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Diaphragmatic impairments exhibit high morbidity as well as mortality while current treatment options remain unsatisfactory. Tissue engineering (TE) approaches have explored the generation of an optimal biocompatible scaffold for diaphragmatic repair through tissue decellularization or de novo construction, with or without the addition of cells. We conducted a systematic review on the current state of the art in diaphragmatic tissue engineering (DTE) and found 24 articles eligible for final synthesis. The included approaches studied decellularization-based graft generation (9) and de novo bioscaffold construction (9). Three studies focused on in vitro host-scaffold interaction with synthesized, recellularized grafts (2) and decellularized extracellular matrix scaffolds (1). Another three studies investigated evaluation tools for decellularization efficacy. Among all studies, recellularization was performed in both decellularization-based (4) and de novo generated scaffolds (4). De novo constructed biocomposites as well as decellularized and recellularized scaffolds induced pro-regenerative remodeling and recovery of diaphragmatic function in all examined animal models. Potential therapeutic applications comprise substance defects requiring patch repair, such as congenital diaphragmatic hernia, and functional diseases demanding an entire organ transplant, like muscular dystrophies or dysfunction after prolonged artificial respiration.

Recent developments in immuno-oncology demonstrate that not only cancer cells, but also features of the tumor microenvironment guide precision medicine. Still, the relationship between tumor and microenvironment remains poorly understood. To overcome this limitation and identify clinically relevant microenvironmental and cancer features, we applied single-cell RNA sequencing to lung adenocarcinomas. While the highly heterogeneous carcinoma cell transcriptomes reflected histological grade and activity of relevant oncogenic pathways, our analysis revealed two distinct microenvironmental patterns. We identified a prognostically unfavorable group of tumors with a microenvironment composed of cancer-associated myofibroblasts, exhausted CD8+ T cells, proinflammatory monocyte-derived macrophages and plasmacytoid dendritic cells (CEP2 pattern) and a prognostically favorable group characterized by myeloid dendritic cells, anti-inflammatory monocyte-derived macrophages, normal-like myofibroblasts, NK cells and conventional T cells (MAN2C pattern). Our results show that single-cell gene expression profiling allows to identify patient subgroups based on the tumor microenvironment beyond cancer cell-centric profiling.

Formalin-fixed paraffin-embedded (FFPE) tissues are a valuable resource for retrospective clinical studies. Here, we evaluate the feasibility of (phospho-)proteomics on FFPE lung tissue regarding protein extraction, quantification, pre-analytics, and sample size. After comparing protein extraction protocols, we use the best-performing protocol for the acquisition of deep (phospho-)proteomes from lung squamous cell and adenocarcinoma with >8,000 quantified proteins and >14,000 phosphosites with a tandem mass tag (TMT) approach. With a microscaled approach, we quantify 7,000 phosphosites, enabling the analysis of FFPE biopsies with limited tissue amounts. We also investigate the influence of pre-analytical variables including fixation time and heat-assisted de-crosslinking on protein extraction efficiency and proteome coverage. Our improved workflows provide quantitative information on protein abundance and phosphosite regulation for the most relevant oncogenes, tumor suppressors, and signaling pathways in lung cancer. Finally, we present general guidelines to which methods are best suited for different applications, highlighting TMT methods for comprehensive (phospho-)proteome profiling for focused clinical studies and label-free methods for large cohorts., Formalin-fixed, paraffin-embedded (FFPE) specimens are an attractive resource for retrospective clinical proteomics studies. Here, the authors benchmark and optimize proteomics workflows for FFPE sample analysis and provide guidelines on which methods to use for different samples and applications.

Background In patients with non-small cell lung cancer (NSCLC), asphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) has shown prognostic significance. This study aimed at validation in an independent, sufficiently large cohort. Patients and Methods Retrospective study in 311 NSCLC patients undergoing FDG-PET/CT before curatively intended treatment (always including surgery). 140 patients had UICC stage I, 78 stage II, and 93 stage III (adenocarcinoma [ADC]:153; squamous cell carcinoma [SCC]:141). Primary tumor MTV was delineated with semiautomated background-adapted threshold relative to SUVmax. Cox regression (PFS/OS) for PET (MTV, ASP, SUVmax), clinical (T/N descriptor, UICC stages), histological and treatment variables (Rx/1 vs. R0 resection, chemotherapy/radiotherapy yes/no). Results Events (progression/relapse) occurred in 167/311 patients, 137 died (median survivor follow-up, 37 months). In multivariable Cox regression for OS, ASP>33.3% (HR, 1.58 [1.04-2.39]), male sex (1.84), age (1.04 per year), EGOG≥2 vs. 0/1 (2.68), stage II vs. I (1.96), and Rx/1 vs. R0 resection (2.1) were significant. Among separate UICC stages, ASP only predicted OS in stage II (optimal, >19.5%; median OS, 33 vs. 59 months). Regarding PFS, ASP>21.2%, male sex, EGOG≥2, stage II vs. I, and Rx/1 resection were prognostic. ASP remained prognostic in stage II (optimal, >19.5%; PFS, 12 vs. 47 months). Log-rank test for ASP was significant at any cut-off ≥18% (OS) or from 9-59% (PFS). Conclusion ASP was validated as prognostic factor for PFS and OS in patients with NSCLC and curative treatment intent, especially stage II. High ASP in stage II could imply intensified treatment or intensified follow-up.

Einleitung: Die Thymektomie wird bei der Myasthenia gravis und/oder Thymomen mit der Intention einer kausalen Therapie durchgeführt. Die Charakteristik der Krankheit und die Lokalisation des Thymus im Hals- und Thorax-Kompartment mit häufig ektopem Gewebe sind Ursache der Entwicklung [zum vollständigen Text gelangen Sie über die oben angegebene URL], 133. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Das Dogma der Notwendigkeit einer Sternotomie zur Resektion von Thymustumoren wird durch neue Daten in Frage gestellt. Die Resektion von Thymomen kann heute vielfach minimal-invasiv durchgeführt werden. Der Parameter der Größe ist für die Diagnostik und minimalinvasive[for full text, please go to the a.m. URL], 132. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Der Häufigkeit nach sind bei großen Raumforderungen des vorderen Mediastinums Lymphome (Hodgkin/non-Hodgkin), Thymustumoren (hauptsächlich Thymome) oder auch Teratome anzutreffen. Die Symptomatik und genaue bildgebende Charakteristik sind nicht immer zur Differentialdiagnose[for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Minimal-invasive Operationstechniken haben einen festen Stellenwert in der Chirurgie. Mehr als 700 Thymektomien und 100 Ösophagusresektionen illustrieren diese neue roboter-assistierte Operationsform. Besonders bei weit vom Zugang entfernten und engen anatomischen Arealen wie im Mediastinum[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie