評估治療性胸腔手術與白細胞介素17相關之肺部疾病

Abstract

Pneumonia may progress to parapneumonic empyema. Streptococcus pneumoniae is the common pathogen. IL-17 produced by Th17 cells has a role to against Streptococcus pneumonia. However, old age and heart failure with reduced left ventricular ejection fraction are high risks for operation. This kind of patients developing parapneumonic empyema remain challenges for surgeons. To overcome this problem, a novel therapeutic protocol using non-intubated video assisted thoracoscopic surgery was applied. We investigated the morbidities, mortality, and quality of life in high risk parapneumonic empyema patients. There were two methods, conventional tube thoracostomy and non-intubated video assisted thoracoscopic surgery, to deal with the patients. The novel therapy surgery was proven to have better results of morbidities, mortality, and quality of life than conventional tube thoracostomy. IL-17 of Th 17 response not only involves pulmonary inflammation, but promotes non-small cell lung cancer development. Epidermal growth factor receptor tyrosine kinase inhibitor therapy is the main treatment in advanced stage lung cancer patients harbored EGFR mutation. We retrospectively investigated the clinical characteristics and treatment outcomes of advanced stage lung cancer patients treated with tyrosine kinase inhibitor therapy. Non-smokers have a benefit in overall survival. Unfortunately, there are no good biomarkers to predict overall survival in advanced stage lung cancer. We detected sialylated LewisA, a cancer related O-glycan or CA 19-9, on lung cancer tumor cells. Immunohistochemistry staining was performed using sialylated LewisA antibody. There were sixty-six advanced stage patients receiving tyrosine kinase inhibitor therapy in our study. Positive immunohistochemistry staining patients (n=37) had better overall survival than negative immunohistochemistry staining patients (median survival time: 29.9 versus 12.5 months; p = 0.006). In proper selected lung cancer patients, sialylated LewisA or CA 19-9 immunohistochemistry staining may serve as a biomarker to predict overall survival.