66

249

MS36 CHENICAL. CHROKMETRY FOR TRE DIACN.CNOSIS OF LUNG CANCER CHEST X-RAY (CXR) SCREENING IMPROVES LUNG CANCER

Ren Gang-CuopCheng Dan-jian,Sheng Tin-Xi.et al Sichuan Cancer Institute & Uorpital .Chengdu 810041.P.R.CHINA.

Ihe papsr reported 130 cases of lung cancer and 58 oases of shadow of unoarcinoma in lung that were studied by a test using siallo aoid in a ner ray -- F8836 single reagent ohemical chronometry. Ibe teat results were following.

disease cases absorbance(XfSD) positive rate(l)

lung cancer 130 0.248 fO.043 82.3

spuamous oell caloinoma II 0.858 f&038 97.6

adenocaroinoma 33 0.284+_0.@38 87.8

undifferentiated carcinoma 15 0.263 f0.054 86.1

(small cell lung oancer)

unclassificated paroinoma 41 0.245 kO.041 92.1

shadow of uncarcinoma* 59 0.174+0.013 3.1

*pneumonia* globus of pulmonary tuberculosis. benign tunour of lung

The results of dymamic check 30 oases of lung canoer ohanged SA showed that the absorbance of F8838 changes (up or dosn) correlated

to the state of patients of lung oanoer (wares or better). It’s concluded that these values are useful in diagnosis and evaluation of effect of treatment and judgment of clinical prognosis of lung canoer .

251

ACUTE PHASE PROTEINS IN MALIGNANT PLEURAL

MESOTHELIOMA : USEFUL MARKERS IN DIFFERENTIATING

FROM ADENOCARCINOMA.

T.Nakano, MShinjo, T.Nakae, T.Nishigaki, T.Nishi-an, N.lwahashi,

T.Hada, K.Higashino. 3rd Dept. of Internal Medicine, Hyogo

College of Medicine, Nishinomiya, Hyogo, Japan.

Distinguishing malignant mesothelioma (MM) from adenocarcinoma

with pleural involvement remains a difficult problem. Thrombocytosis is

one of the characteristic clinical features in MM. Mesothelioma cell

lines have been shown to produce interleukind (11-6) that induce thrombocytosis and acute phase proteins (APP) in serum. We

therefore investigated whether APP could be valuable indicators of this

neoplasm and thus be clinically useful markers in distinguishing from

adenocarcinoma with pleural involvement. The incidence of

thrombocytosis and levels of serum IL-6 in MM were significantly

higher than those in stage TEA + III& or stage IV lung cancer. The

values of CRP, a,-antitrypsin, and a,-acid glycoprotein in MM were

significantly higher than those in adenocarcinoma. Serum IL-6 levels

were positively correlated with CRP values. We conclude that APP are

useful markers in distinguishing MM from adenocarcinoma, in addition

to the absence of elevated CEA value.

252

DO PROGNOSTIC FACTORS CHANGE OVER THE COURSE OF TREATMENT FOR PATIENTS WITH SMALL CELL LUNG CANCER (SCLC)? E Hall, MKB Parmar and RJ Stephens for the British Medical Research Council (MRC) Lung Cancer Workin

% Shaftes Party (LCWP). MRC Cancer Trials Office, 5

ury Road, Cambridge, UK. It is generally acknowledged that the two most important

pre-treatment prognostic factors for patients with SCLC are extent of disease and performance status. However, lt is quite possible that during the course of treatment these prognostic factors will change in value and influence, and other factors will become more important.

Using data from a 3-arm randomised clinical trial of 456 patients in which a regimen of 6 cycl;n;f ECMV (etoposide, cyclophosphamide, methotrexate vmcnstine) was compared to 3 cycles of the same chemotherapy and 6 cycles of El (etoposide and ifosfamide), we fitted a time-dependent Cox model using pre-treatment information and data collected at the time of the 2nd and 3rd cycles of chemotherapy to try to predict the length of survival of the patients.

In this trial, the most important prognostic factors were found to be extent of disease at presentation and current performance status (the performance status as assessed at each visit).

Possible hypotheses for the current performance status being a better prognostic indicator than pretreatment status are that It is an indicator of (i) a treatment effect, (ii) the course of the disease, or a combination of the two.

Although this is only one trial, albeit a large one, and thus can be considered only as a hypothesis generating result, this finding does su gest we may have to rethink the way in which new prognostic 9 actors are investigated and used. For example, treatment may be able to be tailored to the current prognosis of the patient.