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

The usefulness of saline-irrigated bile for the intraoperative cytologic diagnosis of tumors and tumorlike lesions of the gallbladder.

Intraoperative cytology was performed for 48 patients with polypoid lesions (36 benign and 12 malignant) of the gallbladder. The cytologic samples consisted of pure bile from 48 patients and diluted bile collected by saline irrigation from 29 patients. Pure bile gave 32 correct diagnoses (67%) and 14 diagnoses of inadequate material (29%), which contained few nondegenerated cells and made microscopic diagnosis unreliable. Inadequate material was frequently obtained in cases of cholesterol polyp (45%), tubular or papillary adenomatous carcinoma (50%) and polypoid carcinoma (17%), but not in cases of inflammatory polyp (0%). On the other hand, cytologic study of bile samples obtained by saline irrigation showed no inadequate material and only one false negative, from a case in which the cancerous focus was mostly covered with nonneoplastic epithelium. These results imply that saline irrigation succeeded in collecting many nondegenerated cells newly exfoliated from the wall of lesions and the technique is useful in the intraoperative cytologic study of polypoid gallbladder lesions.

Adenoma↗

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↗