BackgroundWe investigated the correlation between cavity formation, prognosis, and tumor stage for pathologic stage I invasive lung adenocarcinomas (IADCs) ≤3 cm in size.Material/Methods2106 candidates with pathologic stage I IADC were identified from Shanghai Chest Hospital between 2009 and 2014. There were 227 patients who were diagnosed as having cavity formation and another 1879 patients who were not (the non-cavitary lung cancer group). Kaplan-Meier analysis curves were conducted to compare the overall survival (OS) and relapse-free survival (RFS) between these 2 groups. Cox proportional hazards regression was performed to discover the independent risk factors of OS and RFS. Receiver operating characteristic (ROC) curve was done to determine the cutoff value of cavity size for predicting prognosis. Furthermore, subgroup analysis was stratified by the size of tumor and the 8th classification of T category.ResultsCompared with non-cavitary lung cancer group, patients with cavity formation were found to have a higher prevalence of male patients (P=0.015), older age patients (P=0.039), larger size tumors (P=0.004), and worse cancer relapse (P<0.001). Survival analysis found that patients with cavitary IADC had significantly shorter RFS than those with non-cavitary IADC (P=0.001). Further, subgroup analysis confirmed a significantly worse RFS in cavitary IADC group both in stage T1a (P=0.002) and T1b (P<0.001), but not for stage T1c (P=0.962) and T2a (P=0.364). Moreover, cavity formation was still less of a significant predictor of RFS in multivariable analysis (hazard ratio [HR] 1.810, 95% confidence level [CI] 1.229–2.665, P=0.003). The ROC curve showed that the best cutoff value of maximum diameter of the cavity for judging RFS was 5 mm (sensitivity: 0.500; specificity: 0.783). At the same time, multiple cavities were more likely to lead to recurrence (sensitivity: 0.605; specificity: 0.439).ConclusionsCavitary adenocarcinoma was a worse prognostic indicator compared with non-cavitary adenocarcinoma, especially for cavity >5 mm and multiple cavities. Thus, for stage T1a and T1b, cavitary and non-cavitary IADC should be considered separately.

A novel double-cladding Ho 3+ /Tm 3+ co-doped Bi 2 O 3 -GeO 2 -Ga 2 O 3 -BaF 2 glass fiber, which can be applied to a 2.0-μm infrared laser, was fabricated by a rod-tube drawing method. The thermal properties of the glass were studied by differential scanning calorimetry. It showed good thermal stability and matching thermal expansion coefficient for fiber drawing when T x −T g > 193°C and the maximum difference of the thermal expansion coefficient is 3.55 × 10 −6 /°C or less. The 2.0-μm luminescence characteristics were studied using the central wavelength of 808 nm pump light excitation. The results show that when the concentration ratio of Ho 3+ /Tm 3+ reaches 0.5 mol%:1.0 mol%, the maximum fluorescence intensity was obtained in the core glass, the emission cross section reached 10.09 × 10 −21 cm 2 , and the maximum phonon energy was 751 cm −1 . In this paper, a continuous laser output with a maximum power of 0.986 W and a wavelength of 2030 nm was obtained using an erbium-doped fiber laser as a pump source in a 0.5 m long Ho 3+ /Tm 3+ co-doped glass fiber. In short, the results show that Ho 3+ /Tm 3+ co-doped 36Bi 2 O 3 -30GeO 2 -15Ga 2 O 3 -10BaF 2 -9Na 2 O glass fiber has excellent laser properties, and it is an ideal

Background To determine the clinical prognosis after sublobectomy versus lobectomy in elderly patients ≥75 years old with stage I invasive lung adenocarcinoma ≤3 cm in size. Methods In patients ≥75 years old, 255 patients were diagnosed with stage I invasive lung adenocarcinoma ≤3 cm in size between 2010 and 2014 in Shanghai Chest Hospital, they were all treated with sublobectomy or lobectomy. Potential confounding factors that consisted in the baseline characteristics of these two groups was balanced by the method of propensity score matching (PSM). The stratified analysis was conducted to compare the relapse-free survival (RFS) and lung cancer special survival (LCSS) rates in the sublobectomy and lobectomy groups. Results As for the 255 patients, 112 cases conducted sublobectomy and 143 with lobectomy. Significant difference existed in RFS before (P=0.002) and after (P=0.010) PSM. Similarly, we still recognized significant difference in LCSS between the two groups before (log-rank P<0.001) or after (log-rank P=0.002) PSM. We still identified different RFS or LCSS rates between the stratified tumor size group and the stratified lymph node dissection group after adjustment of PSM. Conclusions Lobectomy showed a survival advantage for sublobectomy for patient ≥75 years old with stage I lung adenocarcinoma ≤3 cm in size. Considering that lobectomy could get a better prognosis, it should be preferable for the treatment of patient ≥75 years old with stage I lung adenocarcinoma ≤3 cm in size.