Biomedical subjects

O Doi

Publications and source records attributed to O Doi.

188 records · Page 11Linked to original sources

PubMedDate not supplied

Pleural lavage cytology immediately after thoracotomy and before closure of the thoracic cavity for lung cancer without pleural effusion and dissemination: clinicopathologic and prognostic analysis.

BACKGROUND: The significance of intraoperative pleural lavage cytology (PLC) in lung cancer patients without malignant effusion remains undetermined in terms of staging, prognosis, and local management. METHODS: PLC was performed both after thoractomy and before closure of the thoracic cavity in 325 patients with lung cancer without malignant pleurisy. RESULTS: According to the PLC results (positive [+] or negative [-] after thoracotomy/before closure), the patients were classified as follows: group A (-/-), 262 patients; group B (+/-), 19; group C (-/+), 22; and group D (+/+), 22. In comparison with group A, group C showed more advanced stage with aggressive nodal involvement, and group D showed more advanced lung cancer related to pleural and nodal involvement, whereas group B showed characteristics similar to those of group A. The rate of pleural recurrence in group D was the highest (26%). In particular, pleural recurrence was seen in the patients with a relatively large number of adenocarcinoma cells in PLC after thoractomy. The patients in groups C and D, especially those with adenocarcinoma, showed poorer prognosis, but in a multivariate analysis, PLC status was not an independent prognostic factor. CONCLUSIONS: PLC status after thoractomy provides useful information in the detection of high-risk subgroup for pleural recurrence. Although PLC status is closely associated with survival, its prognostic value is not independent.

Adult↗

PubMedDate not supplied

Retinoblastoma protein expression in lung cancer: an immunohistochemical analysis.

Several analyses of the retinoblastoma (RB) gene in lung cancer at the DNA, mRNA and protein levels have recently been reported. In particular, small cell lung carcinoma shows a high incidence of RB gene abnormalities, suggesting that alterations of this gene may participate in tumor development. In the present study, we used an immunohistochemical technique with a monoclonal antibody raised against RB protein (PMG3-245) to detect its expression in representative paraffin sections of tissues obtained from 108 patients with various types of lung cancer treated by surgical resection of the primary tumor. While deletion of RB protein expression was observed in 7 (88%) of small cell lung carcinomas, only 17 (17%) of 100 non-small cell lung carcinomas showed decreased RB protein levels and 6 (6%) showed no RB protein expression. This low incidence of RB protein expression abnormalities in non-small cell lung carcinomas was significant (p < 0.0001). Thus, in contrast to small cell lung carcinoma, abnormalities in RB protein expression may be minor events in non-small cell lung carcinoma. In addition, no significant correlation was found between abnormalities in RB protein expression and clinical factors such as stage, tumor size, and nodal involvement in non-small cell lung carcinoma. However, abnormalities in RB protein expression in squamous cell carcinoma were observed only in the less differentiated types (p = 0.144), and there was a weak but not statistically significant association in non-small cell lung carcinoma between RB protein status and prognosis (p = 0.09). Therefore, in non-small cell lung carcinoma, although abnormalities in RB protein appear not to be closely associated with tumor development, further studies on a larger scale and with a longer-term follow-up are required to determine the clinicopathological significance of RB gene abnormalities, in particular the relationship between abnormalities of RB protein and differentiation or prognosis.

Adult↗

PubMedDate not supplied

Effectiveness of intrathoracic chemothermotherapy for malignant pleurisy due to Ewing's sarcoma: a case report.

This paper describes a case of malignant pleurisy which showed evidence of the effectiveness of a new mode of cancer treatment, intrathoracic chemothermotherapy (ICT). ICT consisted of a bolus intrathoracic injection of 50 mg cis-diamminedichloroplatinum (CDDP) and local heating using 8 MHz radiofrequency waves for 60 min. A patient with multiple lung metastases and malignant pleurisy on both sides due to Ewing's sarcoma was treated on the right side with ICT, along with concomitant systemic administration of 50 mg CDDP. Intrathoracic temperatures were monitored by insertion of thermocouple temperature sensors, and temperatures of 43 degrees C or over were successfully maintained for about 40 min during each of three treatments. Although the patient died 3 months later of advanced metastases in the left lung and malignant pleurisy on the left side, lung metastases in the right lung were stable on radiographs, and autopsy results showed no cancerous lesions in the right thoracic cavity, which had been treated with ICT. Since no effective response had been obtained clinically or histologically before starting ICT, despite frequent administration of anti-cancer drugs, we conclude that heat acted synergistically with CDDP on drug-resistant cells in this case.

Adult↗

PubMedDate not supplied

Unusual extension of lung cancer into the left atrium via the pulmonary vein.

Four operative cases of lung cancer with intra-atrial extension via the pulmonary vein were reviewed. Three of them had circulatory as well as respiratory symptoms, and their performance status (PS) was extremely poor. In two cases, after assessment of the cardiac involvement using two-dimensional echocardiography and/or CT-scan, we successfully removed the tumor en bloc through combined left atrial resection and radical left pneumonectomy with cardiopulmonary bypass. In both cases, the postoperative course was uneventful, and PS was improved. However, seven months later one patient died of widespread metastases, while the other is alive but has recurrence. The other two patients underwent ordinary lobectomy because there were no abnormal findings in the hilar examinations. However, the lumens of the resected pulmonary veins were filled with tumor tissue. One patient developed a massive embolism, never regained consciousness, and died on the second postoperative day. The last case was discharged without trouble, although the intra-atrial portion of the tumor dislodged intraoperatively into the circulation. As a result, he developed multiple brain metastases four months after the operation. There were no clear patterns in terms of the histological type or tumor location in these cases. On the other hand, all the tumors showed rapid growth and comprised a large mass in the lung parenchyma. Especially the cardiac and intravascular portions of each tumor were less differentiated and more necrotic than the primary focus in the lung. We conclude that radical surgery using a cardiopulmonary bypass for lung cancer patients with such intracardiac involvement is effective for improvement of PS and reduces the risk of sudden death due to cardiac failure or tumor emboli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMedDate not supplied

Reconstruction of the chest wall after full thickness resection: a comparison between myocutaneous flap and acrylic resin plate as reconstructive techniques.

Thirty-three patients with chest wall malignancies underwent full thickness resection of the chest wall and immediate reconstruction of the defects with either synthetic materials (acrylic resin plate, 16 patients) or with myocutaneous flaps (rectus abdominis flaps, 17 patients). Although the acrylic resin plate proved to be excellent for maintaining stability of the chest wall, five patients suffered from local skin necrosis, requiring skin grafting, and four suffered from persistent foreign body reactions, necessitating ultimate removal of the plate. The patients receiving myocutaneous flap repair had excellent wound healing, acceptable rigidity of their chest wall, and no foreign body reactions throughout the follow-up period. The 50% post-operative survival time for the entire series was 29 months, suggesting that the procedure in an effective treatment modality for breast cancer involving the chest wall. Reconstruction with a myocutaneous flap is indicated as long as the chest wall defect is not too extensive.

Acrylic Resins↗

PubMedDate not supplied

Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy.

Although adrenal metastases from lung cancer are frequently detected during the late clinical stage or at autopsy, they are rarely surgically treated following pulmonary resection for lung cancer. We detected adrenal lesions as initial clinical recurrence in 9 (1%) of 904 patients who underwent pulmonary resection for lung cancer at our institute between 1980 and 1992. Adrenalectomy was performed in five who had developed unilateral adrenal metastasis. One underwent simultaneous operation for primary and metastatic lesions, and 4 underwent adrenal surgery following pulmonary resection. The adrenal tumor was removed via laparotomy in three patients, and via posterolateral non laparotomic approach in two. Co-metastatic lesions which were detected incidentally at operation included intestinal metastasis in two patients and regional lymph node metastasis in two; these were simultaneously resected. Following adrenalectomy, all these patients were treated with adjuvant chemotherapy or radiotherapy. Two patients have remained free of relapse for 40 and 26 months, respectively, after adrenal surgery, while three died of other distant metastases more than 9 months after adrenalectomy. In contrast, the four patients who received chemotherapy or radiation therapy died less than 6 months after palliative therapy. Thus, we consider that surgical treatment for adrenal metastases following pulmonary resection for lung cancer is effective in selected cases. The indications for adrenalectomy are presented in comparison with those for palliative therapy, and several difficulties in the surgical management of adrenal metastases are discussed.

Adenocarcinoma↗

PubMedDate not supplied

High prevalence of bcl-2 oncoprotein expression in small cell lung cancer.

Bcl-2 oncoprotein, a member of a new category of oncogenes associated with the regulation of programmed cell death (apoptosis), has been considered to be involved in biological processes such as tumorigenesis and tumor development. To determine the role of bcl-2 oncoprotein in lung cancer, we preliminarily examined the expression of this protein in various histological types. Immunohistochemical staining using monoclonal bcl-2 oncoprotein antibody was performed in surgically resected frozen specimens. Bcl-2 staining was seen in nine of 13 small cell lung cancers (69%), while only 18 out of 69 non-small cell lung cancers (26%) expressed bcl-2 oncoprotein, showing a significantly increased incidence of bcl-2 oncoprotein expression in the former histological type. Considering the greater aggressiveness of small cell lung cancer compared to non-small cell lung cancer, the possibility exists that the high prevalence of bcl-2 oncoprotein expression in small cell lung cancer is closely associated with tumorigenesis and tumor development.

Antibodies, Monoclonal↗

PubMedDate not supplied

Estimation of serum level of pS2 protein in patients with lung adenocarcinoma.

We measured pS2 protein in the serum of patients with adenocarcinoma and non-adenocarcinoma types of lung cancer, non-cancerous lung lesions, and the control sera. Although the serum pS2 protein level in patients with lung adenocarcinoma was significantly higher than that in patients with other diseases, as well in control samples, it had little clinical value as a screening tumor marker because the levels in control samples showed a wide range of variation. However, analysis according to the histological subtype of lung adenocarcinoma, ordinary and bronchioloalveolar, revealed a high serum level of pS2 protein in several patients with advanced stage disease in the former, and mucus-producing goblet cell subtypes in the latter, which showed strong pS2 protein expression in tissues, whose serum levels diminished to the control level after resection. Thus, the serum levels of pS2 protein may be a useful marker of tumor burden in selected patients with lung adenocarcinoma.

Adenocarcinoma↗