135 hundred and ninety-eight patients (11%) of the total yearly 1745 adult admissionsfulfilled our criteria of prolongedcough. Asthma, suspicion of asthmaand postnataldrip were the commonestcansesof prolonged cough in 147 patientswith normal chestroentgenograms(26%. 9% and 16%. respectively), and in 45% the cough was of unexplained origin. Nonspecific bronchialhypetreactivity was common in this latter group ofpatientsprobablyduetoapreviousrespiratoryinfection.Lungcancer (37%) tuberculosis(16%). sarcoidosis(16%), and allergic alveolitis (9%) were the most important findings in patientswith abnormal chest roentgenograms.
In situ observation of lymphocyte-tumor cell interaction in human lung carcinoma Wei Y, Hang 2. Department of Pathology. West China University of Medical Sciences, Chengdu. lmmunol Investig 1989;18:1095-1105. Gf thirty surgical specimensof human lung carcinoma examined with electron microscopy, eleven were found to contain killer cells (cytotoxic lymphocytes).Nearly one-thirdof the killer cells showedthe polarization of their cytoplasm in which Golgi apparatus,dense granulesorcentriolescould be seen.The tumorcells conjugatedby the killer cells showed lesions to varying degrees, including loss of cell membranes,alterationsof cell organelles,even cell necrosis.The killer cells frequently penetrated into the cytoplasm, even the nuclei of the tumor cells. The results of the present study suggest that the lymphocytemediatedtumor cell lysis may exist in the microenvironmentof human lung carcinoma and that someof these cytotoxic lymphocytesmay kill their target cells by a similar mechanism of the pore formation or granule exocytosis model, but some different aspects were also observed, as compared with the results of the in vitro studies.
Lackof beneftt from semi-annual screening for cancer of the lung: Follow-up report of a randomized controlled trial on a population of high-risk males in Czechoslovakia Kubik A, Parkin DM, Khlat M, Erban J, Polak J, Adamec M. Research Institute of Tuberculosis and Respiratory Diseases, 18071 Prague. Int J Cancer 1990;45:26-33. Cigarette-smokingmales (6,364). aged 40-64, were randomizedinto an interventiongroup which received 6.monthly screeningby chestXray and sputum cytology, and a control group which received no asymptomatic investigation. After 3 years, both groups entered a follow-up period duringwhich they receivedannualchestX-rays. Lung cancer cases detected by screening were identified at an earlier stage, more often resectable, and had a significantly better survival than ‘interval’ casesdiagnosedmainly becauseof symptoms.Comparisonof the 2 groups showeda higher incidenceof lung cancer in the intervention group, despite the follow-up period when both groups received annual examinations.There was no significant difference in mortality between the 2 groups.
Presence of high concentration of 782 in pleural effusion Iguchi H. Hara N, Miyazaki K et al. Department of Biochemistry, Kyushu Cancer Center, Fukuoka 815. Endocrinol Jpn 1988;35:885-9. 7B2 (a novel pituitary protein) is a secretory protein in the nenroendocrine tissuesand an increase in the plasma 782 concentration was noted in some patientswith various endocrine tumors, including small cell carcinoma of the lung and acromegaly, suggestingthat 7B2 is a possiblemarker for these tumors. Using a radioimmunoassay,the 782 concentrationwas measuredin pleural fluid samplesobtained from 36 patients with lung cancer and benign pulmonary disease to assessits concentrationas a marker for small cell carcinoma of the lung (SCCL) or malignant effusion. 7B2-immunoreactivity (IR) was present in pleural fluid and its concentration was much higher than in plasma. However, there was no significantdifference betweenpleural fluid 7B2 in patientswith SCCL and in other histologicaltypesof lung carcinoma
or in malignant and nonmalignant patients. In the chromatographic analysis of pleural fluid on gel permeation chromatographyand reverse-phase high-performance liquid chromatography, there was no molecular heterogeneity between malignant and nonmalignanteffusion. These results suggest that pleural fluid 7B2-IR is not a useful marker for SCCL or malignant effusion.
Neurotensin elevates cytosolic calcium in small cell lung cancer cells Staley J, Fiskum G, Davis TP, Moody TW. Department ofBiochemistry. The George Washington University Medical Center, 2300 Eye Street, N.W., Washington, DC 20037. Peptides 198910: 1217-21. The ability of neurotensin(NT) to elevate cytosolicCa” in small cell lung cancer (SCLC) cells was investigatedusing the fluorescentCa” indicator Fura 2-AM. Using SCLC cell line NCI-H345, NT elevated cytosolicCa” levels in a concentration-dependentmanner. Using a 10 nM dose, NT and C-terminal fragments such as NT@-13) but not Nterminal fragmentssuchas NT(l-8) elevated the cytosolic Ca*+ levels. BecauseEGTA (5 mM) did not affect the NT response,NT may cause release of Ca” from intracellular stores. These data indicate that that SCLC NT receptors may use Ca2’ as a second messenger.
Site, size, and tumour involvement of resected extrapulmonary
lymph nodes in lung cancer Kayser K, Bach S, Bulzebruck H, Vogt-Moykopf I, ProbstG. Depwtment ofPathology. Thoraxklinik. Amalienstrasse 5, D6900 Heidelberg. J Surg Oncol 1990;43:45-9. A prospectivestudywas performed analyzing resectedextrapulmonttryIymphnodesof544ofoperatedlungcarcinomapatients. Volumeof lymphnodeswasdetetminedbyweight.Lymphnodeswerecutinserial sections300 pm thick, and the volume of tumour metastasisin each resected lymph node was computed measuringthe tumourousarea in the lymph node sections.The following resultswereobtained: Percentage of resectedlymph nodesvaried with lymph node site of the primary lung cancer. Hilar lymph nodes were resected in 50% of the patients, lymph nodes of the main and stem bronchi in 57% and 63%. respectively. Tumour metastaseswere found in lo%-15% of the resected lymph nodes.The size.of the lymph nodesvaried to a large amount and was found to be independentof the lymph node site if no metastases could be detected. Lymph nodes measuring ~0.1 ccm were tumour intiltrated in 9% (771706 lymph nodes), large lymph nodes (~10 ccm) in 62% of the cases (20/32). Tumourous involved lymph nodes of the main bronchuswere found more frequently in casesof central locahzed lung cancer compared to carcinoma arising from the peripheral lung, where the opposite was seen in subaortal located lymph nodes. The percentageof lymph node involvement and stze of tumour intiltrated lymph nodeswas found to be independentof tumour cell type. Size of resected lymph nodes is not a reliable parameter for estimating existence of tumour infiltrations.
Surgery A contribution on the prognostic significance of the tumor formula (pTNM) in squamous cell carcinoma of the bronchus Huwer H, Volkmer I, Hulsewede R, Hausinger F. Department of Thoracic and Cardiovascular Surgery, Surgery Division, Garland UniversityMedicalSchool,D-6650IiomburglSaar. ThoracCardiovasc Surg 1989;37:2814. Analysable data on survival time could be obtained in the context of a follow-up investigationfor 435 of 5 18 patientswho had beenoperated on for squamous-cellcarcinoma of the bronchusin the period 1976 to 1986. For better comparison, all tumors were staged retrospective accordingto the fourth edition (1987) TNM scheduleof the UICC. The mean survival time after potentially curative operation was 7.15 years