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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several radiopharmaceuticals have recently been shown to have a considerable affinity for malignant tissue. All the tumor-seeking radiopharmaceuticals in current use are nonspecific and may also be picked up by benign tumors and infectious processes, including abscess and granuloma. The sensitivity of the tumor-imaging procedure depends on the radiopharmaceutical employed, the type of tumor, its size and location, and previous or current treatment. Gallium-67 citrate (67Ga), the most widely used tumor-seeking radiopharmaceutical, seems to have its greatest value in detecting bronchogenic carcinomas irrespective of cell type. The sensitivity for lung cancer in 489 studies was 93 per cent. Gallium-67 is also of great value in the staging of Hodgkin's disease, in which its sensitivity is 87 per cent. Non-Hdgkin's lymphomas are detected with only slightly lower sensitivity. There is, in fact, evidence that 67Ga is at least complemenatry, if not more sensitive than lymphangiography, in the staging of lymphoma. However, adenocarcinomas originating in the gastrointestinal tract are detected by 67Ga with a sensitivity of only about 40 per cent, whereas various chelates of bleomycin (including 111In-Bleo, 99mTc-Bleo and 57Co-Bleo) detect adenocarcinoma of the gastrointestinal tract with considerably higher sensitivity. In the few studies available comparing bleomycin chelates, 57Co-Bleo and 99mTc-Bleo appear to be more sensitive in detecting tumor than 111In-Bleo. Other tumor-seeking radiopharmaceuticasl which have been employed with somewhat less success include selenium compounds, labeled pyrimidines, several inorganic cations, lanthanide chelates and labeled proteins. Yet to be evaulated clinically is the efficacy of radiolabeled antibodies which are specific for tumor antigens, such as 131I-anti-CEA (carcinoembryonic antigen).
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PMID:Cancer diagnosis. The role of tumor-imaging radiopharmaceuticals. 5 31

The in vivo observation that bleomycin may be used as a synchronizing agent provides the basis for testing 4 days of continuous bleomycin infusion followed by 5 days of intensive chemotherapy with cyclophosphamide, vincristine, methotrexate, and 5-fluorouracil. Thirty-eight patients with extensive non-oat cell bronchogenic carcinoma (adenocarcinoma[17 patients], squamous cell carcinoma[14 patients], and poorly differentiated carcinoma [seven patients]) were registered for chemotherapy. There were 11 patients with 50% regression of all measurable lesions and four with improved but poorly measurable radiographic lesions, providing a crude response rate of 39% (15 of 38 patients). An overall survival median of 19 weeks compares favorably with Veterans' Administration Lung Cancer Study Group control data, but was not substantially better than our own historical controls (P = 0.15). The median survival for responders was 36 weeks compared to 16 weeks for historical controls (P = 0.001) and 12 weeks for nonresponders (P less than 0.001).
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PMID:Bleomycin (NSC-125066) followed by cyclophosphamide (NSC-26271), vincristine (NSC-67574), methotrexate (NSC-740), and 5-fllorouracil (NSC-19893) for non-oat cell bronchogenic carcinoma. 6 31

Serum levels of carcino-embryonic antigen (CEA) and beta2-microglobulin (beta2m) were assayed on 133 sera during follow-up of 31 patients with lung carcinoma (squamous cell ca. without recurrence : 2, squamous cell ca. with recurrence : 11, anaplastic cell ca. : 4, adenocarcinoma : 2, unclassifiable : 5). Normal creatinine (less than or equal to 12 mg/l) levels were found in all sera. CEA and beta2m levels showed no correlation nor in these groups, nor in the whole. The squamous cell carcinomas with recurrence showed the largest dispersion for CEA as for beta2m levels. However, the trends of serial beta2m values did not correlate with clinical features. Increasing or decreasing levels of CEA and beta2m levels showed no correlation in the whole nor in patients undergoing radiotherapy. In our experience, beta2m levels failed to correlate with clinical findings during the follow-up of lung cancer patients.
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PMID:[Comparison of serum levels of beta2-microglobulin and carcino-embryonic antigen in the follow-up of lung cancer (author's transl)]. 8 84

Six cases of primary lung cancer that closely mimic malignant pleural mesothelioma clinically and anatomically are compared with four proven cases of malignant pleural mesothelioma. Findings on roentgenograms of the chest, clinical history, and gross examination of the lung specimens are not helpful in distinguishing between these two neoplasms. Microscopic examination of the hematoxylin and eosin-stained tissues is often inconclusive. Tissues were stained with hematoxylin and eosin, PAS with and without diastase treatment (DPAS), mucicarmine, alcian blue, toluidine blue, and colloidal iron with and without digestion by testicular hyaluronidase. Among these histochemical methods, DPAS was found to be particularly useful in distinguishing the primary lung cancers from the mesotheliomas. All primary lung cancers except one showed DPAS-positive material (mucin) in both the cytoplasm of the cancer cells and within the lumina of neoplastic glands. In contrast, none of the mesotheliomas showed the presence of DPAS-positive material. Histologically, all lung cancers were glandular. Five were classified as bronchiolar carcinoma, the remaining one as poorly differentiated adenocarcinoma. In two of the bronchiolar carcinomas, a small subpleural primary focus was demonstrated. This finding suggests a possible origin of these cancers as a small subpleural tumor that became widely disseminated via the subpleural lymphatics. This form of primary lung cancer possesses sufficient gross and microscopic characteristics that recognition should be given to it as a variant of primary lung cancer, with emphasis on differentiating it from pleural mesothelioma.
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PMID:Pseudomesotheliomatous carcinoma of the lung. A variant of peripheral lung cancer. 17 52

Detailed studies of immune reactivity were performed in 154 patients with primary lung cancer, 20 patients with benign thoracic lesions, and 109 healthy persons. Reactions to the 2,4-dinitrochlorobenzene (DNCB) skin test were postive in 73 per cent of patients with lung cancer and all (100 per cent) of the patients with benign disease (p less than 0.05). The incidence of DNCB reactions was 78 per cent for Stage I and II cancers (37 patinets), 73 per cent for resectable Stage III cancer (22 patients), and 66 per cent in patients with unresectable or inoperable Stage III cancer. DNCB reactivity showed a relationship to primary histology. The incidence of DNCB positive reactions was 80 per cent in patients with epidermold carcinoma versus 57 per cent in patients with adenocarcinoma, 64 per cent in patients with oat cell cancer, and 80 per cent in patients with terminal bronchiolar carcinoma. In vitro immune studeis correlated best with stage of disease. These included the absolute lymphocyte count and absolute T cell count and lymphoxyte stimulation witalen A (Com A). These values were in the normal range in patients with Stage I cancer but were significantly depressed in patients with Stage III cancer. Svrvival curves were plotted in patients with Stage III disease according to the responses to three immune parameters: DNCB, absolute lymphocyte count, and PHS stimulation. Although patients with normal reactions generally had better survival rates, PHA responses showed the most significant correlation to survival. These tests support the usefulness of immune testing as an additional parameter of assessing biological risk in patients with primary lung cancer.
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PMID:Immune reactivity in primary carcinoma of the lung and its relation to prognosis. 18 63

In order to estimate the possibility of a cytologic differential diagnosis of bronchiolo-alveolar carcinoma and bronchogenic adenocarcinoma, 121 histologically proven cases of these two types of lung cancer were studied. Certain features of the tumor cells were used as differential diagnostic parameters. By means of these features it was possible to correctly type 90% of the bronchiolo-alveolar carcinomas and 72% of the bronchogenic adenocarcinomas. The most striking characteristics of bronchiolo-alveolar carcinoma was the uniformity of cells, the occurrence of such cells in tightly packed clusters, the absence of prominent nucleoli and also the scarcity of single tumor cells. Thus, it seems possible to make a correct cytologic differential diagnosis between these two types of lung tumors with high accuracy.
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PMID:Cytologic differential diagnosis of bronchiolo-alveolar carcinoma and bronchogenic adenocarcinoma. 18 34

One hundred and seven patients with carcinoma of the lung underwent immunologic testing, and 62 of these patients were randomized to an immunotherapy protocol comparing the effects of Pasteur strain BCG, either alone or combined with allogeneic tumor cells, to the effects of no immunotherapy. Patients with residual disease left at the time of surgery or with metastatic disease at the time of diagnosis showed no increase in survival as a result of this form of immunotherapy. An insufficient number of patients with less advanced disease, in whom we would expect the most beneficial effect, have been entered in this study. In general, we were unable to document substantial effects of immunotherapy on the immunologic parameters tested. Only in recall antigen skin testing was there a statistically significant increase in reactivity in the immunotherapy groups. Tests of general immune status appeared to have a predictive value in monitoring lung cancer patients. Anergic patients had a poorer prognosis than did patients who demonstrated skin test reactivity. Patients with normal percentages of lymphocytes (T cells) forming rosettes with sheep erythrocytes at 29 degrees C were generally normal in other tests of immune competence. In serial studies of rosette formation, all patients who developed recurrent disease had a pattern of depressed or falling rosette values, and these abnormalities occurred an average of 3.1 months prior to clinical detection of recurrence. Patients with large-cell anaplastic carcinoma were found to have a significantly higher incidence of depressed rosette levels than the other histologic types. Both large and small-cell anaplastic patients had significantly depressed lymphocyte proliferation by mitogens and allogeneic cells. Although lung cancer patients have been described as immunologically depressed, they are capable of recognizing tumor-associated antigens. When tested in leukocyte migration inhibition assays with tumor-associated antigens, the majority of the patients in our study were found to be reactive. The use of a 3 M KCl extract of pleural effusion cells from a patient with pulmonary adenocarcinoma has given good reactivity and specificity in lung cancer patients of all histologic types. In addition, these patients have been shown to respond in a mixed lymphocyte/tumor interaction to tumor-associated antigens (Dean, 1976b).
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PMID:Immunological monitoring and immunotherapy in carcinoma of the lung. 18 17

Four hundred and seventy nine primary lung cancers were typed according to the WHO histological classification. The character of the material and the methods of investigation are described. All patients had been subjected to mediastinoscopy and 313 patients had been operated upon. Nearly half of the tumours (48 per cent) was epidermoid carcinomas. Small cell anaplastic carcinoma occurred in 25 per cent and around two thirds of these were of oat cell type. Adenocarcinoma was found in 22 per cent and the acinar type predominated. Bronchiolo-alveolar carcinoma occurred in 1 per cent and large cell carcinoma in 3 per cent. Typing of biopsy specimens was made in 289 cases in which a positive biopsy had been obtained during the pretreatment period. The result of the biopsy typing was checked against that of the final one. In the total group the preoperative histological diagnosis tallied with the final one in 88 per cent. In patients who had been subjected to surgery the pretreatment diagnosis of the epidermoid carcinoma was correct in 86 per cent, that of small cell anaplastic carcinoma in 92 per cent and that of adenocarcinoma in 100 per cent. The consistency was also high in the category of patients not subjected to surgery. Despite their critical attitude towards the delimitation of epidermoid carcinoma in the WHO-classification the present authors find it to be a reliable guide to routine typing of lung cancer.
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PMID:Histological typing of lung cancer. Application of the World Health Organization classification to 479 cases. 18 6

A controlled clinical trial comparing two-drug and three-drug combination chemotherapy was performed in 206 patients with advanced bronchogenic carcinoma, comprised of 26.2% with epidermoid carcinoma, 30.1% with small cell anaplastic carcinoma, 27.2% with adenocarcinoma, and 15.6% with large cell carcinoma. Each drug combination consisted of agents with different modes of action and included a cell-cycle-stage nonsensitive and a cell-cycle-state-sensitive agent. The overall response rate was highest for small cell carcinoma (48.2%) and adenocarcinoma (23.6%); it was less than 10% in epidermoid and large cell carcinoma. Similarly, the overall median survival was twice as long for the first two cell types (7 months) as compared with that recorded for the other two cell types (3 1/2 months). The combination of 1 (2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), cyclophosphamide, and methotrexate was shown to be statistically superior to cyclophosphamide and methotrexate with regard to objective respones rate, duration of response, and median survival for adenocarcinoma. Responders lived significantly longer than nonresponders (254 versus 90 days for small cell anaplastic carcinoma patients and 244 versus 184 days for adenocarcinoma patients). No difference in survival or objective response rate was observed between the different treatments for the other two cell types of lung cancer.
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PMID:Combination chemotherapy of advanced lung cancer: a randomized trial. 18 12

Twenty-eight patients with lung cancer, 26 with extensive disease, were treated with the drugs Cytoxan (Cyt) and methotrexate (MTX). The schedule was based on cellular kinetics concepts. Initial therapy was with Cyt 1.1 g/m2 (intravenously) followed by MTX 20 mg/m2 orally, twice weekly, started 9 days later, when the tumor was considered to be most susceptible to an S-phase-specific drug. The course was repeated at three-week intervals. Based on dose response curves, Cyt and MTX dose modifications were individually adjusted to the whit blood cell counts and platelet counts over a 3-week period. Twenty of 28 patients (five of seven large cell, five of eight adenocarcinoma, 10 or 11 small cell, none of two epidermoid) responded with greater than or equal 50% tumor reduction. Ten patients had complete responses, seven of whom had small cell carcinoma. Two of the nonresponders were nonevaluable. Five patients were alive and the extimated median survival time of the patients is almost 1 year, which compares quite favorably to previous reports. On this schedule of therapy, very high doses of Cyt and MTX were maintained with less than 3% incidence per course of a WBC less than 1,500/mm3 or a platelet count less than 50,000/mm3.
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PMID:Combination chemotherapy in advanced lung cancer with increased survival. 18 14


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