Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A technetium 99m diphosphonate scan is a sensitive detector of bony metastases of breast, prostate, and lung cancer. For these particular neoplasms, a negative bone scan in an asymptomatic patient is adequate evidence for absence of bony metastases and a correlative roentgenographic examination may not be necessary. Positive studies demonstrating multiple characteristic discrete areas of increased activity should be considered strong evidence for metastases. Single equivocal lesions require roentgenographic and occasionally biopsy correlation. If roentgenography fails to reveal the source of increased uptake, (e.g., degenerative disease) the scan lesion should remain suspicious for metastases.
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PMID:Accuracy of 99mTC-diphosphonate bone scans and roentgenograms in the detection of prostate, breast and lung carcinoma metastases. 123 61

In an attempt to formulate indications for mediastinoscopy, the histologic tumor type and the radiographic manifestations of the tumor were correlated with the occurrence of mediastinal node metastases in 121 patients who had potentially resectable bronchogenic carcinoma. Our results demonstrated that mediastinal metastases occur commonly in patients with central lesions irrespective of cell type, but that the histologic tumor type has a definite influence on the frequency of mediastinal involvement in patients with parenchymal masses or peripheral lesions. Our results also demonstrated that the absence of radiographic evidence of mediastinal involvement cannot be given strong consideration when selecting patients for mediastinoscopy, because almost 50 per cent of patients with mediastinal involvement did not have mediastinal widening on the chest roentgenogram. Our results, in conjunction with currently accepted principles governing the management of patients with bronchogenic carcinoma, have allowed us to propose a logical approach for the use of mediastinoscopy in the prethoracotomy evaluation of patients with potentially resectable lung cancer.
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PMID:Indications for mediastinoscopy in bronchogenic carcinoma. 124 33

With the aim of analysing the pathological findings of upper gastrointestinal endoscopy in patients with bronchial or breast cancer and gastrointestinal symptoms a multicenter study was carried out over one year (1990) by 26 medical departments. One duodenal metastasis was verified among 188 patients with lung cancer. Seven of 118 patients with breast cancer developed symptomatic stenosis of the esophagus. A total of 42.9% of the patients with lung cancer and 38.6% of the patients with breast cancer had pathological findings detected by upper gastrointestinal endoscopy. Most frequent findings were duodenal and gastritic ulcers (lung cancer 15.0%, breast cancer 15.8%), esophagitis (lung cancer 16.3%, breast cancer 8.9%) and symptomatic stenosis of the esophagus (lung cancer 9.5%, breast cancer 7.0%). The authors conclude that there is a high frequency of relevant pathological upper gastrointestinal tract findings in symptomatic patients with breast or lung cancer, but that true metastatic disease is a rare phenomenon with the exception of metastatic involvement of the esophagus.
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PMID:[Upper intestinal endoscopy in 188 bronchial cancer patients and 118 breast cancer patients with abdominal symptoms. The GI Metastases Study Group]. 128 24

Results of standard X-ray tomography, computed tomography and ultrasonic tomography (UT) used for detecting mediastinal metastases from lung cancer were compared in 50 patients who were later operated on. UT sensitivity in the diagnosis of paravasal lymph node involvement proved superior to that of X-ray tomography and only slightly yielded to that of computed tomography. As regards bifurcation lymph node assessment, results of the radiation imaging techniques were similar to those obtained by surgery. Ultrasonographic signs of tumor spreading to the mediastinum were observed in cases of stage IIIa-IIIb tumors only. UT assured detection of metastases in normal-sized lymph nodes of the upper mediastinum. Combined application of standard X-ray and ultrasonic tomography of the mediastinum assured better staging of tumor roughly in half the patients. Absence of X-ray signs of mediastinal lymph node enlargement is considered a direct indication for UT.
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PMID:[Ultrasonic tomography of the mediastinum in the staging of lung cancer]. 130 Jul 57

The occurrence of ERBB-2 (HER-2/NEU) oncogene amplification was studied in 203 DNA samples obtained from 175 cancer patients. Amplification of ERBB-2 oncogene was established in 14 out of 63 (22%) patients with breast cancer, 1 out of 23 cases of ovarian tumor, 1 out of 19 cases of large bowel cancer and 1 out of 27 patients with cancer of the thyroid. Patients with lung cancer (34), soft tissue sarcoma (6) and malignant melanoma (3) failed to reveal any changes in the above oncogene. A tendency was established for ERBB-2 oncogene amplification to be associated with lymph node involvement in female patients with breast cancer: amplification was observed in 9 out of 28 patients presenting with lymph node metastases and only in 5 out of 29 metastases-free cases. To summarize, ERBB-2 oncogene is fairly often activated in human tumors but a high occurrence of the gene amplification was observed in female patients with breast cancer only.
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PMID:[The search for amplification of the ERBB-2 oncogene in human tumors]. 130 Jul 65

A retrospective analysis is reported of 185 patients treated at the Memorial Sloan-Kettering Cancer Center, New York, in whom in the period 1984-1989 metastases to the brain from non-microcellular lung cancer were removed surgically. The statistical analysis was done by the Kaplan-Meier test. For neurosurgical treatment patients should be qualified without metastases to other organs and with brain metastatic tumor accessible for operation. The median survival was 12 months after operation on the brain, and 27 months after thoracic operation. The patients with cerebellar metastases had the same survival time after the operation as those with supratentorial metastases. Radiotherapy had no influence on the length of survival after tumor removal. Recurrence of brain tumour occurred in half the cases. Reoperation in case of recurrence prolonged the survival by another 10 months.
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PMID:[Surgical treatment of brain metastases from non-microcellular lung cancer]. 130 11

Lung cancer arises after a series of morphological changes, which take several years to progress from normal epithelium to invasive cancer. The morphological changes progress from hyperplasia, to metaplasia, to dysplasia, to carcinoma in situ, to invasive cancer and finally to metastatic cancer. Multiple molecular changes have been documented in lung cancers, both small cell (SCLC) and non-small cell (NSCLC) types. The number of changes has been estimated to be in double digits. These changes include activation of dominant oncogenes myc family, (K-ras and neu genes), as well as loss of recessive growth regulatory genes or anti-oncogenes (p53, and RB as well as unidentified gene or genes on chromosome 3). However, cytogenetic and molecular genetic studies indicate that multiple other specific sites of actual or potential DNA loss may be present in lung cancers. Other changes may include development of drug resistance, and production of growth factors and their receptors. It is tempting to associate specific molecular changes with specific morphological changes, as has been attempted in the colon. However, because of the difficulties in serially sampling the respiratory tract, such studies have not been performed to date. Documentation of molecular changes in premalignant lesions and prospective studies of their prognostic effects will be necessary for the design of rational chemoprevention trials.
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PMID:The molecular biology of lung cancer. 130 9

Between August 1985 and September 1989, 62 patients with medically inoperable or surgically unresectable, non-small cell lung cancer were treated with both external beam radiotherapy and high dose rate bronchial brachytherapy. Treatment consisted of external beam radiotherapy (5000-6000 cGy in 5-6 1/2 weeks) and weekly high dose rate bronchial brachytherapy (three to five fractions, 500 cGy at 1 cm from the source) delivered either concurrently or sequentially. Median survival for all patients was 13 months (m). Stage I and Stage IIIA-B patients had median survivals of 20 m and 10 m, respectively. Patients without nodal disease (No) had a significantly longer median survival compared to patients with regional node metastases (N1-3), 17 m versus 9 m. A total of 54 patients were evaluable for local tumor control analysis. Local tumor control was achieved in six of eight patients who had a normal pre-treatment radiograph. Patients with measurable tumor on the pre-treatment radiograph and negative regional nodes had local tumor control in eight of twenty-two (36%) cases. In patients with regional lymphadenopathy, loco-regional tumor control was achieved in four of eight cases. Additionally, there were sixteen patients with non-measurable tumor due to associated effusion, atelectasis and/or infiltrate. Four of these (25%) were considered to have local tumor control. Of 60 evaluable patients, there were nine occurrences of fatal hemorrhage, one of whom was disease-free (NED) at autopsy. The remaining eight patients had either clinical or pathological evidence of recurrent or persistent tumor. Patients who had follow up bronchoscopies were found to have varying degrees of concentric narrowing in the treated areas. One such patient had total lung collapse with no evidence of tumor. While this form of treatment may yield high local control rates in earlier stages, this study suggests the potential risk of fatal complication. Additional studies are warranted to further investigate the use of this modality in the treatment of lung cancer.
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PMID:Treatment of non-small cell lung cancer with external beam radiotherapy and high dose rate brachytherapy. 157 23

Refinements of computed tomographic (CT) scanning techniques, such as high-resolution CT, CT densitometry, and contrast enhancement CT, have been shown to improve diagnostic accuracy in differentiating between benign and malignant lung nodules. Unfortunately, none of these techniques is fail proof, and, even when a lesion is considered to be benign, periodic observation is mandatory. In staging the locoregional extent of lung cancer, magnetic resonance imaging has not been shown to be superior to CT scanning and should not be substituted for or used in addition to CT except in special situations. Transesophageal ultrasonography, which identifies additional mediastinal lymph nodes that are not visualized by CT scanning, may become an important adjunct in the clinical staging of the regional extent of the disease. Study findings have supported the value of pleural lavage cytology at thoracotomy. Additional studies of the technique as a prognostic factor should be conducted in patients with resected early-stage disease. The high incidence of cerebral metastasis in patients with adenocarcinoma and stage III disease suggests the possible value of routine use of CT scans in this subset of patients who, otherwise, have potentially resectable lung tumors. However, no evidence supports routine scanning in patients with stage I or II disease. The low sensitivity of abdominal CT scans in identifying adrenal metastatic involvement further decreases the value of using this examination routinely to identify occult adrenal metastatic disease.
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PMID:Screening, diagnosis, and staging of non-small cell lung cancer and consideration of unusual primary tumors of the lungs. 131 18

Thirty-three patients with biopsy-proven lung cancer and a total of 150 lesions diagnosed by conventional staging procedures were imaged using a Tc-99m labeled monoclonal Fab fragment of an IgG2B murine monoclonal antibody (MoAb) (NR-LU-10, NeoRx Corporation). Immunoscintigraphy demonstrated 100% of primary and 78% of metastatic lesions. MoAb imaging detected 88% of lesions in 12 small cell lung cancer (SCLC) patients and 77% of lesions in 21 non-small cell lung cancer (NSCLC) patients. Based on initial evaluation by other methods, 29 sites of MoAb activity were not associated with evidence of disease. Eleven of these were subsequently shown to represent sites of metastases; 18 remain unconfirmed. Four of ten patients studied with limited NSCLC had eight unsuspected lesions on MoAb imaging. Confirmation of unsuspected lesions in two patients altered initial clinical staging, and surgical therapy was abandoned. This study demonstrates that Tc-99m labeled NR-LU-10 can accurately stage patients with lung cancer.
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PMID:Staging lung carcinoma with a Tc-99m labeled monoclonal antibody. 131 60


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