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878 Value of CYFRA-21, CEA and NSE baseline assessment in advanced non-small cell lung cancer (NSCLC)
224 874 El
Biology
Characteristics of long-term lung cancer (SCLC)
survivors
with small-cell
It was established that extrathoracic metastasis existed in 552 (17.1%) patients. In 276 (50%) cases they were situated in the lymph glands (supraclavicular, scalenic, paraaortal). Metastasis in liver was diagnosed in 192 (34.8%) patients, in bones in 82 (14.8%) in brain in 57 (10.3%) in adrenal glands in 46 (8.3%) in pericard in 9 (1.6%) and in skin in 7 (1.3%) patients. The greatest metastatic potential showed Ca microcelullare and then adeno Ca. But also high level of metastasing has Ca planocelullare. Our findings show that almost in l/5 (17.1%) patients, at the moment of making the diagnosis, had distant metastasis (which exerts a great influence on selection of medical treatment). Almost all types of lung cancer showed high metastatic potential.
N. S&en, T. ZikiC, M. Antonic, B. Perin, V. Canak, M. KakaS, Dj. Povaian, J. Stanic, G. Balaban. University of Now’Sad, School of medicine, institute of pulmonary diseases, Sremska Kamenica, Yugoslavia In the institute of pulmonary diseases in Sremska Kamenica, FR of Yugoslavia, in five years period there were 3231 patients with histologically proven diagnosis of lung cancer. Among them there were 527 patients with histologically proven SCLC. 41 patients with SCLC have been surviving more than 24 months, beyond 24 and 71 months. All of them were with limited disease (LD), average age 54. There were 37 males and 4 females. Thirty five were heavy smokers and 6 non-smokers, but passive smokers. When SCLC was diagnosed 21 of smokers gave up smoking. Nine patients were operated and postoperatively treated by chemotherapy and prophylactic cranial irradiation. Nonoperated patients were treated with combination chemotherapy (PE protocol) and radiotherapy and with prophylactic cranial irradiation. In the case of relapse patients were treated with the chemotherapy CAV protocol and supportive care. Conclusion: survival among patients with SCLC is prolonged at the last decade. As the main characteristics of long-term survivors we found good performance status, limited stage of disease, older ages, low level of lactate dehydrogenase (LDH), alkine phosphatase (AP) and sedimentation rate, complete remission after first line chemotherapy and long disease free period, late relapse.
I
Twenty three cases of resected peripheral adenocarcinomas of the lung revealed only by computed tomography (CT) were examined retrospectively to evaluate their clinical features and roentgeno-pathological correlations. The 23 cases comprised 12 males and 11 females with a median age of 67 (range 46-78) years. Abnormal shadows were detected in one from anterior chest pain, four were detected while under observation and the remainder by CT screening. The CT images were classified into two groups; air density type (17 cases) with obscure margins and solid density type (6 cases) with clear margins. The primary tumors were overlooked on plain chest X-ray images because the former had a vague internal texture or edge and the latter were located in the paramediastinal area. Pathological evaluation showed stage I in 22 cases (96%). We conclude that CT is more useful than plain chest X-ray in early detection of lung cancer. Chest CT examinations are therefore expected to be useful in screening for lung cancer.
of clinical data and autopsy finding in with nondiagnosed lung carcinoma and sudden death
Z. Uskokovic, G. Radosavljevic, V. Kacar, K. Radotic ’ institute of Lung diseases and TB, XC, Belgrade; ‘Institute of fatholog): Medical School, Belgrade’s Universi@! Yugoslavia
I876
;~;n~h~lysis
D. Bozic, N. Bogdanovic, for Pulmonary Diseases
of extrathoracic
metastatis of CA
A. Milinkovic. Clinical Centre of Serbia, and TBC, Belgrade, Yugoslavia
Institute
In order to consolidate expansion of malignant pulmonary disease the analysis was performed in 3228 patients with confirmed diagnosis of Ca bronchi. The diagnosis of Ca bronchi was made by usual methods of bronchoscopi, needle biopsy, extirpatio of lymph glands and histological verification.
Computed tomography analysis resected adenocarcinoma of the lung revealed by computed tomography
Kouzo Yamada, Mutsumi Kondou, Yuji Katou, Fumihiro Oshita, lkuo Nomura, Kazumasa Ncda, Tatsushi Yamagata, Michihiko Tajiri, Youichi Kameda. Kanagawa Cancer Center, Yokohama, Japan
875 Analysis L-.-J patients
Total of 52 patients nonverified in course of lung carcinoma who succombed in Institute of Lung Diseases and TB during 1990-1995. have been analysed. Symptoms at admission, duration of hospitalisation and autopsy diagnosis have been registered. After autopsy and histopathology analysis of tissue (routinely formalin fixed, paraffin embedded and HE stained), primary lung carcinoma has been found, histology type and level of dissemination determined. Out of 52 cases, 12 were female (age in average 62.92 yrs) and 40 male (57 yrs). In all patients only 3 were nonsmokers. Frequency distribution of day hospitalization is not normal, with median of 1 hour and 40 min (range 0.5 h-18 days). Out of total there were 15 microcellular, 25 adeno, 8 planocellular Ca and 4 tumor mixtus. Two way ANOVA results in: (1) Carcinoma type does not point to the site of metastasis, providing the basis to consider all types as a whole. (2) Type of carcinoma does not interfere with frequency of symptoms. (3) One way ANOVA test reveals highly significant difference in frequency of symptoms originating from the organ with malignancy. Symptoms of respiratory system (dyspnea, haemoptysis etc.) were dominant (88.5%) followed by CNS (nausea, vomiting, epilepsy and coma) in 50% and kidneys in 25%. Adrenal glands and pancreas in the spite of metastases do not reveal any symptom. In all cases exitus occurred in first hours (Mode is shorter than 1 day). We hypothesize that the cause is in the failure of patients proper education and progressing of the disease.
877
I
878
Value of CYFRA-21, CEA and NSE baseline assessment in advanced non-small cell lung cancer (NSCLC)
M. Cafferata, M. Paganuzzi, L. Tixi, F. Grossi, R. Rosso. Genova, ltaly
M. Oneto, A. Ardizzoni, MC. Pennucci, lstituto Nazionale per /a Ricerca sul Cancro
The role of serum markers assessment in the diagnosis and prognosis of NSCLC is still debated. The value of baseline assessment of CYFRA, CEA and NSE in 55 advanced non small cell lung cancer patients (pts) treated with cisplatin-based polichemotherapy was prospectively studied. Among 55 pts, 26 had adenocarcinoma, 25 squamous carcinoma and 4 unspecified non small cell carcinoma; 24 pts had stage Ill and 31 stage IV. 20/55 (36.6%) had elevated CEA serum levels, 42/55 (76.3%) and lo/55 (18.8%) had elevated serum levels of CYFRA and NSE, respectively, suggesting that the CYFRA is the most sensitive marker in this category of pts. 8/55 (14.5%) pts had normal values for all markers and only 2/55 had all abnormal markers. 24 pts had only one elevated marker and 21 had two elevated markers. 85.4% of pts had at least one elevated tumor marker. While only 35% of pts with elevated CYFRA had also CEA elevation, 75% of pts with elevated CEA had also abnormal CYFRA. Markers elevation seemed to be related to a favourable response rate: in fact, the % of objective response in pts with elevated CEA, CYFRA and NSE was 44%, 42.5%, 42.8% respectively. Moreover, pts with more than one elevated marker had a response rate of 48.8% whereas pts with only one or no marker elevation had 22.9% response rate. In conclusion, preliminary results indicate that base-line multiple marker assessment is helpful in identifying more than 80% of pts with at least one elevated tumor marker which could be helpful in following the disease course. In addition, pts with multiple marker elevation seem to fare better in terms of response rate.
Biology
Characteristics of long-term lung cancer (SCLC)
survivors
with small-cell
It was established that extrathoracic metastasis existed in 552 (17.1%) patients. In 276 (50%) cases they were situated in the lymph glands (supraclavicular, scalenic, paraaortal). Metastasis in liver was diagnosed in 192 (34.8%) patients, in bones in 82 (14.8%) in brain in 57 (10.3%) in adrenal glands in 46 (8.3%) in pericard in 9 (1.6%) and in skin in 7 (1.3%) patients. The greatest metastatic potential showed Ca microcelullare and then adeno Ca. But also high level of metastasing has Ca planocelullare. Our findings show that almost in l/5 (17.1%) patients, at the moment of making the diagnosis, had distant metastasis (which exerts a great influence on selection of medical treatment). Almost all types of lung cancer showed high metastatic potential.
N. S&en, T. ZikiC, M. Antonic, B. Perin, V. Canak, M. KakaS, Dj. Povaian, J. Stanic, G. Balaban. University of Now’Sad, School of medicine, institute of pulmonary diseases, Sremska Kamenica, Yugoslavia In the institute of pulmonary diseases in Sremska Kamenica, FR of Yugoslavia, in five years period there were 3231 patients with histologically proven diagnosis of lung cancer. Among them there were 527 patients with histologically proven SCLC. 41 patients with SCLC have been surviving more than 24 months, beyond 24 and 71 months. All of them were with limited disease (LD), average age 54. There were 37 males and 4 females. Thirty five were heavy smokers and 6 non-smokers, but passive smokers. When SCLC was diagnosed 21 of smokers gave up smoking. Nine patients were operated and postoperatively treated by chemotherapy and prophylactic cranial irradiation. Nonoperated patients were treated with combination chemotherapy (PE protocol) and radiotherapy and with prophylactic cranial irradiation. In the case of relapse patients were treated with the chemotherapy CAV protocol and supportive care. Conclusion: survival among patients with SCLC is prolonged at the last decade. As the main characteristics of long-term survivors we found good performance status, limited stage of disease, older ages, low level of lactate dehydrogenase (LDH), alkine phosphatase (AP) and sedimentation rate, complete remission after first line chemotherapy and long disease free period, late relapse.
I
Twenty three cases of resected peripheral adenocarcinomas of the lung revealed only by computed tomography (CT) were examined retrospectively to evaluate their clinical features and roentgeno-pathological correlations. The 23 cases comprised 12 males and 11 females with a median age of 67 (range 46-78) years. Abnormal shadows were detected in one from anterior chest pain, four were detected while under observation and the remainder by CT screening. The CT images were classified into two groups; air density type (17 cases) with obscure margins and solid density type (6 cases) with clear margins. The primary tumors were overlooked on plain chest X-ray images because the former had a vague internal texture or edge and the latter were located in the paramediastinal area. Pathological evaluation showed stage I in 22 cases (96%). We conclude that CT is more useful than plain chest X-ray in early detection of lung cancer. Chest CT examinations are therefore expected to be useful in screening for lung cancer.
of clinical data and autopsy finding in with nondiagnosed lung carcinoma and sudden death
Z. Uskokovic, G. Radosavljevic, V. Kacar, K. Radotic ’ institute of Lung diseases and TB, XC, Belgrade; ‘Institute of fatholog): Medical School, Belgrade’s Universi@! Yugoslavia
I876
;~;n~h~lysis
D. Bozic, N. Bogdanovic, for Pulmonary Diseases
of extrathoracic
metastatis of CA
A. Milinkovic. Clinical Centre of Serbia, and TBC, Belgrade, Yugoslavia
Institute
In order to consolidate expansion of malignant pulmonary disease the analysis was performed in 3228 patients with confirmed diagnosis of Ca bronchi. The diagnosis of Ca bronchi was made by usual methods of bronchoscopi, needle biopsy, extirpatio of lymph glands and histological verification.
Computed tomography analysis resected adenocarcinoma of the lung revealed by computed tomography
Kouzo Yamada, Mutsumi Kondou, Yuji Katou, Fumihiro Oshita, lkuo Nomura, Kazumasa Ncda, Tatsushi Yamagata, Michihiko Tajiri, Youichi Kameda. Kanagawa Cancer Center, Yokohama, Japan
875 Analysis L-.-J patients
Total of 52 patients nonverified in course of lung carcinoma who succombed in Institute of Lung Diseases and TB during 1990-1995. have been analysed. Symptoms at admission, duration of hospitalisation and autopsy diagnosis have been registered. After autopsy and histopathology analysis of tissue (routinely formalin fixed, paraffin embedded and HE stained), primary lung carcinoma has been found, histology type and level of dissemination determined. Out of 52 cases, 12 were female (age in average 62.92 yrs) and 40 male (57 yrs). In all patients only 3 were nonsmokers. Frequency distribution of day hospitalization is not normal, with median of 1 hour and 40 min (range 0.5 h-18 days). Out of total there were 15 microcellular, 25 adeno, 8 planocellular Ca and 4 tumor mixtus. Two way ANOVA results in: (1) Carcinoma type does not point to the site of metastasis, providing the basis to consider all types as a whole. (2) Type of carcinoma does not interfere with frequency of symptoms. (3) One way ANOVA test reveals highly significant difference in frequency of symptoms originating from the organ with malignancy. Symptoms of respiratory system (dyspnea, haemoptysis etc.) were dominant (88.5%) followed by CNS (nausea, vomiting, epilepsy and coma) in 50% and kidneys in 25%. Adrenal glands and pancreas in the spite of metastases do not reveal any symptom. In all cases exitus occurred in first hours (Mode is shorter than 1 day). We hypothesize that the cause is in the failure of patients proper education and progressing of the disease.
877
I
878
Value of CYFRA-21, CEA and NSE baseline assessment in advanced non-small cell lung cancer (NSCLC)
M. Cafferata, M. Paganuzzi, L. Tixi, F. Grossi, R. Rosso. Genova, ltaly
M. Oneto, A. Ardizzoni, MC. Pennucci, lstituto Nazionale per /a Ricerca sul Cancro
The role of serum markers assessment in the diagnosis and prognosis of NSCLC is still debated. The value of baseline assessment of CYFRA, CEA and NSE in 55 advanced non small cell lung cancer patients (pts) treated with cisplatin-based polichemotherapy was prospectively studied. Among 55 pts, 26 had adenocarcinoma, 25 squamous carcinoma and 4 unspecified non small cell carcinoma; 24 pts had stage Ill and 31 stage IV. 20/55 (36.6%) had elevated CEA serum levels, 42/55 (76.3%) and lo/55 (18.8%) had elevated serum levels of CYFRA and NSE, respectively, suggesting that the CYFRA is the most sensitive marker in this category of pts. 8/55 (14.5%) pts had normal values for all markers and only 2/55 had all abnormal markers. 24 pts had only one elevated marker and 21 had two elevated markers. 85.4% of pts had at least one elevated tumor marker. While only 35% of pts with elevated CYFRA had also CEA elevation, 75% of pts with elevated CEA had also abnormal CYFRA. Markers elevation seemed to be related to a favourable response rate: in fact, the % of objective response in pts with elevated CEA, CYFRA and NSE was 44%, 42.5%, 42.8% respectively. Moreover, pts with more than one elevated marker had a response rate of 48.8% whereas pts with only one or no marker elevation had 22.9% response rate. In conclusion, preliminary results indicate that base-line multiple marker assessment is helpful in identifying more than 80% of pts with at least one elevated tumor marker which could be helpful in following the disease course. In addition, pts with multiple marker elevation seem to fare better in terms of response rate.