1
114 Ahstral~rs :I Lung cam that with small cell lung cancer (SCLC) (27.3%, P < 0.01, P < 0.001). In NSCLC, elevated CYFRAZI-1 was measured in 35.3% for stage 1. 55.6% for stage II, 63.6% for stage III and 73 3% for stage IV diseases Elevated NSE was dominant in SCLC with a sensitivity of 59.1%. The sensitivity of all lung cancer case was soared to 6 I .7% or even higher by combining CYFRA21-I and NSE. The decline of CYFRA21-I was observed when remission of the tumor became clinically evident. CYFRA21-1 seemed to be of clinical interest for NSCLC. particularly so for SQC. Small-cell carcinoma of the lung with paraneoplastic cerebel- lar degeneration Miyashita N, Nakajima M, Niki Y, Matsushima T Division ofResprra- tory Disease. Department of Medicine, Kawasakr Medical School, Kawasaki. Jpn J Thorac Dis 1996;34:380-3. A SO-year-old man was admitted to our hospital because of slowly progressing ataxia. After the neurological examination and after obser- vation of the clinical course, paraneoplastic cerebellar degeneration was suspected. Extensive examination revealed a malignant tumor in the right upper lobe of the lung. Immunoblotting with rat cerebellum re- vealed a 68 KJ3a protein in the patient’s serum, which suggested that paraneoplastic cerebellar degeneration was caused by an auto-antibody. Anti-cancer drugs and radiation therapy were begun 4 months after the onset of symptoms. After 4 months of therapy, the lung cancer had shrunk, but the neurological symptoms had become more severe. Adenocarcinoma of the lung with aspergillus in tumor necrotic area Tanaka M, Ohtawa M, Chohnabayashi N, Saiki S. Jpn J Lung Cancer 1996;36: 139-45. A 62 year-old male complained of hemosputum. As lung abscess was suspected, antibiotic therapy was performed. About one month later, his complaint had not improved and his chest X-ray revealed a mass shadow in the lefl upper lobe, so he was admitted to our hospital on the suspicion of lung cancer. No malignant cells were obtained by transbronchial lung biopsy, but adenocarcinoma was diagnosed by spu- tum cytology. Left upper lobectomy was performed, and lung cancer was revealed pathologically with the aspergillus fungi in areas of can- cer necrosis. There have been 24 reported cases of lung cancer contain- ing aspergillus. but this report is the 4th in the literature without cavi- tat-y formation. Prognostic factors and long-term survival of non-resected cases with non-small cell lung cancer Kodama A, Maruta T, Izumiyama K, Sakaguchi T, Kono M. Deparf- merit of Radiology, School of Medicine, Kobe lJnwersi@, Kobe. Jpn J Lung Cancer 1996;36:91-8. We retrospectively reviewed the outcome and 7 prognostic factors (sex, age, stage, histologic type, chemotherapy, dose and response) of 167 patients with non-small cell lung radiotherapy on primary site more than 40 Gy between 1984 and 1991. The 2-year overall survival rate and MST were 22% and 13.4 months. Stage I, II and adenecarcinoma are favorable prognostic factors by univariate analysis, 40 patients (24%) survived over 2 years. State I- IIIa and adenocarcinoma were also sig- nificant factors in the over 2-year survival group. But there were no significant prognostic factors during 20 - 25 months by multivariate analysis (Cox’s regression analysis). ‘ET 16 (1996) 105-l-77 Microsatellite alterations in bronchial and sputum specimens of lung cancer patients Miozzo M, Sozzi G, Musso K et al. Division ofExperrmental Oncol- ogy A, Isfituto Nazionale Tumori, C7a G. Venerlan I, 20133 Milano. Cancer Res 1996;56:2285-8. Early diagnosis of lung cancer based on conventional screening procedures has been unable thus far to decrease lung cancer mortality. We explored the possibility of using microsatellite instability in the detection and screening of early phases of lung carcinogenesis We stud- ied tumor, histopathologically normal bronchial mucosa, and cytologi- cal specimens of 51 lung cancer patients for the presence of clonal variations at microsatellite polymorphisms. Microsatellite alterations were found in tumor, normal bronchial mucosa and cytological speci- mens of 25 of 51 (49%) of the patients. The detection of microsatellite alterations in histopathologically normal bronchial specimens and cy- tological clinical samples with minimal atypia suggests a possible ap- plication of this genetic marker in early diagnosis of precancerous le- sions and lung cancer. The staging of lung cancer by bronchoscopic transbronchial needle aspiration Harrow EM, Wang KP 3001 South Hanover Street, Balttmore. MD 21225. Chest Surg Clin North Am 1996;6:223-5. The development of Rexible transbronchial needles for hilar and mediastinal aspiration has made possible noninvasive staging at the time of the initial diagnostic bronchoscopic examination. Combining the specificity of TBNA with the sensitivity of thoracic CT scanning greatly enhances the utility of this procedure. A bronchoscopically ori- ented staging system that utilizes the complementary advantages of both of these techniques is outlined. The staging of bronchogenic carcinoma by TBNA is a safe and cost- effective technique that cart be routinely utilized to stage lung cancer. Ultimately, its value will depend upon whether the initial encouraging reports of its use can be reproduced by bronchoscopists in practice. bcl-2 and p53 protein expression in non-small cell lung can- cers: Correlation with survival time Ohsaki Y, Toyoshima E, Fujiuchi S et al. First Department ofMedi- tine, Asahikmva Medical College, Nishikagura 4-5-3, Asahikawa 078. Clin Cancer Res 1996;2:915-20. Apoptosis-related genes have received increasing attention in car- cinogenesis, drug sensitivity, radiation sensitivity, and patient survival. bcl-2 and mutated ~53 genes have been reported to inhibit apoptosis. To determine bcl-2 and ~53 protein expression and their impacts on survival time in lung cancers, we studied 99 surgically resected, paraf- fin-embedded non-small cell lung cancer (NSCLC) specimens by im- munohistochemical staining. The bcl-2 protein was expressed in 19.2% of NSCLCs. bcl-2-positive cases were found in 30.4% of stages I and II carcinomas in 36.8% of squamous cell carcinomas. Patients with bcl-2 expression survived longer than those without, p53 protein was found in 44.4%; there was no significant difference in survival time between patients with and without ~53 expression. Patients who were both bcl- 2 positive and ~53 negative survived significantly longer than those who were bcl-2 negativeorp53 positive. These results suggest that bcl- 2 protein expression cart be histologically specific and stage dependent, and that the bcl-2 protein expression is potentially valuable for progno- sis in NSCLC, particuIarly in the early stages, when bcl-2 protein ex- pression is considered with mutant ~53 protein expression.

Prognostic factors and long-term survival of non-resected cases with non-small cell lung cancer

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114 Ahstral~rs :I Lung cam

that with small cell lung cancer (SCLC) (27.3%, P < 0.01, P < 0.001). In NSCLC, elevated CYFRAZI-1 was measured in 35.3% for stage 1. 55.6% for stage II, 63.6% for stage III and 73 3% for stage IV diseases Elevated NSE was dominant in SCLC with a sensitivity of 59.1%. The sensitivity of all lung cancer case was soared to 6 I .7% or even higher by combining CYFRA21-I and NSE. The decline of CYFRA21-I was observed when remission of the tumor became clinically evident. CYFRA21-1 seemed to be of clinical interest for NSCLC. particularly so for SQC.

Small-cell carcinoma of the lung with paraneoplastic cerebel- lar degeneration Miyashita N, Nakajima M, Niki Y, Matsushima T Division ofResprra- tory Disease. Department of Medicine, Kawasakr Medical School, Kawasaki. Jpn J Thorac Dis 1996;34:380-3.

A SO-year-old man was admitted to our hospital because of slowly progressing ataxia. After the neurological examination and after obser- vation of the clinical course, paraneoplastic cerebellar degeneration was suspected. Extensive examination revealed a malignant tumor in the right upper lobe of the lung. Immunoblotting with rat cerebellum re- vealed a 68 KJ3a protein in the patient’s serum, which suggested that paraneoplastic cerebellar degeneration was caused by an auto-antibody. Anti-cancer drugs and radiation therapy were begun 4 months after the onset of symptoms. After 4 months of therapy, the lung cancer had shrunk, but the neurological symptoms had become more severe.

Adenocarcinoma of the lung with aspergillus in tumor necrotic area Tanaka M, Ohtawa M, Chohnabayashi N, Saiki S. Jpn J Lung Cancer 1996;36: 139-45.

A 62 year-old male complained of hemosputum. As lung abscess was suspected, antibiotic therapy was performed. About one month later, his complaint had not improved and his chest X-ray revealed a mass shadow in the lefl upper lobe, so he was admitted to our hospital on the suspicion of lung cancer. No malignant cells were obtained by transbronchial lung biopsy, but adenocarcinoma was diagnosed by spu- tum cytology. Left upper lobectomy was performed, and lung cancer was revealed pathologically with the aspergillus fungi in areas of can- cer necrosis. There have been 24 reported cases of lung cancer contain- ing aspergillus. but this report is the 4th in the literature without cavi- tat-y formation.

Prognostic factors and long-term survival of non-resected cases with non-small cell lung cancer Kodama A, Maruta T, Izumiyama K, Sakaguchi T, Kono M. Deparf- merit of Radiology, School of Medicine, Kobe lJnwersi@, Kobe. Jpn J Lung Cancer 1996;36:91-8.

We retrospectively reviewed the outcome and 7 prognostic factors (sex, age, stage, histologic type, chemotherapy, dose and response) of 167 patients with non-small cell lung radiotherapy on primary site more than 40 Gy between 1984 and 1991. The 2-year overall survival rate and MST were 22% and 13.4 months. Stage I, II and adenecarcinoma are favorable prognostic factors by univariate analysis, 40 patients (24%) survived over 2 years. State I- IIIa and adenocarcinoma were also sig- nificant factors in the over 2-year survival group. But there were no significant prognostic factors during 20 - 25 months by multivariate analysis (Cox’s regression analysis).

‘ET 16 (1996) 105-l-77

Microsatellite alterations in bronchial and sputum specimens of lung cancer patients Miozzo M, Sozzi G, Musso K et al. Division ofExperrmental Oncol- ogy A, Isfituto Nazionale Tumori, C7a G. Venerlan I, 20133 Milano. Cancer Res 1996;56:2285-8.

Early diagnosis of lung cancer based on conventional screening procedures has been unable thus far to decrease lung cancer mortality. We explored the possibility of using microsatellite instability in the detection and screening of early phases of lung carcinogenesis We stud- ied tumor, histopathologically normal bronchial mucosa, and cytologi- cal specimens of 51 lung cancer patients for the presence of clonal variations at microsatellite polymorphisms. Microsatellite alterations were found in tumor, normal bronchial mucosa and cytological speci- mens of 25 of 51 (49%) of the patients. The detection of microsatellite alterations in histopathologically normal bronchial specimens and cy- tological clinical samples with minimal atypia suggests a possible ap- plication of this genetic marker in early diagnosis of precancerous le- sions and lung cancer.

The staging of lung cancer by bronchoscopic transbronchial needle aspiration Harrow EM, Wang KP 3001 South Hanover Street, Balttmore. MD 21225. Chest Surg Clin North Am 1996;6:223-5.

The development of Rexible transbronchial needles for hilar and mediastinal aspiration has made possible noninvasive staging at the time of the initial diagnostic bronchoscopic examination. Combining the specificity of TBNA with the sensitivity of thoracic CT scanning greatly enhances the utility of this procedure. A bronchoscopically ori- ented staging system that utilizes the complementary advantages of both of these techniques is outlined. The staging of bronchogenic carcinoma by TBNA is a safe and cost- effective technique that cart be routinely utilized to stage lung cancer. Ultimately, its value will depend upon whether the initial encouraging reports of its use can be reproduced by bronchoscopists in practice.

bcl-2 and p53 protein expression in non-small cell lung can- cers: Correlation with survival time Ohsaki Y, Toyoshima E, Fujiuchi S et al. First Department ofMedi- tine, Asahikmva Medical College, Nishikagura 4-5-3, Asahikawa 078. Clin Cancer Res 1996;2:915-20.

Apoptosis-related genes have received increasing attention in car- cinogenesis, drug sensitivity, radiation sensitivity, and patient survival. bcl-2 and mutated ~53 genes have been reported to inhibit apoptosis. To determine bcl-2 and ~53 protein expression and their impacts on survival time in lung cancers, we studied 99 surgically resected, paraf- fin-embedded non-small cell lung cancer (NSCLC) specimens by im- munohistochemical staining. The bcl-2 protein was expressed in 19.2% of NSCLCs. bcl-2-positive cases were found in 30.4% of stages I and II carcinomas in 36.8% of squamous cell carcinomas. Patients with bcl-2 expression survived longer than those without, p53 protein was found in 44.4%; there was no significant difference in survival time between patients with and without ~53 expression. Patients who were both bcl- 2 positive and ~53 negative survived significantly longer than those who were bcl-2 negativeorp53 positive. These results suggest that bcl- 2 protein expression cart be histologically specific and stage dependent, and that the bcl-2 protein expression is potentially valuable for progno- sis in NSCLC, particuIarly in the early stages, when bcl-2 protein ex- pression is considered with mutant ~53 protein expression.