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Lung cancer in young patients (aged less 40 years)
410
levels havesignificantlyshortersurvival timea; (4)apositivecorrelatioo between pretreatment NSE and NCAM levels was found (n = 221, r = 0.60); and (5) a correlation between serum marker levels aod clinical status was found in follow-up studies of 19 patients. Conclusions. From these data, ir ISconcluded that NCAM is. along with NSE. a pnlentlal Nmor marker for SCLC.
Cardiopulmonary Function after pulmonary lohectomy in patients with lung cancer Nisbimura H, Haniuda M. Morimoto M. Kubo K. Depunmenr of Surgery. Shitrrhu Universiv School of Med., 3-I-l Rcahi, Matswnoto 3!=w.ANI Thorac surg 1993% 1477-84. The. effects of pulmonary lobectomy on cardiopulmonary function were investigated in 9 patients with lung cancer. Hemodynamic studies at restandduringexercisewerepertormedbeforeand4 to6moothsafter the operation. Differences in hemodynamics between before and after operation were observed with respect to heart rate, pulmonary artenal pressure, pulmonary vascular resistance index, and stroke volume index. Heart rate, pulmonary arterial pressure, and pulmonary vascular resistance index were significantly increased after operation, whereas stroke volume Index was significantly decreased. It is thought that cardiac index was preserved by the increase in heart rate despite a deccn;tse in stroke volume index associated with thedecreased pulmonary vascular bed atier the operation. When driving pressure and cardiac mdex were studied after operatton. the pressure at rest and during exerc,se was higher. and the pressure-flow curve increased more steeply. as compared with the preoperative values. These results suggest asib~iticantdeterioration in cardiopulmonary functiooafterlobectomy. As the patient characteristics were heterogeneous (live lobectomies and four bilobectomies), and thalr findings are limited. additional studies may be necessary in the future.
Lung cancer in young patients (aged lfss 40 years) Cangemi V, Volploo P. D’AndreaN, Tomassmj R, Grazani E. Fabrizi S et al. Via Syuarcialupo 19/A, 0162 Roma. Chirurgia (Turm) 1993;6: 134-9. It is generally agreed that there is an increase mcideoce of lung cancer but its incidence in young people is very low. During 1987 65.078 patients were treated in Italy for primary lung cancer. The incidence of broochogeoic carcmoma in patients less than 40 years was 4.9 %. A total of 516 cases of histologically proven broochogeoic carcinoma were observedat lstSurgica1 ClimcoftheUniversityofRome ‘LaSapierua’. Eighteen of these cases (3.5 %) aged between 6 and 40 years. The male to female ratio was 2.6. 80% were habitual smokers; 78% had symptoms before diagnosis. The most common cell types were adroocarcinomas and large cell carcinomas (33.3 96 respectively) (five cases in stage I and II; 7 cases in stage III and IV). Squamous carcinomas and oat cell carcinomas were 16.7% respectively (all of them presented m stage III and IV were unresectable). Eight patients uodenvent resectton. XX of them for care. The actuarial survival, expressed by Kapla&Meler method, was 58% at five years for the surgical treated group and 0% at 2 years for the group that did not undergo surgical resection. Four of five patients wnh stage I and II disease are alive after 9- 10 years. Even Ihe patients surgically treated with stage III disease had a better survival (33% at 3 years) than rhe patients who were not suqlcally treatul.
Asbestos-related pleural plaques and hmg cancer Weiss W. 3912 &rhe@Xd Rood, Philadelphia. PA 19129. Chest 1993;103: 1854-9. The English-language literature was reviewed to evaluate a possible relationship betweo asbestos- related pleural plaques and lung cancer
Abstracts/Lung
Cancer 10 (1994) 395-430
in the absence of pareochymal asbestosis. There were six cohort studies in which the comparison group was limited to unexposed persons or the general population, four lung cancer case-control studies, and three autopsy sNdies. Oftbe 13 investigations, only3 supported the hypothesis that lung cancer risk is elevated among parsons witb pleural plaques over the risk in unexposed people: 2 cohort studies from the same city in England with much the same data and 1 case-control study. These three studies had the most defects in design. The other ten sNdiu failed to confirm the hypothesis. Thus, the weight of the evidence favors the conclusion that persons with asbestos- related pleural plaques do not have an increased risk of lung cancer in Ihe absence of parenchymal asbestosis.
Terminal pulmonary infections in patients with lung cancer Nagata N, Nikaido Y, Kido M, Isbibasbi T, Sueisbi K. Division of RespimrotyDiseoses, Univ. OccupationaUEntiron Health, I-l Iseigaokn, Yaharanishiku, Kimkyuhu 807. Chest 1993:103:1739-42. To determine the factors that predispose the patient with lung cancer to develop terminal pulmonary infections, we reviewed the case records and autopsy data of 304 patients who died of lung cancer in the Kyushu University Hospital between 1976 and 1990. The incidence of mycobacterial infection was signiticandy higher among those treated with antineoplastic therapy and corticosteroids (group 3) than io those who received antineoplastic therapy alone (group 2). The incidence of nonbacterial infection did not differ significantly between the two groups. IO some ymup 3 patients, the administration of corticosteroids forrelativclyshortperiods(Iessthanooemooth) ledtofatalmycobacterial infection. Among those pauentswith lymphocytopenia, the incidenceof fatal mycobacterial iofe&ioo was significantly higher in group 3 than in group 2, whereas the incidence of fatal nonbacterial infection was not. In group 3, the incidence of fatal mycobacterial and nonbacterial infrrtions did not differ s@ficantly among those with and wlthout lymphocytopenia. Thus, in pauentswitb lungcancerwho were receiving antinmplastic treatment, corticosteroids were more cloxly associated with the development and exacerbation of mycobactenal infection than was Iymphocytopeoia. The influence of corticosteroids on the development ofnonbacterial infection was not more marked than that of lymphocytopenia. The incidence ofcommon bacterial infectloos was no higheramong thosepatients who receivednoantineopiastic treatment or corticosteroid (group I), group 2. and group 3. Therefore, the local and systemic cffocts of the lung cancer itself are likely more important in predisposing the patient to bacterial infections than arz either antineoplastic agents or corucosteroids. Phenotypes and lymphokineactivated killer activity of pleural cavity lymphocytes of lung cancer patienti without millignant effusion Takabashi K, Sooe S. Kimura S, Ogura T, Moodeo Y. 2nd Deponmenf of Surgery, Tokushima Univ. School of Medicine, Tokushima 770. Chest 1993: 103: 1732-8. We examined the phenotypes of lymphocytes in the pleural cavity of 23 lung cancer patients without malignant effusion. The ability of those lymphocytes to develop lymphokioe-activated killer (LAK) activity and the regulation of LAK by pleural cavity macrophages were also compared with theircounlerparts in the peripheral blood. Mooonuclzar cells(MNC)wereobtamedsimultaneouslyfromthebloodand bylavage of the pleural cavity of patients with lung cancer. The proportion of the T-cell subset of HLA-DR’ cells was signiticantly higher in the pleural cavity than in the peripheral blood. but the proportions of CD3’ and CD8’ cells in the pleural cavity were similar to the corresponding proportions in the blood. The proport~oos of CD4’ and CD 16’cells were lower in the pleural cavity than in the blood. The LAK activity could be developed by MNC from the pleural cavity following incubation with
levels havesignificantlyshortersurvival timea; (4)apositivecorrelatioo between pretreatment NSE and NCAM levels was found (n = 221, r = 0.60); and (5) a correlation between serum marker levels aod clinical status was found in follow-up studies of 19 patients. Conclusions. From these data, ir ISconcluded that NCAM is. along with NSE. a pnlentlal Nmor marker for SCLC.
Cardiopulmonary Function after pulmonary lohectomy in patients with lung cancer Nisbimura H, Haniuda M. Morimoto M. Kubo K. Depunmenr of Surgery. Shitrrhu Universiv School of Med., 3-I-l Rcahi, Matswnoto 3!=w.ANI Thorac surg 1993% 1477-84. The. effects of pulmonary lobectomy on cardiopulmonary function were investigated in 9 patients with lung cancer. Hemodynamic studies at restandduringexercisewerepertormedbeforeand4 to6moothsafter the operation. Differences in hemodynamics between before and after operation were observed with respect to heart rate, pulmonary artenal pressure, pulmonary vascular resistance index, and stroke volume index. Heart rate, pulmonary arterial pressure, and pulmonary vascular resistance index were significantly increased after operation, whereas stroke volume Index was significantly decreased. It is thought that cardiac index was preserved by the increase in heart rate despite a deccn;tse in stroke volume index associated with thedecreased pulmonary vascular bed atier the operation. When driving pressure and cardiac mdex were studied after operatton. the pressure at rest and during exerc,se was higher. and the pressure-flow curve increased more steeply. as compared with the preoperative values. These results suggest asib~iticantdeterioration in cardiopulmonary functiooafterlobectomy. As the patient characteristics were heterogeneous (live lobectomies and four bilobectomies), and thalr findings are limited. additional studies may be necessary in the future.
Lung cancer in young patients (aged lfss 40 years) Cangemi V, Volploo P. D’AndreaN, Tomassmj R, Grazani E. Fabrizi S et al. Via Syuarcialupo 19/A, 0162 Roma. Chirurgia (Turm) 1993;6: 134-9. It is generally agreed that there is an increase mcideoce of lung cancer but its incidence in young people is very low. During 1987 65.078 patients were treated in Italy for primary lung cancer. The incidence of broochogeoic carcmoma in patients less than 40 years was 4.9 %. A total of 516 cases of histologically proven broochogeoic carcinoma were observedat lstSurgica1 ClimcoftheUniversityofRome ‘LaSapierua’. Eighteen of these cases (3.5 %) aged between 6 and 40 years. The male to female ratio was 2.6. 80% were habitual smokers; 78% had symptoms before diagnosis. The most common cell types were adroocarcinomas and large cell carcinomas (33.3 96 respectively) (five cases in stage I and II; 7 cases in stage III and IV). Squamous carcinomas and oat cell carcinomas were 16.7% respectively (all of them presented m stage III and IV were unresectable). Eight patients uodenvent resectton. XX of them for care. The actuarial survival, expressed by Kapla&Meler method, was 58% at five years for the surgical treated group and 0% at 2 years for the group that did not undergo surgical resection. Four of five patients wnh stage I and II disease are alive after 9- 10 years. Even Ihe patients surgically treated with stage III disease had a better survival (33% at 3 years) than rhe patients who were not suqlcally treatul.
Asbestos-related pleural plaques and hmg cancer Weiss W. 3912 &rhe@Xd Rood, Philadelphia. PA 19129. Chest 1993;103: 1854-9. The English-language literature was reviewed to evaluate a possible relationship betweo asbestos- related pleural plaques and lung cancer
Abstracts/Lung
Cancer 10 (1994) 395-430
in the absence of pareochymal asbestosis. There were six cohort studies in which the comparison group was limited to unexposed persons or the general population, four lung cancer case-control studies, and three autopsy sNdies. Oftbe 13 investigations, only3 supported the hypothesis that lung cancer risk is elevated among parsons witb pleural plaques over the risk in unexposed people: 2 cohort studies from the same city in England with much the same data and 1 case-control study. These three studies had the most defects in design. The other ten sNdiu failed to confirm the hypothesis. Thus, the weight of the evidence favors the conclusion that persons with asbestos- related pleural plaques do not have an increased risk of lung cancer in Ihe absence of parenchymal asbestosis.
Terminal pulmonary infections in patients with lung cancer Nagata N, Nikaido Y, Kido M, Isbibasbi T, Sueisbi K. Division of RespimrotyDiseoses, Univ. OccupationaUEntiron Health, I-l Iseigaokn, Yaharanishiku, Kimkyuhu 807. Chest 1993:103:1739-42. To determine the factors that predispose the patient with lung cancer to develop terminal pulmonary infections, we reviewed the case records and autopsy data of 304 patients who died of lung cancer in the Kyushu University Hospital between 1976 and 1990. The incidence of mycobacterial infection was signiticandy higher among those treated with antineoplastic therapy and corticosteroids (group 3) than io those who received antineoplastic therapy alone (group 2). The incidence of nonbacterial infection did not differ significantly between the two groups. IO some ymup 3 patients, the administration of corticosteroids forrelativclyshortperiods(Iessthanooemooth) ledtofatalmycobacterial infection. Among those pauentswith lymphocytopenia, the incidenceof fatal mycobacterial iofe&ioo was significantly higher in group 3 than in group 2, whereas the incidence of fatal nonbacterial infection was not. In group 3, the incidence of fatal mycobacterial and nonbacterial infrrtions did not differ s@ficantly among those with and wlthout lymphocytopenia. Thus, in pauentswitb lungcancerwho were receiving antinmplastic treatment, corticosteroids were more cloxly associated with the development and exacerbation of mycobactenal infection than was Iymphocytopeoia. The influence of corticosteroids on the development ofnonbacterial infection was not more marked than that of lymphocytopenia. The incidence ofcommon bacterial infectloos was no higheramong thosepatients who receivednoantineopiastic treatment or corticosteroid (group I), group 2. and group 3. Therefore, the local and systemic cffocts of the lung cancer itself are likely more important in predisposing the patient to bacterial infections than arz either antineoplastic agents or corucosteroids. Phenotypes and lymphokineactivated killer activity of pleural cavity lymphocytes of lung cancer patienti without millignant effusion Takabashi K, Sooe S. Kimura S, Ogura T, Moodeo Y. 2nd Deponmenf of Surgery, Tokushima Univ. School of Medicine, Tokushima 770. Chest 1993: 103: 1732-8. We examined the phenotypes of lymphocytes in the pleural cavity of 23 lung cancer patients without malignant effusion. The ability of those lymphocytes to develop lymphokioe-activated killer (LAK) activity and the regulation of LAK by pleural cavity macrophages were also compared with theircounlerparts in the peripheral blood. Mooonuclzar cells(MNC)wereobtamedsimultaneouslyfromthebloodand bylavage of the pleural cavity of patients with lung cancer. The proportion of the T-cell subset of HLA-DR’ cells was signiticantly higher in the pleural cavity than in the peripheral blood. but the proportions of CD3’ and CD8’ cells in the pleural cavity were similar to the corresponding proportions in the blood. The proport~oos of CD4’ and CD 16’cells were lower in the pleural cavity than in the blood. The LAK activity could be developed by MNC from the pleural cavity following incubation with