpose of this study was to create a mathematical model based on the metabolic parameters of PET/CT with clinicopathological characteristics to predict the EGFR mutation status of patients with lung adenocarcinoma.MethodsThis study retrospectively enrolled patients with lung adenocarcinoma who underwent surgical treatment at two centres in China between January 2012 and December 2015. PET/CT metabolic parameters and Classical EGFR mutation status detection by molecular pathology were performed before and after surgery, and we analysed the associations of EGFR mutation status with patient sex, age, smoking history, maximum primary lesion diameter, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 fragment (CYFRA21-1), TNM stage and histopathological subtype of lung adenocarcinoma.ResultsA total of 310 patients were included, comprising 161 with EGFR mutations (51.9%) and 149 with wild-type EGFR (48.1%). EGFR mutations were more common in females, non-smokers, and those with stage IV disease, a low SUVmax, and ≤35 mm nodules, whereas wild-type EGFR was more common in males, smokers, and those with a solid growth pattern. Multivariate analysis suggested that liver SUVratio, smoking history, tumour size, TNM stage, and solid growth pattern can predict EGFR mutation status, and these factors were used to construct a mathematical model.ConclusionThe prediction model constructed in this study based on clinicopathological characteristics and PET/CT parameters might offer a basis by which to predict Classical EGFR status and provide a certain reference value for guiding the use of EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with lung adenocarcinoma.

Background: The azygos lobe (AL) combined with partial anomalous pulmonary venous return (PAPVR) is comparatively uncommon as well as in radical surgery for right lung cancer.Case presentation: We herein present an extremely rare case of lung cancer coexisting with AL and asymptomatic PAPVC, which was diagnosed with preoperative contrast three-dimensional reconstruction and received radical surgery by thoracoscopy. During the surgery, we preserved azygos vein successfully and found a split type of PAPVR in right upper pulmonary vein.Conclusions: AL combined with PAPVR may cause confusion on the vascular separation and disconnection of the right pulmonary hilar. However, preoperative 3D reconstruction are more conducive to the correct performing of this type of surgery.

Background: Dysregulated circadian dynamic balance is strongly associated with cancer development. However, biological functions of circadian rhythms in lung adenocarcinoma (LUAD) have not been elucidated. This study aimed at valuating the modulatory effects of circadian rhythms in the LUAD tumor microenvironment.Methods: Multiple open-source bioinformatics research platforms are used to comprehensively elucidate the expression level, prognosis, potential biological function, drug sensitivity, and immune microenvironment of circadian clock genes in LUAD.Results: Most circadian clock genes in LUAD are dysregulated and are strongly correlated with patient prognosis, and missense mutations at splicing sites of these genes. Besides, these genes are closely associated with some well-known cancer-related marker pathways, which are mainly involved in the inhibition of the Apoptosis, Cell cycle, and DNA Damage Response Pathway. Furthermore, functional enrichment analysis revealedthat circadian clock genes regulate transcription factor activities and circadian rhythms in LUAD tissues. As for drug sensitivity, high expression of CLOCK, CRY1, and NR1D2 as well as suppressedPER2 and CRY2 expression levels are associated with drug resistance. The expression levels of circadian clock genes in LUAD correlate with immune infiltration and are involved in the regulation of immunosuppression.Conclusions: Our multi-omics analysis provides a more comprehensive understanding of the molecular mechanisms of the circadian clock genes in LUAD and provides new insights for a more precise screening of prognostic biomarkers and immunotherapy.