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

Copper, zinc, magnesium, calcium and iron were measured in serum and lung tissue - tumor mass and histologically nonneoplastic tissue - from lung cancer patients and compared with serum concentrations in healthy subjects and control lung tissue obtained from patients with nonmalignant lung disease. Lung cancer patients showed a significant increase in serum Cu and Cu/Zn ratio levels and decrease in serum Zn and Fe concentrations. These findings were correlated with TNM stage of the disease, but not with histologic type of tumor. Malignant lung tissue showed a higher level of Cu, Ca, Mg, and Cu/Zn ratio and lower Zn level than that found in control samples, as well as an increase in Cu, Mg and Cu/Zn ratio concentrations with regard to histologically nonneoplastic tissue samples from the same patient. Tissue concentration of trace metals was not significantly influenced either by histologic type of tumor or clinical TNM stage. Significant correlation coefficients between serum and tissue trace metal levels were not found.
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PMID:Serum and tissue trace metal levels in lung cancer. 274 65

To more clearly characterize the role of computed tomography in staging the mediastinal lymph nodes of patients with lung cancer, we analyzed computed tomographic and surgical findings in the chest in 345 consecutive patients with lung cancer who underwent operative staging. Patients were grouped according to the TNM staging system of the American Joint Commission, central or peripheral location of the primary tumor, lobar location of the tumor, and maximum tumor diameter as determined by computed tomography or gross pathology. One third of patients with abnormal findings on the computed tomographic scan did not have mediastinal lymph node metastases. Mediastinal metastases occurred frequently in patients with central cancers (38%). The predictive value of a negative scan in all patients was high (greater than or equal to 90%) except for patients with central T3 lesions (72%), left upper lobe lesions (83%), and central adenocarcinomas (75%). However, only the differences between central T3 and central T2 or T1 lesions, and between central adenocarcinomas and central squamous cell carcinomas, were unlikely to be due to chance alone (p less than 0.05). None of the lobar differences were statistically significant. The frequency of mediastinal metastases in patients with peripheral lesions was 15% (28 of 192 patients); computed tomography correctly identified enlarged mediastinal lymph nodes in all but seven patients. However, there were no true-positive computed tomographic scans in 59 patients with peripheral lesions 2 cm in diameter or smaller; accordingly, we suggest that computed tomography is not indicated for the sole purpose of mediastinal staging in this group. Ninety-four percent of patients in this series undergoing thoracotomy with a curative intent had a curative resection. Only 4% had unresectable lesions; palliative resections were done in 2%.
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PMID:Mediastinal lymph node evaluation by computed tomography in lung cancer. An analysis of 345 patients grouped by TNM staging, tumor size, and tumor location. 282 7

From this and other studies, it is clear that the determination of tumor cell type is dependent on cellular and architectural patterns which are fraught with considerable interobserver and even intraobserver variations. Even though determination of cell type is semiobjective at best, previous reports have sought to determine prognosis solely on the basis of cell type or subtype while other studies have made attempts to define the prognosis of the disease based on even less precise terms. In seeking an answer to the question of which is more important for prognosis of lung cancer, cell type or TNM stage, the findings reported herein support the hypothesis that the TNM stage is the single most important factor for survival. This conclusion is substantiated by the following observations: 1. When cell type is stratified by stage, no significant differences can be determined in survival according to tumor cell type. 2. There is a minor difference (not statistically significant) in survival for tumor cell type when considering resected stage I tumors (67 of 99) in terms of adenocarcinomas which had a survival of 38 percent at 5 years versus squamous cell carcinomas which had a survival of 23 percent at 5 years. The numbers of cases in this study were not sufficiently large to comment on the possible difference between surgically resected large cell and small cell carcinomas. 3. TNM staging is a highly significant predictor in the survival of patients with lung cancer. The significance for survival by stage remains even if the data are stratified by the cell type diagnosis. These conclusions apply to the total group of 124 patients, and also to the subgroup of 99 surgically resected patients. Many reports have attempted to determine survival of carcinoma of the lung in terms of cell type without regard to its stage. Consequently, comparison of data from various institutions is difficult. We believe TNM staging of the disease not only allows reasonable comparison of data obtained from different institutions, but also, affords a useful and accurate means of assessing the extent of the disease and its prognosis.
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PMID:Tumor cell type versus staging in the prognosis of carcinoma of the lung. 282 2

Lung cancer stands as the most important malignant neoplasm in the United States because of its high prevalence, increasing incidence, high rate of mortality, and great potential for prevention through the control of cigarette smoking. The World Health Organization (WHO) classification of lung cancer identifies four major types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and small cell carcinoma. These tumors are commonly divided into two groups based on differences in their biology and treatment: small cell (SCLC) and non-small cell carcinomas (NSCLC). This review analyzes NSCLC with a strong emphasis on the practical aspects of treatment. We give recommendations about smoking cessation and early diagnosis through screening of high-risk individuals. We review contemporary diagnostic and staging techniques in the context of the new international TNM system of staging. Subsequent discussions of treatment are based on this new staging system. We stress the pivotal role of surgery for the management of local disease, and in addition present the potential contributions of newer radiation therapy techniques. We examine chemotherapy in detail, including a review of the comparative activity of the available cytotoxic agents against NSCLC, the relative contribution of combination chemotherapy, and the role of surgical adjuvant treatment with either chemotherapy or immunotherapy. We advise that patients with NSCLC be treated under the aegis of modern clinical trials of new therapy whenever possible. When this is not possible, we recommend an individualized approach based on such factors as the patient's age, general state of health, cardiopulmonary status, psychosocial status, and personal system of values.
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PMID:Non-small cell lung cancer. 283 55

Seventy-seven prognostic factors influencing survival time in patients with unresectable lung cancer treated from 1964 to 1983 at Aichi Cancer Center Hospital were analyzed using univariate analysis by log rank test and multivariate analysis by proportional hazard model of Cox. Statistical significance using univariate analysis was identified in 19 factors in small cell lung cancer patients, and in 40 factors in non-small cell lung cancer patients. The string prognostic factors determined by multivariate analysis were, in the order of importance, serum LDH level, chest pain, peripheral lymphocyte count, bone marrow metastasis, brain metastasis, age, and performance status in small cell lung cancer patients. These 7 factors had a p value of less than 0.01. On the other hand, they were the number of metastatic sites, performance status, serum albumin level, serum LDH level, sex, BUN level, N category according to TNM staging system in non-small cell lung cancer patients, with a p value of less than 0.001. The most important prognostic factors were serum LDH level in small cell lung cancer, and the number of metastatic sites and performance status in non-small cell lung cancer. A metastasis to bone marrow or brain was a more important prognostic factor than overall M category in small cell lung cancer patients, and the number of metastatic sites rather than clinical stage classification or TNM staging system in non-small cell lung cancer patients with respect to staging system. Accurate evaluation of the treatment results in unresectable lung cancer patients must take the strong prognostic factors into account.
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PMID:[Prognostic factors in unresectable lung cancer]. 284 34

A new TNM staging system was proposed and the previous system has been revised recently. To evaluate the new TNM staging system for lung cancer, we analyzed records of 1737 patients who underwent pulmonary resection at the National Cancer Center Hospital, Tokyo. With regard to clinical stages, three patients had occult carcinoma; 821 patients had stage I disease; 248 patients, stage II; 465 patients, stage IIIA; 82 patients, stage IIIB; and 118 patients, stage IV. The 5-year survival rates for the respective stages were 50.1% for stage I, 31.2% for stage II, 20.2% for stage IIIA, 5.1% for stage IIIB, and 7.9% for stage IV. In terms of postoperative stages, four patients were classified in stage 0, 536 in stage I, 221 in stage II, 559 in stage IIIA, 159 in stage IIIB, and 258 in stage IV. The 5-year survival rates were as follows: stage I, 65.0%; stage II, 42.9%; stage IIIA, 22.2%; stage IIIB, 5.6%; and stage IV, 7.5%. In both the clinical stage and the postoperative stage, there were significant prognostic differences between stage I and stage II, stage II and stage IIIA, and stage IIIA and stage IIIB, but there was no significant difference in 5-year survival rates between stage IIIB and stage IV.
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PMID:Prognosis and survival in resected lung carcinoma based on the new international staging system. 284 49

The usefulness of tumour ploidy as a prognostic determinant in lung cancer was evaluated in a group of 100 surgically treated patients. Archival paraffin sections of the tumours were analysed by flow cytometry. 45% of tumours were aneuploid and 55% were diploid. Overall, patients with aneuploid tumours had significantly shorter survival (p less than 0.0005) than those with diploid tumours. The subset of patients without nodal involvement at operation and with diploid tumours had a particularly long survival rate. Of these 45 patients 41 (91%) were alive at 2 years compared with only 16 (55%) of the 29 with aneuploid tumours (p less than 0.05). A group with such a favourable prognosis has not previously been recognised except when staging is based on total mediastinal nodal clearance. Ploidy was found to be independent of age, sex, type of operation, site of primary tumour, histology, or TNM category. On Cox multivariate analysis ploidy was the most important and independent prognostic determinant. Therefore, in patients with operable lung cancer, ploidy should be taken into account in planning of management, in estimation of prognosis, and in stratification for treatment trials.
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PMID:Ploidy as a prognostic determinant in surgically treated lung cancer. 288 32

Surface phenotypes of peripheral blood lymphocytes of lung cancer patients and those of two control groups were assessed by means of indirect immunofluorescence with monoclonal antibodies, prior and after 10 day pokeweed mitogen (PWM) in vitro stimulation. There was no significant alteration in pan T cell per cent values prior and after mitogen stimulation in all groups tested. CD4+ cells in lung cancer group were however significantly decreased as compared to blood donor group (37.3% vs 44.9%, p less than 0.05). This decline was even more pronounced in III/IVo stage of tumour progression according to TNM classification (36.8%, p less than 0.05). These changes, however were not cancer specific, because similar decrease of CD4+ cells was seen in a group of patients with nonneoplastic lung conditions (35.7%, p less than 0.01). Following 10 day PWM culture per cent values of CD4+ cells did not change significantly. The assessment of CD8+ lymphocytes has shown marked differences in two subgroups of lung cancer, namely in II (17.4%) and III/IV (26.2%) of tumour progression (p less than 0.05), which returned to normal values following PWM culture. CD4/CD8 ratio was distinctly depressed in cancer patients in relation to donors. The evaluation of surface markers of B lymphocytes activated cells and monocytes did not show significant alterations in all groups examined. Per cent of HNK1+ cells was heightened in cancer group, especially in III/IV stage of tumour progression in relation to donors (21.7% and 22.8% vs 17.3%, p less than 0.05 respectively). PWM stimulation resulted in marked fall of HNK1+ cells to values corresponding to those in donor group. This study indicates some alterations in per cent values of blood lymphocytes subpopulations belonging mainly to T cell lineage in lung cancer patients linked to tumour staging which only partially return to normal following PWM stimulation.
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PMID:Assessment of phenotype of blood lymphocyte subsets prior and after PWM stimulation in patients with lung carcinoma. 292 22

Satellite nodules are considered to be predictive of poor prognosis in breast cancer and in melanoma. In lung cancer, there is no information as to their definition, prevalence, or implication as a prognosis factor of survival after resection. Over the past 18 years (1969 to 1987), 84 patients underwent pulmonary resection for primary lung cancer accompanied by satellite nodules. These nodules were defined as well-circumscribed accessory carcinoma foci clearly separated from the main tumor but with identical histologic characteristics. All were smaller than the primary carcinoma and most were located within the same lobe. Survival rates of patients with satellite nodules were compared to those of 1021 patients without satellite nodules who underwent resection during the same time interval. The 1-, 3-, and 5-year survival rates for all patients classified as having no satellite nodules were 78%, 54%, and 44%, respectively, and the median survival for the entire group was 30 months. In patients with satellite nodules, these survival rates were 60.9%, 32.7%, and 21.6%, respectively, with a median survival of 15 months. The deleterious effect of satellite nodules was more significant in patients with stage I disease (p = 0.0008) than in patients with stage II (p = 0.0354) or stage III (p = 0.0145) disease. Survival data obtained by comparison of satellite nodule status and histologic characteristics shows that 5-year survival figures are better for patients with no satellite nodules in both the squamous and the nonsquamous groups. This study demonstrates that satellite nodules associated with lung cancer are indicative of locally advanced and/or premetastatic disease. These patients should be included in the stage group IIIa of the TNM stage grouping classification.
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PMID:Carcinoma of the lung. Evaluation of satellite nodules as a factor influencing prognosis after resection. 292 56

The effect of regional lymph node cells on the cytotoxicity of killer lymphocytes against autologous tumor cells was investigated in 42 patients with primary lung cancer by a 4-h 51Cr-release assay. The cytotoxicities of killer lymphocytes against autologous tumor cells were either significantly inhibited, enhanced, or remained unchanged by the addition of regional lymph node cells in 27, 4 and 11 cases, respectively. Correlation between the inhibitory activity (IA) and the clinical features was studied in terms of age, tumor histologic type, post-surgical TNM stage and chemotherapy. Patients less than 50 years old, those with adenocarcinoma, and those in the N2 stage showed significant inhibition of cytotoxicity, indicating suppressor cell predominance in these cases. Although no significant difference of IA was observed between the stages of lung cancer, T-factor groups, and groups with or without chemotherapy, considerably greater deviation of IA was observed in the chemotherapy group, indicating the possible influence of the drug treatment on the cytotoxicity of lymphocytes.
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PMID:[Clinical features and inhibitory activity of regional lymph node cells on the cytotoxicity of autologous killer cells in patients with primary lung cancer]. 295 5


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