Lung cancer is one of the most common types of cancer. The lungs are a pair of cone-shaped organs situated inside the chest, they bring oxygen into the body and take out waste carbon dioxide. There is a strong link between smoking and lung cancer. There are two main categories of lung cancer; Small Cell Lung Cancer (SCLC) , and Non-Small Cell Lung Cancer (NSCLC). World-wide over 1 million people are diagnosed with lung cancer each year.
GLCC Established in 2001, the GLCC comprises 28 non-government patient organisations from around the world. It aims include increasing awareness and destigmatising the disease amongst patients, the medical community, policy makers, the general public and the media, by delivering highest quality information and programmes through its member groups,
National Cancer Institute PDQ summaries are written and frequently updated by editorial boards of experts Further info. Information about methods of cancer detection including new imaging technologies, tumor markers, and biopsy procedures.
An independently incorporated, international, educational and scientific society, founded in 1905, with a focus on respiratory and critical care medicine. There is a detailed public site with detailed information and also a members area.
Founded in 2002 to increase awareness about lung cancer, support patients living with lung cancer and the individuals who care for them and provide educational resources to lung cancer patients, their family members and health care professional.
LCFA Founded in 2002 LCFA aims to improve the survival rate of lung cancer by raising money from the private sector and channeling those funds to lung cancer researchers, so that researchers find effective ways to predict, detect, and treat lung cancer.
PubMed Central search for free-access publications about Lung Cancer MeSH term: Lung Neoplasms US National Library of Medicine PubMed has over 22 million citations for biomedical literature from MEDLINE, life science journals, and online books. Constantly updated.
National Cancer Institute PDQ summaries are written and frequently updated by editorial boards of experts Further info. Information about methods of cancer detection including new imaging technologies, tumor markers, and biopsy procedures.
ALTG ALTG is a multi-disciplinary organization dedicated to reducing the incidence, morbidity and mortality of lung and other thoracic cancers and improving the quality of life of these patients, carers and families in Australia and New Zealand through the coordination and facilitation of high quality clinical research.
Royal College of Physicians Since 2010 this project joins up healthcare teams including doctors and nurses from different NHS Trusts to share best practice in diagnosing, treating and supporting patients with lung cancer, and to look for the underlying differences in rates of lung cancer survival at different Trusts.
Johns Hopkins Medical Institute The Registry was established at The Johns Hopkins Medical Institutions in September 1993. Over 270 lung cancer families are registered to date. So far, research with these families includes studies of DNA repair capacity and genetic markers and their relationship to environmental factors. Risk Factors and Prevention of Lung Cancer
TAKD is a professional association for lung cancer and tobacco control established in 2003. The society represents multidisciplinary approach in the lung cancer care policy and education. Risk Factors and Prevention of Lung Cancer
This list of publications is regularly updated (Source: PubMed).
Yu H, Jiang L, Sun C, et al. Decreased circulating miR-375: a potential biomarker for patients with non-small-cell lung cancer. Gene. 2014; 534(1):60-5 [PubMed] Related Publications
MicroRNAs (miRNAs) are directly involved in cancer initiation, progression and metastasis. Alterations of miRNAs expression in cancer tissue may be reflected in circulation.We attempted to investigate the expression and clinical significance of plasma miR-20a, miR-31 and miR-375 in patients with non-small cell lung cancer (NSCLC). The plasma levels of miR-20a, miR-31 and miR-375 in 164 NSCLC patients and 164 healthy controls (discovery cohort)were evaluated and compared among various clinicopathological characteristics. The relationship between miRNA expression and clinical outcome of NSCLC patients was examined in an independent cohort (53 cases and 53 controls). The expression level of miR-375 in tissue was also examined. Plasma miR-375 levels in NSCLC patients were significantly decreased in both patient cohorts (P b 0.05). In addition, patients with metastatic NSCLC had lower plasma miR-375 expression than those with non-metastatic NSCLC (P b 0.05). Survival analysis showed that patients with low miR-375 expression had worse overall survival rates than those with high miR-375 expression (hazard ratios (HR)=1.537 (1.046–2.258), P=0.029). This association was independently validated in a separate cohort of 53 NSCLC patients (HR=2.406, 95% CI 1.170–4.945, P=0.017). The expression level of miR-375 was also found to be significantly down-regulated in NSCLC tissues compared with paracancerous tissues (P b 0.001). These findings indicate that miR-375 has an important role in NSCLC initiation and progression, and may be an independent poor prognostic factor in NSCLC patients.
Sachdeva R, Gupta KB, Mathur SK, Sachdeva S Solitary fibrous tumour of lung. Indian J Chest Dis Allied Sci. 2013 Jul-Sep; 55(3):171-3 [PubMed] Related Publications
Fibrous tumours arising entirely within the substance of the lung are rare. We report one such rare case in whom the diagnosis was established after surgical removal.
Voulgaridis A, Apollonatou V, Lykouras D, et al. Pleural mesothelioma in a young male patient. Monaldi Arch Chest Dis. 2013; 79(2):96-9 [PubMed] Related Publications
We present the case of a 33-year-old male patient suffering from lymphocytic pleural effusion, as a result of pleural mesothelioma. Mesothelioma is a malignant tumor of the pleura that is mainly caused by chronic exposure to asbestos fibers and more than 40 years of exposure are needed to develop the disease. Early studies on the relationship of asbestos and mesothelioma were issued in the 1960s. Fibers migrate from the parenchyma of the lung to the visceral pleura. It is widely known that asbestos is an oncogenic factor which can cause damage to DNA. A chest x-ray may reveal pleural effusion with or without pleural thickening, whereas a chest CT may also reveal pleural thickening, uniform and/or lobular. Specific tests, such as immunohistochemical staining, are used in order to help differential diagnosis. Extrapleural pneumonectomy is used as a therapeutic option which involves removal of the lung as well as both the visceral and parietal pleura, the affected part of the pericardium and diaphragm. Surgery should be followed up by radiotherapy and chemotherapy. The surgery may lead to a mean survival rate of approximately 9-21 months. The case presented underlines that in the event of pleural effusion with a lymphocyte type physicians should consider the possibility of a pleural mesothelioma during differential diagnosis, even in relatively young patients.
Pasqua F, Geraneo K, Nardi I, et al. Pulmonary rehabilitation in lung cancer. Monaldi Arch Chest Dis. 2013; 79(2):73-80 [PubMed] Related Publications
Non-small-cell lung cancer (NSCLC) represents a very severe disease, being its incidence increasingly reported and, nowadays, successfully treatable only when surgery is deemed to be feasible. Furthermore, the disease and the clinical effects related to the complementary therapies (radio and/or chemotherapy) may strongly affect, frequently with dramatic clinical side effects, the patient's ability to endure physical exercise. In such context, the PR(PR), which has already been proved to be useful and effective in other diseases such as COPD, could play a pivotal role. The aim of this review article is, therefore, to analyze the pertinent data recently reported in English literature in order to highlight the role of rehabilitation as complementary therapy in the management of patients with NSCLC. The evidence currently available suggests that, when surgery is indicated, PR is a safe and feasible option, both during pre-operative and post-operative timing.The safety and feasibility of rehabilitation are proven even in inoperable patients, although to date, little evidence has been reported on its role in the overall management of such complex diseases.
Dominioni L, Rotolo N, Poli A, et al. Cost of a population-based programme of chest x-ray screening for lung cancer. Monaldi Arch Chest Dis. 2013; 79(2):67-72 [PubMed] Related Publications
BACKGROUND: After the implementation of a population-based programme of chest x-ray (CXR) screening on smokers in Varese, Italy, lung cancer (LC) mortality was significantly reduced. Analysis of the incremental costs due to this type of screening programme is needed to evaluate its economic impact on the healthcare system. METHODS: In July 1997 a population-based cohort, consisting of all high-risk smokers (n=5,815) identified among 60,000 adult residents from the Varese province, was invited to a LC screening programme (an annual CXR for five years) in a general practice setting, and was observed through 2006. Invitees received National Health Service (NHS) usual care, with the addition of CXRs in screening participants. At the end of observation, among the 245 LCs diagnosed in the entire screening-invited cohort the observed LC deaths were 38 fewer than expected. To estimate the incremental direct cost due to screening in the invited cohort for the period July 1997-2006, we compared the direct cost of screening administration, CXR screens and LC management in the invited cohort and in the uninvited and unscreened controls in NHS usual care setting. RESULTS: Over the 9.5 years, the total incremental direct healthcare costs (including screening organization/administration, CXR screens, additional procedures prompted by false-positive tests, overdiagnosed LCs) were estimated to range from euro 607,440 to euro 618,370 (in euros as of 2012), equating to between euro 15,985- euro 16,273 per patient out of the 38 LC deaths averted. CONCLUSIONS: In a general practice setting, the incremental cost for a CXR screening programme targeted at all high-risk smokers in a population of 60,000 adults was estimated to be about euro 65,000 per annum, approx. euro 16,000 for each LC death averted.
Lang J, Hartman M Use of a left-sided double-lumen endotracheal tube in a patient with a prior left pneumonectomy. AANA J. 2013; 81(5):369-75 [PubMed] Related Publications
A 77-year-old man, 7 years after left pneumonectomy, was scheduled for a right upper pulmonary lobectomy. The early identification of a newly developing carcinoma on the right upper pulmonary lobe warranted surgical resection. Right exploratory thoracotomy, pleural lysis, partial pleurectomy, and right upper lobe wedge resection were completed, and the patient was discharged without sequelae. This case report describes the intraoperative anesthetic management of a right upper lobe wedge resection and attributes the uneventful intraoperative outcome to a strategically and skillfully placed left double-lumen endotracheal tube.
Foster R, Meyer J, Iyengar P, et al. Localization accuracy and immobilization effectiveness of a stereotactic body frame for a variety of treatment sites. Int J Radiat Oncol Biol Phys. 2013; 87(5):911-6 [PubMed] Related Publications
PURPOSE: The purpose of this study was to analyze the pretreatment setup errors and intrafraction motion using cone beam computed tomography (CBCT) for stereotactic body radiation therapy patients immobilized and localized with a stereotactic body frame for a variety of treatment sites. METHODS AND MATERIALS: Localization errors were recorded for patients receiving SBRT for 141 lung, 29 liver, 48 prostate, and 45 spine tumors representing 1005 total localization sessions. All patients were treated in a stereotactic body frame with a large custom-molded vacuum pillow. Patients were first localized to the frame using tattoos placed during simulation. Subsequently, the frame was aligned to the room lasers according to the stereotactic coordinates determined from the treatment plan. Every patient received a pretreatment and an intrafraction CBCT. Abdominal compression was used for all liver patients and for approximately 40% of the lung patients to reduce tumor motion due to respiration. RESULTS: The mean ± standard deviation pretreatment setup errors from all localizations were -2.44 ± 3.85, 1.31 ± 5.84, and 0.11 ± 3.76 mm in the anteroposterior, superoinferior, and lateral directions, respectively. The mean pretreatment localization results among all treatment sites were not significantly different (F test, P<.05). For all treatment sites, the mean ± standard deviation intrafraction shifts were 0.33 ± 1.34, 0.15 ± 1.45, and -0.02 ± 1.17 mm in the anteroposterior, superoinferior, and lateral directions, respectively. The mean unidimensional intrafraction shifts were statistically different for several of the comparisons (P<.05) as assessed by the Tukey-Kramer test. CONCLUSIONS: Despite the varied tumor locations, the pretreatment mean localization errors for all sites were found to be consistent among the treatment sites and not significantly different, indicating that the body frame is a suitable immobilization and localization device for a variety of tumor sites. Our pretreatment localization errors and intrafraction shifts compare favorably with those reported in other studies using different types of immobilization devices.
Lv J, Zhang W, Xu R Investigation of radon and heavy metals in Xuanwei and Fuyuan, high lung cancer incidence areas in China. J Environ Health. 2013; 76(4):32-8 [PubMed] Related Publications
Xuanwei and Fuyuan, two counties located in southwest China, are areas with known high lung cancer incidence. Pollution relative to coal combustion, especially serious air pollution generated by burning smoky coals in unvented households, has been thought to be the most predominant cause. Possible inorganic carcinogenic matter including radon in air and arsenic, lead, chromium, cadmium, nickel, and beryllium in water, soil, and coal were sampled and examined to find the current pollution status, distributions, characteristics, and relationships to the lung cancer incidence. The concentrations of mercury in air of Xuanwei and Fuyuan ranged from 1.7 to 205.3 ng/m3 (indoor), 1.3 to 7.5 ng/m3 (ambient). No radon concentration exceeded the World Health Organization standard. Results indicated that household stove improvement by changing stoves from unvented to vented obviously alleviated the indoor air pollution of carcinogenic metals. Most of the carcinogenic metals were also found at very low levels in water and soil, which therefore had little influence on human health. Concentrations of these elements at different sites did not vary in any relation to lung cancer incidence. The study described in this article added basic data; the results of the authors' study will be helpful in determining pollution status and to future studies on the etiology of lung cancer.
Ngodngamthaweesuk M, Attanawanich S, Kijjanon N Video-assisted thoracic surgery lobectomy for lung cancer in Ramathibodi Hospital. J Med Assoc Thai. 2013; 96(7):819-23 [PubMed] Related Publications
BACKGROUND: Although the public perceives video-assisted thoracic surgery (VATS) as advantageous because it is less invasive than a standard thoracotomy There are questioned the safety of VATS lobectomy and its adequacy as a cancer operation. This study is reviewed to assess this issue. MATERIAL AND METHOD: This retrospective study was performed between January 2009 and June 2011 in 58 patients who underwent VATS for a standard anatomic lobectomy with lymph node sampled or dissection for lung cancer 43 women (74%) and 15 men (26%) and mean age 60.28+/-11.14 years. None of this study group had any pleural effusion or pleural dissemination. RESULTS: The most symptom and sign of patients with lung cancer were normal [48 cases (83%), 54 cases (93%) respectively]. The most risk factor was smoking [12 cases (20%)]. The most lobectomy of VATS lobectomy was right upper lobectomy [17 cases (29%)] and the longest duration of VATS lobectomy was left upper lobectomy was 237.00+/-38.60 minutes. Thirty-one patients (53.4%) were adenocarcinoma. The VATS lobectomy was adequate for lung cancer surgery because malignant cells were not found from cytologic study of pleural lavages. The conversion rate from VATS to standard thoracotomy lobectomy was seven cases (12%), which the common causes were pleural symphysis and inadequate one lung ventilation. The postoperative courses showed minimal blood transfusion (0.11+/-0. 37ū), intensive care unit (ICU) stay (0.61+/-0.56 days) and intercostal drainage (ICD) duration (6.10+/-5.79 days). There were no intra-and post-operative death. Seven cases (12%) had many complications; the most complication was bacteria pneumonia. A case needed re-thoracotomy due to medical treatment failure for chylothorax. CONCLUSION: VATS lobectomy (anatomic lobectomy and lymph nodes sampled or dissection)for lung cancer can be performed with low morbidity and no mortality.
Elchoufani SE, Efird JT, O'Neal WT, et al. The relation of race and type of health insurance to long-term risk of mortality among lung cancer patients in rural Eastern North Carolina. N C Med J. 2013 Nov-Dec; 74(6):464-9 [PubMed] Related Publications
BACKGROUND: Black patients with lung cancer have a higher mortality rate than do their white counterparts. Differences in insurance coverage, demographic characteristics, and treatment profiles may explain this disparity. The purpose of this study was to compare the longterm risk of mortality of black lung cancer patients with that of white lung cancer patients, by insurance type. METHODS: Patients who were diagnosed with lung cancer in Eastern North Carolina and treated at the Leo Jenkins Cancer Center between 2001 and 2010 were included in this study. A Cox regression model was used to compare the risk of mortality of black patients with that of white patients. RESULTS: A total of 2,351 lung cancer patients (717 black and 1,634 white) were treated at the Leo Jenkins Cancer Center during the study period. Independent of age and sex, black patients with lung cancer were observed to die sooner than their white counterparts (hazard ratio = 1.2; 95% confidence interval, 1.04-1.3; P = .0070). However, this difference was not statistically significant after controlling for and stratifying by insurance type. LIMITATIONS: Residual confounding and the misclassification of some variables could have biased estimated study effects. CONCLUSION: The racial disparity in lung cancer mortality observed in Eastern North Carolina is no longer apparent after health insurance type is accounted for.
Galizia D, Palesandro E, Nuzzo AM, et al. Prolonged disease stability with trabectedin in a heavily pretreated elderly patient with metastatic leiomyosarcoma of the thigh and renal failure: a case report and review of the literature. Oncol Res. 2013; 20(10):483-90 [PubMed] Related Publications
Leiomyosarcoma represents about 24% of all soft tissue sarcomas and can originate from retroperitoneum, uterus, or extremities. Adequate local control may be achieved with surgery and radiotherapy. In the presence of unresectable metastases either doxorubicin- or gemcitabine-based chemotherapy is the standard of treatment. Nevertheless, prognosis remains poor regardless of the selected chemotherapy regimen, and new effective therapeutic agents for patients with advanced leiomyosarcoma are needed. Trabectedin, a promising new DNA-damaging agent with a mechanism of action that is different from that of traditional alkylating agents, is approved in Europe for the treatment of patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents and in combination with pegylated liposomal doxorubicin (PLD) for the treatment of patients with relapsed platinum-sensitive ovarian cancer. We present a case of a 76-year-old patient with progressive metastatic lung lesions from a previously resected primary leiomyosarcoma of the thigh and moderate renal failure, who achieved 17 months of disease stability during third-line treatment with trabectedin. Trabectedin was not associated with any cumulative toxicity and was consistently well tolerated for a total of 22 treatment cycles. Current evidence on trabectedin is also presented.
Kumar MS, Armenteros-Monterroso E, East P, et al. HMGA2 functions as a competing endogenous RNA to promote lung cancer progression. Nature. 2014; 505(7482):212-7 [PubMed] Article available free on PMC after 09/07/2014 Related Publications
Non-small-cell lung cancer (NSCLC) is the most prevalent histological cancer subtype worldwide. As the majority of patients present with invasive, metastatic disease, it is vital to understand the basis for lung cancer progression. Hmga2 is highly expressed in metastatic lung adenocarcinoma, in which it contributes to cancer progression and metastasis. Here we show that Hmga2 promotes lung cancer progression in mouse and human cells by operating as a competing endogenous RNA (ceRNA) for the let-7 microRNA (miRNA) family. Hmga2 can promote the transformation of lung cancer cells independent of protein-coding function but dependent upon the presence of let-7 sites; this occurs without changes in the levels of let-7 isoforms, suggesting that Hmga2 affects let-7 activity by altering miRNA targeting. These effects are also observed in vivo, where Hmga2 ceRNA activity drives lung cancer growth, invasion and dissemination. Integrated analysis of miRNA target prediction algorithms and metastatic lung cancer gene expression data reveals the TGF-β co-receptor Tgfbr3 (ref. 12) as a putative target of Hmga2 ceRNA function. Tgfbr3 expression is regulated by the Hmga2 ceRNA through differential recruitment to Argonaute 2 (Ago2), and TGF-β signalling driven by Tgfbr3 is important for Hmga2 to promote lung cancer progression. Finally, analysis of NSCLC-patient gene-expression data reveals that HMGA2 and TGFBR3 are coordinately regulated in NSCLC-patient material, a vital corollary to ceRNA function. Taken together, these results suggest that Hmga2 promotes lung carcinogenesis both as a protein-coding gene and as a non-coding RNA; such dual-function regulation of gene-expression networks reflects a novel means by which oncogenes promote disease progression.
Schiavon M, Marulli G, Rebusso A, et al. Techniques of right extended pneumonectomy. Ann Thorac Surg. 2013; 96(6):2252-5 [PubMed] Related Publications
Tracheal sleeve pneumonectomy is considered the operation of choice for tumors involving the right tracheobronchial angle, even though the procedure is burdened by a high rate of perioperative morbidity and mortality. In this report, we present our experience with two different techniques to avoid sleeve pneumonectomy: the tangential tracheal suture and the tracheoplasty.
Taira N, Kawabata T, Gabe A, et al. Right lower lobectomy with middle lobe preservation after right upper lobectomy in lung cancer of the right lower lobe. Ann Thorac Surg. 2013; 96(6):2227-30 [PubMed] Related Publications
A 73-year-old woman who underwent right upper lobectomy for tuberculosis 40 years earlier was diagnosed with adenocarcinoma, clinical stage IIA (T2bN0M0), in the right lower lobe of her lung. A lower lobectomy with preservation of the middle lobe was performed. The patient had an uneventful recovery. She is alive without signs of recurrence or requirement for additional oxygen support 6 years after the operation.
Gilbert CR, Toth JW, Kaifi JT, et al. Endobronchial valve placement for spontaneous pneumothorax from stage IIIA non-small cell lung cancer facilitates neoadjuvant therapy. Ann Thorac Surg. 2013; 96(6):2225-7 [PubMed] Related Publications
Spontaneous pneumothorax has previously been described as a presenting symptom of lung cancer. This presentation can, unfortunately, complicate and delay further definitive oncologic care until the pneumothorax can be effectively managed. We describe the case of a 58-year-old man who presented with secondary spontaneous pneumothorax and persistent air leak related to his primary lung carcinoma. Endobronchial valve placement allowed for the avoidance of pleurodesis, timely discharge, and neoadjuvant chemotherapy, followed by definitive surgical resection.
Madrid-Carbajal CJ, García-Clemente MM, Gutiérrez-Rodríguez M, et al. Pneumothorax as atypical presentation of bronchial carcinoid. Ann Thorac Surg. 2013; 96(6):2219-21 [PubMed] Related Publications
We present a case of pneumothorax associated with an endobronchial carcinoid tumor in a 18-year-old man with dyspnea and chest pain. Additional tests were done, identifying in the chest roentgenogram a complete left pneumothorax with persistent leak, which was confirmed by computed tomography of the chest, and also finding an endobronchial lesion that limited the complete reexpansion of the left lung. Surgical excision was performed, and the lesion was identified as a typical bronchial carcinoid, with satisfactory outcome after the intervention.
Carinal resection and sleeve pneumonectomy are rare procedures and challenging issues in thoracic surgery. In spite of the knowledge of the technique, the incidence of postoperative complications is higher compared with standard resections. Adequate patient selection, improved anesthetic management and surgical technique, and better postoperative management might reduce the rate of postoperative morbidity and mortality.
McGuire AL, Hopman WM, Petsikas D, Reid K Outcomes: wedge resection versus lobectomy for non-small cell lung cancer at the Cancer Centre of Southeastern Ontario 1998-2009. Can J Surg. 2013; 56(6):E165-70 [PubMed] Article available free on PMC after 09/07/2014 Related Publications
BACKGROUND: Sublobar resection for non-small cell lung cancer (NSCLC) remains controversial owing to concern about local recurrence and long-term survival outcomes. We sought to determine the efficacy of wedge resection as an oncological procedure. METHODS: We analyzed the outcomes of all patients with NSCLC undergoing surgical resection at the Cancer Centre of Southeastern Ontario between 1998 and 2009. The standard of care for patients with adequate cardiopulmonary reserve was lobectomy. Wedge resection was performed for patients with inadequate reserve to tolerate lobectomy. Predictors of recurrence and survival were assessed. Appropriate statistical analyses involved the χ(2) test, an independent samples t test and Kaplan-Meier estimates of survival. Outcomes were stratified for tumour size and American Joint Committee on Cancer seventh edition TNM stage for non-small cell lung cancer. RESULTS: A total of 423 patients underwent surgical resection during our study period: wedge resection in 71 patients and lobectomy in 352. The mean age of patients was 64 years. Mean follow-up for cancer survivors was 39 months. There was no significant difference between wedge resection and lobectomy for rate of tumour recurrence, mortality or disease-free survival in patients with stage IA tumours less than 2 cm in diameter. CONCLUSION: Wedge resection with lymph node sampling is an adequate oncological procedure for non-small cell lung cancer in properly selected patients, specifically, those with stage IA tumours less than 2 cm in diameter.
Devarakonda S, Morgensztern D, Govindan R Clinical applications of The Cancer Genome Atlas project (TCGA) for squamous cell lung carcinoma. Oncology (Williston Park). 2013; 27(9):899-906 [PubMed] Related Publications
Very little progress has been made in the treatment of patients with metastatic squamous cell lung cancer over the past 2 decades. Identification of novel molecular alterations for targeted therapies is necessary to improve outcomes. Advances in genomic technology have now made it possible to analyze the genomic landscape of tumor tissues comprehensively. We summarize here key findings from the comprehensive analysis of squamous cell lung cancer by The Cancer Genome Atlas group and discuss the clinical implications of these findings.
Valentín-Mendoza S, Nieves-Nieves J, Fernández-Medero R, et al. Pulmonary lymphangioleiomyomatosis: literature update. Bol Asoc Med P R. 2013; 105(3):64-9 [PubMed] Related Publications
Pulmonary lymphangioleiomyomatosis is an uncommon disease of unknown etiology characterized by the proliferation of abnormal smooth muscle cells in the lungs, leading to parenchymal destruction and progressive respiratory failure. The natural history of this disease remains poorly understood, primarily seen in women of childbearing age. The diagnosis can be difficult because symptoms are nonspecific and very similar to other respiratory diseases like asthma, emphysema and bronchitis. Lymphangioleiomyomatosis may not be diagnosed until a pneumothorax, chylothorax, interstitial lung disease or angiomyolipomas are discovered. The recent advances in genetic and molecular research provide new hope to discover the intricate mechanism of disease and evaluate new therapies. Internists, primary care physicians and pulmonologists should be aware of this condition in order to avoid delay in the diagnosis and institute appropriate therapy. The clinical features, pathophysiology, molecular genetics and medical treatment will be reviewed.
Field JK, Hansell DM, Duffy SW, Baldwin DR CT screening for lung cancer: countdown to implementation. Lancet Oncol. 2013; 14(13):e591-600 [PubMed] Related Publications
Implementation of lung cancer CT screening is currently the subject of a major policy decision within the USA. Findings of the US National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6·7% decrease in all-cause mortality; subsequently, five US professional and clinical organisations and the US Preventive Services Task Force recommended that screening should be implemented. Should national health services in Europe follow suit? The European community awaits mortality and cost-effectiveness data from the NELSON trial in 2015-16 and pooled findings of European trials. In the intervening years, a recommendation is proposed that a demonstration trial is done in the UK. In this Review, we summarise the existing evidence and identify questions that remain to be answered before the implementation of international lung cancer screening programmes.
Serdarevic N, Stanciu AE Comparison of Architect i2000 for determination of Scc with IMX determination of SCC with different methods. Clin Lab. 2013; 59(9-10):1129-33 [PubMed] Related Publications
BACKGROUND: SCC (squamous cell carcinoma) antigen (SSCA), a tumor marker, is already used for the diagnosis and follow-up of carcinoma of the cervix and lungs. The aim of our study was the determination of SCCA concentration in 96 serum samples using CMIA (chemiluminesecent microparticle immnoassay) on an Architect i2000 (Abbott Diagnostics) and MEIA (microparticle enzyme immnoassay) on an IMx Chemistry Analyzer (Abbott Diagnostics). METHODS: In our investigation we used a CMIA (chemiluminesecent microparticle immnoassay) Architect i2000 and MEIA (microparticle enzyme immnoassay) Imx Chemistry Analyzer for SCCA determination. RESULTS: All patients were hospitalized at the Department of Gynecologic Oncology and Department for Oncology at the University Clinics Center of Sarajevo. The normal serum range of SCCA should be < 0.1 microg/L. The quality control, precision and accuracy of the Architect i2000 were assessed. The quality control was done using quality control serums for low (X = 2.17 microg/L), medium (X = 10.23 microg/L), and high (X = 48.99 microg/L) range. The precision for the Architect i2000 has a CV of 3.44% to 4.44%. We established that the main difference between Architect i2000 and IMx was statistically significant at p < 0.05 according to Student's t-test. The correlation coefficient was r = 0.990. The some samples have higher concentrations on the Architect than on the IMx because the sensitivity of the Architect assay is high (< 0.1 microg/L). CONCLUSIONS: The CMIA Architect technology is an applicable method significant in diagnostic of SCCA.
Roulston A, Wilkinson P, Haynes T, Campbell J Complementary therapy: perceptions of older people with lung or colorectal cancer. Int J Palliat Nurs. 2013; 19(7):333-9 [PubMed] Related Publications
AIM: To explore how older people with lung and colorectal cancer view registered complementary therapy (CT) services in Northern Ireland. BACKGROUND: A literature review highlighted gaps around information, access, and communication between patients and health professionals regarding CT services. METHODS: Using structured interviews, a survey of 68 patients in one hospital and one hospice was conducted in Belfast, Northern Ireland. RESULTS: All respondents felt that CT services should be better promoted and more easily accessible to older people with cancer. Some patients were concerned about the lack of written information provided regarding CT services, which they believed led to poorer uptake and uncertainty regarding the potential benefits. Others were concerned that engaging in or disclosing CT usage might negatively affect existing relationships with medical professionals. CONCLUSION: Patients should be offered high quality written information on CT services to enable choice, improve knowledge, and promote wider access. Increased physician education may facilitate provision of such information.
Kligerman S The clinical staging of lung cancer through imaging: a radiologist's guide to the revised staging system and rationale for the changes. Radiol Clin North Am. 2014; 52(1):69-83 [PubMed] Related Publications
In 2009, the International Union Against Cancer and the American Joint Committee on Cancer accepted a revised staging system for the staging of lung cancer. Changes to the staging system were made to correlate patient survival more accurately with characteristics of the primary tumor (T) and presence or extent of nodal (N) and metastatic disease (M). Many changes were made to the staging system, most notably within the tumor (T) and metastases (M) designations. There are many ways to clinical stage lung cancer, but PET-CT remains one of the most accurate noninvasive methods.
Raad RA, Suh J, Harari S, et al. Nodule characterization: subsolid nodules. Radiol Clin North Am. 2014; 52(1):47-67 [PubMed] Related Publications
In this review, we focus on the radiologic, clinical, and pathologic aspects primarily of solitary subsolid pulmonary nodules. Particular emphasis will be placed on the pathologic classification and correlative computed tomography (CT) features of adenocarcinoma of the lung. The capabilities of fluorodeoxyglucose positron emission tomography-CT and histologic sampling techniques, including CT-guided biopsy, endoscopic-guided biopsy, and surgical resection, are discussed. Finally, recently proposed management guidelines by the Fleischner Society and the American College of Chest Physicians are reviewed.
Chiles C Lung cancer screening with low-dose computed tomography. Radiol Clin North Am. 2014; 52(1):27-46 [PubMed] Related Publications
Current guidelines endorse low-dose computed tomography (LDCT) screening for smokers and former smokers aged 55 to 74, with at least a 30-pack-year smoking history. Adherence to published algorithms for nodule follow-up is strongly encouraged. Future directions for screening research include risk stratification for selection of the screening population and improvements in the diagnostic follow-up for indeterminate pulmonary nodules. Screening for lung cancer with LDCT has revealed that there are indolent lung cancers that may not be fatal. More research is necessary if the risk-benefit ratio in lung cancer screening is to be maximized.
M V JB, Shinde SG, S SK, et al. Dosimetry and radiobiological studies of automated alpha-particle irradiator. J Environ Pathol Toxicol Oncol. 2013; 32(3):263-73 [PubMed] Related Publications
Understanding the effect of alpha radiation on biological systems is an important component of radiation risk assessment and associated health consequences. However, due to the short path length of alpha radiation in the atmosphere, in vitro radiobiological experiments cannot be performed with accuracy in terms of dose and specified exposure time. The present paper describes the design and dosimetry of an automated alpha-particle irradiator named 'BARC BioAlpha', which is suitable for in vitro radiobiological studies. Compared to alpha irradiators developed in other laboratories, BARC BioAlpha has integrated computer-controlled movement of the alpha-particle source, collimator, and electronic shutter. The diaphragm blades of the electronic shutter can control the area (diameter) of irradiation without any additional shielding, which is suitable for radiobiological bystander studies. To avoid irradiation with incorrect parameters, a software interlock is provided to prevent shutter opening, unless the user-specified speed of the source and collimator are achieved. The dosimetry of the alpha irradiator using CR-39 and silicon surface barrier detectors showed that ~4 MeV energy of the alpha particle reached the cells on the irradiation dish. The alpha irradiation was also demonstrated by the evaluation of DNA double-strand breaks in human cells. In conclusion, 'BARC BioAlpha' provides a user-friendly alpha irradiation system for radiobiological experiments with a novel automation mechanism for better accuracy of dose and exposure time.
McCarville MB, Billups C, Wu J, et al. The role of PET/CT in assessing pulmonary nodules in children with solid malignancies. AJR Am J Roentgenol. 2013; 201(6):W900-5 [PubMed] Related Publications
OBJECTIVE. The purpose of this article is to assess the feasibility and utility of PET/CT in distinguishing benign from malignant pulmonary nodules in patients with solid childhood malignancies. SUBJECTS AND METHODS. This prospective study was conducted between March 2008 and August 2010. We enrolled 25 subjects 21 years old or younger with solid childhood malignancies and at least one pulmonary nodule measuring 0.5-3.0 cm. PET/CT was performed within 3 weeks of diagnostic chest CT. Three panels of three reviewers each reviewed diagnostic CT only (panel 1), PET/CT only (panel 2), or diagnostic CT and PET/CT concurrently (panel 3) and predicted each nodule's histologic diagnosis as benign, malignant, or indeterminate. Interreviewer agreement was assessed with the kappa statistic. Using nodule biopsy or clinical follow-up as reference standards, the sensitivity, specificity, and accuracy for each panel was assessed. Logistic regression was used to assess the nodule's maximum standardized uptake value (SUVmax) association with its histologic diagnosis. RESULTS. There were 75 nodules with a median size of 0.74 cm (range, 0.18-2.38 cm); 48 nodules were malignant. Sensitivity was 85% (41/48) for panel 1, 60% (29/48) for panel 2, and 67% (32/48) for panel 3. All panels had poor specificities. Interreviewer agreement was moderate for panel 1 (0.43) and poor for panels 2 (0.22) and 3 (0.33). SUVmax was a significant predictor of histologic diagnosis (p = 0.004). CONCLUSION. PET/CT assessment of pulmonary nodules is feasible in children with solid malignancies but may not reliably improve our ability to predict a nodule's histologic diagnosis. The SUVmax may improve the performance of PET/CT in this setting.
Li X, Zhao M, Wang J, et al. Percutaneous CT-guided radiofrequency ablation as supplemental therapy after systemic chemotherapy for selected advanced non-small cell lung cancers. AJR Am J Roentgenol. 2013; 201(6):1362-7 [PubMed] Related Publications
OBJECTIVE: The purpose of this study is to evaluate the safety and efficacy of percutaneous CT-guided radiofrequency ablation (RFA) as a supplemental therapy after systemic chemotherapy for selected patients with advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 220 patients with advanced NSCLC who were treated with platinum-doublet chemotherapy between January 2000 and January 2012. Among them, 49 patients underwent RFA as a supplemental therapy for tumors in partial response or stable diseases after first-line chemotherapy. The progression-free survival (PFS) was evaluated by Kaplan-Meier method. RESULTS: There were nine women and 40 men (median age, 60 years; range, 24-82 years), including 28 patients with stage IIIb cancer and 21 with stage IV cancer. All 49 patients (partial response, 23 patients; stable disease, 26 patients) underwent 67 RFA sessions for 61 targeted tumors after systemic chemotherapy. There were no procedure-related deaths. Pneumothorax requiring chest tubes developed in eight sessions (11.9%). Thirty-one patients (63.3%) had complete response, 12 patients (24.5%) had partial response, six patients (12.2%) had stable disease, and no patients had progressive disease. The median follow-up period was 19 months (range, 6-34), and the median PFS was 16 weeks (95% CI, 14.5-17.5). CONCLUSION: Percutaneous CT-guided RFA can be performed as a feasible minimally invasive supplemental therapy with satisfactory PFS after systemic chemotherapy for patients with advanced NSCLC.
Shevchenko VE, Kovalev SV, Arnotskaya NE, et al. Human blood plasma proteome mapping for search of potential markers of the lung squamous cell carcinoma. Eur J Mass Spectrom (Chichester, Eng). 2013; 19(2):123-33 [PubMed] Related Publications
Blood plasma proteomes obtained from 77 lung squamous cell carcinoma (LSCC) patients (Stages I-III) and 67 healthy controls (all males) were analyzed by using the label-free liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the search of potential cancer biomarkers. All plasma samples were depleted of 14 highly-abundant plasma proteins by immune-affinity column chromatography before LC-MS/MS. We identified and quantified 809 differential proteins with molecular weights from 6.4 kDa to 3900 kDa using a label-free method. Three hundred and sixty four proteins were identified in all three groups. Changes in levels of an expression of blood plasma proteins associated with LSCC were discovered. Among them, 43 proteins were overexpressed and 39 proteins were down-regulated by more than two-fold between the plasmas of lung cancer patients and healthy men. We focused our attention on proteins whose expression levels increased from control to early stage and then to advanced stage tumor. Each of the 43 unique overexpressed proteins was classified according to its cellular localization, biological processes, molecular function and classes. Many of these proteins are involved in biological pathways pertinent to tumor progression and metastasis and some of these deregulated proteins may be useful clinical markers.