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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The human proto-oncogene c-erbB-2/neu gene, which is structurally similar to the epidermal growth factor receptor gene, encodes a transmembrane protein of 185 kDa (p185) with tyrosine kinase activity. Paraffin-embedded sections from 42 cases with lung carcinoma were stained immunohistochemically using the Avidin-Biotin Horseradish Peroxidase method to search for c-erbB-2 reaction. Results were evaluated semiquantitatively. The c-erbB-2 expression from each case was compared according to tumor type, grade, mitotic activity, clinical stage and lymph node metastasis. Results were statistically analyzed by using chi-square tests. We were unable to detect a significant relation between c-erbB-2 expression and histological grade, nodal metastasis, number of mitotic figures or tumor type, but we did observe a statistically significant correlation between clinical stage and increased c-erbB-2 expression (p < 0.05). In our opinion, c-erbB-2 expression in human lung carcinomas may be useful for determining clinical outcome.
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PMID:Prognostic factors and c-erbB-2 expression in non-small-cell lung carcinoma (c-erbB-2 in non-small cell lung carcinoma). 1184 6

Malignant esophageal stricture secondary to invasion from a tumor arising in a contiguous organ is a relatively rare finding; even more uncommon is a direct metastasis to the esophagus from a distant primary carcinoma. We present six cases, the largest current series, of esophageal strictures secondary to metastases from a separate primary cancer. We reviewed the records of 20 patients treated at Virginia Mason Medical Center between 1972 and 2000 with a diagnosis of malignant esophageal stricture secondary to an extraesophageal primary carcinoma. Patients whose stricture appeared to be secondary to esophageal invasion or compression from a contiguous tumor or lymph nodes were excluded. The remaining six patients who had metastases to the esophagus itself were reviewed with respect to the nature of the primary tumor, presentation, radiologic and endoscopic findings, and treatment. Among the 20 patients reviewed, 14 were excluded owing to either contiguous involvement from a nearby primary malignancy, regional nodal involvement, or complications of external beam radiation treatment. Six patients were considered to have direct metastasis to the esophagus from distant primary malignancies. The mean age of these patients was 72 years (range 68-74). Two of the primary lesions were lung carcinoma, while four primaries were breast cancers. The average time interval from the diagnosis of a primary tumor to esophageal involvement was 7 years in patients with breast cancer and 5 months in patients with lung cancer. Three patients were palliated with endoscopic dilation and stent placement. The other three patients have died secondary to upper gastrointestinal bleeding. Metastatic cancer to the esophagus is a rare occurrence. The process is usually submucosal and can be difficult to diagnose. The diagnosis should be considered when a patient presents with malignant dysphagia and has a background of distant carcinoma.
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PMID:Direct esophageal metastasis from a distant primary tumor is a submucosal process: a review of six cases. 1186 31

It has been widely demonstrated that neo-angiogenesis and its mediators (i.e. vascular endothelial growth factor), represent useful indicators of poor prognosis in non small cell lung carcinoma. In order to verify whether neovascularization and vascular endothelial growth factor may be considered useful markers of clinical outcome also in the small cell lung cancer subgroup, we retrospectively investigated a series of 75 patients with small cell lung carcinoma treated by surgery between 1980 and 1990. Immunohistochemically-detected microvessels and vascular endothelial growth factor expressing cells were significantly associated with poor prognosis, as well as with nodal status and pathological stage. In fact, patients whose tumours had vascular count and vascular endothelial growth factor expression higher than median value of the entire series (59 vessels per 0.74 mm(2) and 50% of positive cells, respectively), showed a shorter overall and disease-free survival (P=0.001, P=0.001; P=0.008, P=0.03). Moreover, the presence of hilar and/or mediastinal nodal metastasis and advanced stage significantly affected overall and disease-free interval (P=0.00009, P=0.00001; P=0.0001, P=0.00001). At multivariate analysis, only vascular endothelial growth factor expression retained its influence on overall survival (P=0.001), suggesting that angiogenic phenomenon may have an important role in the clinical behaviour of this lung cancer subgroup.
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PMID:A high vascular count and overexpression of vascular endothelial growth factor are associated with unfavourable prognosis in operated small cell lung carcinoma. 1187 May 37

The aim of this report was to evaluate the effectiveness of video-assisted thoracoscopic surgery (VATS) in staging, diagnosis, and treatment of lung cancer. Fifty-two patients were scheduled for mediastinal lymph node VATS biopsy at the Oncologic Thoracic Surgery Department of the National Cancer Institute in Milan. Fifty patients underwent lymph nodal thoracoscopic biopsy (96%), whereas for the other 2 patients, histologic diagnosis was done by pleural metastatic nodule thoracoscopic biopsy (4%). We performed 17 lymph nodal biopsies in level 5 (33%), 14 in level 6 (27%), 12 in level 7 (23%), and 7 in level 8 (13%). No postoperative complications were observed, and 19 subjects (36%) underwent open lung resection. The histologic diagnosis was adenocarcinoma in 25 cases (48%), epidermoid carcinoma in 14 (27%), microcytoma in 9 (17%), and giant-cell lung carcinoma in 4 (8%); 10 patients were at stage I (19%), 9 at stage II (17%), 31 at stage III (60%), and 2 at stage IV (4%). The use of VATS allowed diagnosis of the suspected involved mediastinal lymph nodes in lung cancer patients and obviated the need for painful thoracotomy, enabling accurate staging and thus selection of the optimal treatment.
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PMID:Video-assisted thoracoscopic surgery for diagnosis, staging, and management of lung cancer with suspected mediastinal lymphadenopathy. 1194 96

Endoscopic ultrasound (EUS) has become the most accurate imaging modality for locoregional cancer staging of the gastrointestinal (GI) tract. Fine-needle aspiration (FNA) capabilities have added a whole new level of accuracy in nodal staging with reported numbers in the 90% range for luminal and pancreaticobiliary disease. In addition, new non-GI applications are being evaluated like the role of EUS-FNA for non-small cell lung carcinoma and exploration of the posterior mediastinum. Furthermore, the same capabilities that allow for safe tissue sampling are being explored for interventional applications like EUS-guided celiac plexus neurolysis and fine-needle injection. The following review describes the current clinical status of EUS in GI oncology as well as future and novel indications and therapeutic strategies for this technology.
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PMID:Interventional endosonography. 1207 97

Transbronchial needle aspiration has emerged as a key technique for sampling mediastinal adenopathy but variable yields are reported. To determine the number of aspirates needed to optimize yield, we prospectively studied transbronchial needle aspiration and the sequential effect of each successive specimen on diagnostic yield in 79 patients with known or suspected lung carcinoma and mediastinal adenopathy. A total of 451 aspirates were performed in 79 patients (mean, 5.7 aspirates per patient; range, 2-13) with 45 cases (57%) positive for malignancy. A cytologically positive transbronchial needle aspiration occurred with the first aspirate in 42% of patients in whom this procedure established mediastinal nodal involvement. All positive results were achieved with seven or fewer aspirates. Similar yields were obtained for small cell and non-small cell lung cancer after seven aspirates. Rapid on-site specimen cytologic evaluation was used in 55 of 79 cases (70%), with a positive diagnosis obtained in 39 of 55 cases (71%) with on-site evaluation compared with six of 24 cases (25%) performed without on-site evaluation. The data suggest there is a plateau in yield after seven transbronchial needle aspirates, which may be sufficient to obtain an optimal yield in assessing patients with lung cancer and mediastinal adenopathy.
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PMID:Transbronchial needle aspiration in diagnosing and staging lung cancer: how many aspirates are needed? 1215 74

Small cell lung cancer (SCLC) is usually classified into a two-stage system, limited (LD) and extensive disease (ED). However, the criteria for these two categories remain controversial. The widely used Veterans Administration Lung Study Group (VALG) definition of LD includes patients with primary tumor and nodal involvement limited to one hemithorax. In contrast, the International Association for the Study of Lung Cancer (IASLC) recommends that LD should additionally include all patients without distant metastasis. As a consequence, since treatment modalities for LD and ED could be different, individual clinical outcome of SCLC patients may be influenced by the staging system chosen. Among 109 consecutive SCLC patients treated in our clinic between 1989 and 1999 (mean age 68+/-9.1 years, 81% male) 23 patients (21%) could be either classified as LD or ED (LD-ED), depending on the staging system used. The prognosis of this overlapping group (LD-ED: median survival 291 days) was not statistically different from patients with limited disease defined by VALG criteria (LD-VALG: 385 days, log-rank test P = 0.42). On the other hand the survival difference between LD-ED patients and the ED-IASLC population was relevant (ED-IASLC: 208 days, P = 0.05), indicating that LD-ED patients should rather be included in the LD category. This is further supported by the results of a multivariate Cox regression analysis with all clinically relevant data. Only stage as defined by IASLC criteria was an independent prognostic factor in the likelihood-ratio-forward (hazard ratio = 1.94, CI = 1.26-2.99; P = 0.005) and backward model (hazard ratio = 1.76, CI: 1.12-2.76; P = 0.012), confirming the higher discriminatory power of the IASLC definition. In conclusion, the IASLC staging criteria for SCLC patients have a higher prognostic impact and are therefore preferable in clinical practice and future therapeutic trials.
Lung Cancer 2002 Sep
PMID:Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer--what limits limited disease? 1223 95

A 69-year-old male was suspected of having lung cancer by sputum cytology and diagnosed as roentgenographically occult squamous cell carcinoma (ROSCC) at the spur of left B(1+2)/B(3). However, after the first bronchoscopy, no suspicious lesion was detected by any examinations. Therefore, we considered that cancer cells had been removed completely by the initial examination, and the patient was followed up by sputum cytology, chest roentgenogram, and bronchoscopy. Sixteen months later from the initial examination, bronchoscopy was performed for follow-up. The bronchoscopic findings showed the elevation of the surface of left B(1+2) a+b, but the cytologic specimen by brushing toward B(1+2) a+b showed negative findings. However, the lesion had developed to polypoid-shaped tumor and obstructed B(1+2) a+b after the next 6 months. The tumor was diagnosed as squamous cell carcinoma, and hilar and mediastinal nodal involvement was suspected on chest computed tomography. The standard thoracotomy was performed and the pathological results showed positive for nodal involvement on hilus and mediastinum. The tumor is considered to arise from the residual cancer cells of initially detected ROSCC. In conclusion, although some ROSCCs regress by the diagnostic examinations, it is important to detect the recurrence of residual cancer cells as early as possible by intensive follow-up.
Lung Cancer 2002 Oct
PMID:Roentgenographically occult bronchogenic squamous cell carcinoma involving mediastinal lymph nodes after removal of initial lesion by the diagnostic examination. 1236 91

This study was performed to determine the frequency of expression loss of p16 and pRb; their relations with each other, tumour histology, tumour stage, nodal status, and survival in formalin fixed, paraffin embedded tumour tissues of patients with non-small-cell lung carcinoma (NSCLC). P16 and/or pRb expression loss is observed in 72 (75.8%) out of 95 patients, and 70 (73.7%) of them showed inverse correlation (P<0.05). Thirty-six (37.9%) of the p16 positive cases usually showed weak or moderate immunohistochemical staining. Loss of p16 expression was found to be significantly greater in squamous cell carcinoma than in adenocarcinoma cases, whilst no relation was observed with other clinical parameters. Immunohistochemical reactivity for pRb was generally moderate or strong. PRb expression loss was observed in 15.8% of the cases, and no relation was found between pRb loss and age, sex, tumour histology, tumour stage, or nodal status. PRb negative squamous cell carcinoma cases had significantly shorter survival independent of nodal status. These results suggest that disruption of p16/pRb pathway is frequently involved in NSCLC, and pRb expression loss in cases with squamous cell carcinoma may predict clinical outcome.
Lung Cancer 2002 Dec
PMID:Clinical significance of P16INK4A and retinoblastoma proteins in non-small-cell lung carcinoma. 1244 46

The American Joint Committee on Cancer defines stage I non-small cell lung carcinoma (NSCLC) as consisting of patients with a T1 or T2 primary tumor designation and no evidence of hilar or mediastinal nodal disease (N0) or metastatic spread (M0). Medically fit patients in this clinical stage category based on conventional staging techniques should be considered for aggressive local therapy, and curative treatment is possible. Surgical resection is the accepted treatment for patients with this stage grouping, and full lobar or greater (lobectomy, pneumonectomy) rather than sublobar (wedge resection, segmentectomy) resection is strongly suggested. There is insufficient data to suggest that one method of resection (open thoracotomy, minimally invasive techniques) is superior to another. The performance of a systematic sampling or full mediastinal lymph node dissection may improve pathologic staging but is unproven therapeutically. There are no data supporting the routine use of chemotherapy in an adjuvant or neoadjuvant setting; however, recent phase II data suggest that neoadjuvant chemotherapy is feasible and safe, and larger phase III trials are now evaluating this modality. Primary radiation therapy should be considered for inoperable patients. The use of neoadjuvant or adjuvant radiation therapy in patients with stage I NSCLC is of unproven benefit.
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PMID:Treatment of stage I non-small cell lung carcinoma. 1252 78


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