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

Thoracoscopy has been around for decades, advocated by some, but until recently, ignored by many. Not surprisingly, its diagnostic and therapeutic efficacy in patients with suspected or proven malignant pleural effusions has withstood the test of time. Today, the potential benefits of thoracoscopy must be weighed against its cost in patients with limited life expectancy. Although diagnostic thoracoscopy requires only overnight hospitalization, pleurodesis imposes a longer hospital stay. The discomfort of an indwelling chest tube, the need for hospitalization, and the financial burden of thoracoscopic procedures compared with less-invasive means of pleural investigation and pleurodesis must be taken into account on an individual basis. Thoracoscopy should not be performed for the sake of intervention. Its indications and all diagnostic or therapeutic alternatives should always be carefully examined. Its role, however, in the diagnosis and treatment of patients with malignant pleural effusions is undeniable. The diagnostic accuracy of thoracoscopic pleural biopsy is excellent. Several studies demonstrate that thoracoscopic talc pleurodesis is more frequently successful than other methods of pleurodesis. As a staging procedure, thoracoscopy helps determine extent of disease, and possibly, prognosis in patients with metastatic pleural carcinomatosis, lung cancer, and malignant mesothelioma. As this procedure is increasingly rediscovered by our medical and surgical communities, greater clinical and experimental investigation aimed at establishing successful management strategies in patients with malignant pleural effusions will hopefully occur.
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PMID:Thoracoscopic management of malignant pleural effusions. 852 5

Gene therapy is the treatment of any disorder or pathophysiologic state based upon the transfer of genetic information. The lung represents a major target of gene therapy for the treatment of genetic disorders such as cystic fibrosis and alpha 1-antitrypsin deficiency. Other diseases are also being targeted, including pulmonary inflammation, surfactant deficiency, pulmonary hypertension, lung cancer, and malignant mesothelioma. This review will examine some general concepts regarding gene transfer and gene therapy, provide an overview of the current vectors being developed to achieve safe and efficient gene transfer, and summarize the ongoing work to apply this new technology to the treatment of both inherited and acquired pulmonary diseases. Although tremendous progress has been made in the ability to successfully transfer genes to cells, there are several unresolved problems limiting the clinical application of this technology to human pulmonary disease. However, as vector technology evolves, gene therapy may become a reality for a number of lung diseases.
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PMID:Gene therapy approaches for inherited and acquired lung diseases. 853 80

A high prevalence of pleural plaques (41.5%, 148/357) was found during a mass screening for lung cancer in Matsubase town in 1988. The inhabitants of this town were carefully studied each year from 1988 to 1993. The vast majority (81.2%) of inhabitants over the age of 20 years underwent chest roentgenography at least once during this period. Pleural plaques were detected by CT in 938 subjects, which is 17.3% of those studied and 4.1% of the total population. A total of 89 had an occupational history of asbestos exposure, 64 (71.9%) of whom had pleural plaques. However, these subjects with occupational exposure accounted for only 6.8% of the 938 subjects, and therefore most of the pleural plaques seemed to have been caused by general environmental exposure. The incidence of plaques was greater in older subjects: among those in the seventh decade of life it was more than eight times higher than among those in the fourth decade of life. Anthophyllite was detected in the main asbestos mill. The concentrations of asbestos fibers in the air and water near the old asbestos mills and factories were not high. The death rates and the adjusted mortality rates due to lung cancer in Matsubase were lower than in surrounding towns and lower than in Kumamoto prefecture as a whole. These results indicate that there is now no environmental contamination by asbestos fibers in Matsubase town. No cases of malignant mesothelioma have been confirmed in this town during the past 17 years.
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PMID:[Epidemiologic survey of pleural plaques among inhabitants of Matsubase exposed to asbestos]. 869 57

Fifty-seven cases of malignant mesothelioma were analyzed for nuclear diameter, DNA content and ploidy-related parameters, using Feulgen stained paraffin sections with a digital imaging analysis system. Thirty cases had a mean nuclear diameter > 7 microns and 31 cases were classified as near-diploid. A statistically significant correlation between survival and the mean nuclear diameter (P = 0.0006) and between survival and DNA index (P = 0.007) was obtained. For other DNA content parameters (proliferation index, 5c exceeding rate), only one of the two statistical tests showed a significant correlation with survival while the other test was of borderline significance. In this malignant mesothelioma population, the prognosis for patients with the epithelial type was better than for those with sarcomatous tumours (P = 0.01). In this population of patients, about half of the malignant mesotheliomas were aneuploid. The mean nuclear diameter, DNA index analysis and proliferation index analysis of the tumour cells on Feulgen stained paraffin sections can be used as independent prognostic parameters.
Lung Cancer 1996 Jun
PMID:Evaluation and prognostic value of DNA content and of morphometric parameters in malignant mesothelioma using digital image analysis. 879 6

Exposure to asbestos, particularly members of the amphibole subgroup (crocidolite, amosite), is associated with the development of malignant mesothelioma and lung cancer. Although management of asbestos in buildings and increased regulation of asbestos in workplace settings are viable approaches to the prevention of disease, the prognosis of asbestos-associated tumors is generally dismal. Moreover, although a vast amount of information is available on the responses of cells and tissues to fibers, understanding the pathogenesis of asbestos-associated malignancies is hampered by the complexity of and differences between various fiber types. Multiple interactions between components of cigarette smoke and asbestos may be important in the development of lung cancer. In this article, the general properties of asbestos fibers will be discussed with an emphasis on chemical and physical features implicated in tumorigenesis. We will then provide a brief overview of the clinical features and treatment of cancers associated with exposure to asbestos. Finally, we will review recent experimental data providing some insight into the cellular and molecular mechanisms of carcinogenesis by asbestos.
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PMID:Mechanisms of carcinogenesis and clinical features of asbestos-associated cancers. 881 62

This paper reviews the available literature regarding the work environment in pulp and paper mills and the risk for malignant diseases. An increased risk for lung cancer among pulp and paper mill workers has been reported. Most studies are inconclusive with regard to considerations of etiologic agents. However, maintenance workers seem to be at an increased risk for lung cancer, as well as for malignant mesothelioma, indicating that this occupational group was (is) exposed to asbestos. Workers exposed to chlorine compounds also seem to run an increased risk for lung cancer. An increased risk for malignant lymphomas among pulp mill workers is a constant finding. The increased risk is observed both among sulfite and sulfate workers, indicating a common exposure. Such an exposure could be wood dust, terpenes, or preservatives present in the wood. An increased risk for leukemias has been found in many studies carried out on pulp and paper workers, but the studies do not permit any conclusions about etiologic factors. In some studies an increased risk for stomach cancer has been found. However, the socioeconomic status of the workers is strongly related to stomach cancer, and factors, such as dietary habits, have not been taken into account in any of the reviewed studies. Hence, no further conclusions can be drawn regarding etiologic agents.
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PMID:Health effects of working in pulp and paper mills: malignant diseases. 890 14

An update of a cohort study of 4855 employees at a Paulsboro, New Jersey refinery was conducted to further examine mortality patterns. The earlier study investigated refinery workers employed for a minimum of 1 year between 1 January 1946 and 1 January 1979. The vital status of these workers was ascertained through 1979. The update extended enrollment in the study and vital status follow-up for an additional 8 years (1980-1987). As in the previous study, mortality from all causes [standardized mortality ratio (SMR) = 87; 95% confidence interval (95% CI): 83-91] was significantly lower than expected compared with the general population. Total cancer mortality was also lower than expected (SMR = 96; 95% CI: 86-106). A borderline significant mortality increase in prostatic cancer was found (SMR = 144; 95% CI: 106-190). This increase was similar to the nonsignificant increase reported in the original study (SMR = 135; 95% CI: 90-196). The excess was of comparable magnitude among white males and nonwhite males, although it was not significant for the latter. Detailed analysis indicated that the prostatic cancer was not likely to be related to employment at the refinery. Mortality from lymphatic and hematopoietic cancers was similar to the expected mortality. Mortality from overall leukemia was as expected and detailed analyses by specific cell type showed no increase. An increase in mortality occurred from non-Hodgkin's lymphoma among male workers (SMR = 132; 95% CI: 74-217). The increase was not statistically significant and unlikely to be associated with refinery employment. Mortality from multiple myeloma among male employees was lower than expected (SMR = 74; 95% CI: 20-190). Mortality from asbestos-related diseases (pulmonary fibrosis, lung cancer, malignant mesothelioma) was also lower than expected among male workers. No cause-specific mortality was found to be associated with duration of employment at the refinery, including several causes which have been reported to be elevated in previous studies. The findings of this updated study indicate, as in the previous report, the generally favorable mortality experience of Paulsboro refinery workers.
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PMID:An updated cohort mortality study of workers at a northeastern United States petroleum refinery. 883 92

Thirty-one consecutive patients with histologically proven and symptomatic malignant mesothelioma were treated with two dose levels of ifosfamide. The first group of 15 patients were given 2.3 g/m2/day for 5 days (group A) and the following 16 patients were treated with 1.2 g/m2/day for 5 days of ifosfamide (group B). Treatment cycles were repeated every 3 weeks. While the partial response rate (PR) in group A was 38.5%, it was only 6.25% in group B (P > 0.05). The 95% confidence interval for the difference in PR rates was 3.3-61.2% > The overall survival (OAS) of groups A and B were similar (8 months and 9 months, respectively). Higher Grade 3-4 myelotoxicity was observed in group A when compared to group B (30.8% vs. 18.7%; P > 0.05). In conclusion, a favourable response rate could be achieved in malignant mesothelioma with high dose ifosfamide at the cost of increased toxicity.
Lung Cancer 1996 Sep
PMID:Two dose levels of ifosfamide in malignant mesothelioma. 901 90

This study evaluated the mortality of 27,362 members of the U.S. Carpenters' Union who died in 1987-1990. Age-adjusted proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed using the U.S. age-, gender-, and race-specific proportional mortality for the years of the study. For white male carpenters who were last employed while in construction industry locals, raised mortality was observed for lung cancer (PCMR = 107, CI = 103, 111), bone cancer (PMR = 181, CI = 107, 286), asbestosis (PMR = 283, CI = 158, 457), emphysema (PMR = 115, CI = 102, 130), transportation injuries (PMR = 121, CI = 109, 135), and falls (PMR = 122, CI = 104, 142). For white male carpenters who were last employed while in industrial wood products locals, significantly raised mortality occurred for stomach cancer (PMR = 187, CI = 136, 250), male breast cancer (PCMR = 469, CI = 128, 720), and transportation injuries (PMR = 136, CI = 110, 173). Excess breast cancer was associated with last employment inn wood machining trades. Nasal cancer mortality was not elevated. A total of 121 mesotheliomas were observed. Contributing cause of death analyses revealed raised mortality for these and additional causes; 4,594 (18%) death certificates mentioned occupational and other lung disease as a contributing factor, resulting in significantly elevated mortality. These data show that construction carpenters have moderately elevated mortality for the diseases caused by asbestos (lung cancer and malignant mesothelioma) and from traumatic injuries. The finding of elevated mortality for stomach, bone, and breast cancer was unexpected and requires further evaluation of possible occupational factors. This study confirms that construction carpentry is an extremely hazardous trade. The data suggest that additional preventive action guarding against asbestos exposure and occupational injury is urgently needed in this occupation.
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PMID:Mortality of Carpenters' Union members employed in the U.S. construction or wood products industries, 1987-1990. 891 14

In 169 patients with lung cancer the usefulness of physical examination and Daniel's biopsy in detection of metastases to supraclavicular and scalene lymph nodes were evaluated. In 35 patients with palpable lymph nodes and in 25 patients with nonpalpable lymph nodes metastases were confirmed by histological examination. The sensitivity, the specificity and the likelihood ratio of physical examination in detection lymph nodes metastases were respectively: 58%, 86% and 4.1. In 6 patients (5%) among 119 with nonpalpable lymph nodes the positive Daniel's biopsy was the diagnostic procedure. In 5 patients with non-small carcinoma and in 3 patients with malignant mesothelioma positive results of Daniel's biopsy enabled a change of cancer staging and giving up the eventual surgical operation.
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PMID:[Evaluation of the usefulness of palpation and Daniel's biopsy for detection of metastasis to supraclavicular and scalene lymph nodes in patients with lung neoplasms]. 898 44


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