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  1. Poh ME, Liam CK, Mun KS, Chai CS, Wong CK, Tan JL, et al.
    Thorac Cancer, 2019 09;10(9):1841-1845.
    PMID: 31350945 DOI: 10.1111/1759-7714.13156
    Adjuvant chemotherapy has long been indicated to extend survival in completely resected stage IB to IIIA non-small cell lung cancer (NSCLC). However, there is accumulating evidence that chemotherapy or chemoradiotherapy can induce epithelial-to-mesenchymal transition (EMT) in disseminated or circulating NSCLC cells. Here, we describe the first case of EMT as the cause of recurrence and metastasis in a patient with resected stage IIB lung adenosquamous carcinoma after adjuvant chemotherapy. We review the literature and explore the possible mechanisms by which EMT occurs in disseminated tumor cells (DTC) or circulating tumor cells (CTC) in response to adjuvant chemotherapy (cisplatin) as a stressor. We also explore the possible therapeutic strategies to reverse EMT in patients with recurrence. In summary, although adjuvant cisplatin-based chemotherapy in resected NSCLC does extend survival, it may lead to the adverse phenomenon of EMT in disseminated tumor cells (DTC) or circulating tumor cells (CTC) causing recurrence and metastasis.
  2. Zhang X, Dong X, Saripan MIB, Du D, Wu Y, Wang Z, et al.
    Thorac Cancer, 2023 Jul;14(19):1802-1811.
    PMID: 37183577 DOI: 10.1111/1759-7714.14924
    BACKGROUND: Radiomic diagnosis models generally consider only a single dimension of information, leading to limitations in their diagnostic accuracy and reliability. The integration of multiple dimensions of information into the deep learning model have the potential to improve its diagnostic capabilities. The purpose of study was to evaluate the performance of deep learning model in distinguishing tuberculosis (TB) nodules and lung cancer (LC) based on deep learning features, radiomic features, and clinical information.

    METHODS: Positron emission tomography (PET) and computed tomography (CT) image data from 97 patients with LC and 77 patients with TB nodules were collected. One hundred radiomic features were extracted from both PET and CT imaging using the pyradiomics platform, and 2048 deep learning features were obtained through a residual neural network approach. Four models included traditional machine learning model with radiomic features as input (traditional radiomics), a deep learning model with separate input of image features (deep convolutional neural networks [DCNN]), a deep learning model with two inputs of radiomic features and deep learning features (radiomics-DCNN) and a deep learning model with inputs of radiomic features and deep learning features and clinical information (integrated model). The models were evaluated using area under the curve (AUC), sensitivity, accuracy, specificity, and F1-score metrics.

    RESULTS: The results of the classification of TB nodules and LC showed that the integrated model achieved an AUC of 0.84 (0.82-0.88), sensitivity of 0.85 (0.80-0.88), and specificity of 0.84 (0.83-0.87), performing better than the other models.

    CONCLUSION: The integrated model was found to be the best classification model in the diagnosis of TB nodules and solid LC.

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