CYFRA 21-1 determination in patients with non-small cell lung cancer: Clinical utility for the...
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Abstracts/Lung Cancer I5 (19%) 139-157 141 adenocarcinomas, probably as tbeir common precursor. However, the two types of adenocarcinomas, despite their characteristic morphologic features, are indistinguishable using the biological indicators applied in this study. Clinical assessment CYFRA 21-1 determination in patients with non-small cell lung cancer: Clinical utility for the detection of recurrences Niklinski J, Funnan M, Rapellino M, Chycxewski L, Laudanski J, Oliaro A. Ruffmi E. Laboratory of Biological Chemistry, National Cancer Institute, National Imtitutes of Health, Bethesda. MD 20892. J Cardiovasc Surg 1995;36:501- 4. The aim of this study was to evaluate serial determinations of CYFRA 21-l in the follow-up of patients treated surgically for non- small cell lung cancer in order to predict the risk of turnour recurrence. SerumIevelsofCYFRA21-1 weremeasurcdusinganimmunoradiometric assay (CIS bio) in 57 patients with operable non-small cell lung cancer (NSCLC): 2.5 with squamous cell carcinoma (SqCC), 20 with adenocarcinoma (AC), 12 with large cell carcinoma (LCC).and 30 with nonmalignant lung diseases. Elevated preoperative CYFRA21-1 levels were identified in 44% of all patients with NSCLC. The diagnostic specificity of the assay was 97%. Positive CYFRA 21-1 levels was observed in 30% of stage I, 33% of stage II, and 55% of stage IIIa. Statistically significant differences were obtained between stages I and IIIa, II and IIIa, but not between stages I and II. During follow-up recurrence wasobserved in 19 of 57 (33 46) NSCLC patients. Recurrence- free survival probability for patients with elevated serum CYFRA 21- 1 levels before surgery was 52% (13/25), versus 81% (26/32) for patients with normal serum CYFRA 21-l levels (p < 0.01). In 15 patients with increased trend forCYFRA21-1, elevatedserum CYFRA 21-I levels preceded (13 patients) or coincided (2 patients) with the clinical detection of tumour recurrence, providing a predictive value of an increased trend of 87 96. In the multivariate analysis the association of the increase of CYFRA 21-1 level with a higher risk of recurrence is statistically significant (p < 0.001). Our results indicate that serial determination of CYFRA 21-1 may be of value in assessing the efficacy to surgical treatment of patients with NSCLC. Bronchogenic carcinoma: Incidence of metastases to normal sized lymph nodes Arita T, Kuramitsu T, Kawmura M, Matsumoto T, Matsunaga N, Sugi K et al. Department of Radiology, Yamaguchi University, School of Medicine, 1144 Kogushi, Ube, Yamaguchi 755. Thorax 1995;50: 1267- 9. Background - The incidence of metastases to mediastinal lymph nodes was evaluated in patients with normal sized mediastinal nodes on thecomputed tomographic (CT) scan who underwent thoracotomy. The useof hilar lymph nodes in predicting mediastinal lymph node metastases was also assessed. Methods - Ninety patients with non-small cell lung cancer who later underwent thoracotomy were prospectively examined by CT scanning. Lymph nodes with a short axis diameter of 10 mm or more were considered abnormal. Results - Mediastinal lymph node metastases werepresent at thoracotomyin 19patients (21%). In 14 these Iymph node metastases were misdiagnosed because the nodes were normal in size on the CT scan. In only one of the 19 patients with N2 nodes was an N 1 lymph node enlarged, and four of the 19 patients with N2 nodes had metastases to these mediastinal nodes without Nl disease (‘skipping metastaaes’). Conclusionr - Metastases in normal sized nodes seen on the CT scan are a major problem in staging. Hilar lymph nodes did not help to predict reliably the presence or absence of metastases to the mediastinal lymph nodes. Lymphoid monoclonal antibodies reactive with lung tumors: Diagnostic applications Ioachim HL, Pambuccian SE, Hekimgil M, Giancotti FR, Dorsett BH. Department of Pathology, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10021. Am J Surg Patbol 1996;20:64-71. In the course of investigating 30 monoclonal antibodies (MAbs) for their potential reactivity with 25 lung tumors of different histologic types, we found tbat three MAbs commonly used for their speciticities forIymphoidmarkerswerebighlyreactivewithnon-small-celIcarcinomas (NSCLC) and totally nonreactive with small-cell carcinomas (SCLC). Immunostaining was performed by the standard streptavidin-biotin- peroxidase methodafter microwaveantigen retrieval on formalin-fixed, paraffin-embedded tissue sections. LN2 (CD74). LN3 (HLA-DR), and BLA-36, which are commonly used for the identification of B- lymphocytes, strongly immunostained 19 of 25 squamous and adenocarcinomas and none of 34 small-cell carcinomas and carcinoids. Moreover, in combined tumors, these MAbs selectively stained the adenocarcinoma cells but not the adjacent small-cell carcinoma cells. A cocktail mixture of LN2, LN3, and BLA-36 assayed on 24 additional lung tumors produced similar results with even stronger and sharper stainings. Other Iympboid MAbs showed some selective staining but to a lesser degree. Among nonlymphoid MAbs, the results were as expected, with MAbs for cytokeratin (B72.3) and epithelial membrane antigen staining NSCLC but also some SCLC. The MAbs for chromogranin and neuron-specific enolase were not entirely specific, whereas sonic nerve-cell adhesion molecule MAbs showed good specificity for SCLC. In a field with few specific MAbs, tbe newly discovered ability of these lymphoid MAbs to discriminate between SCLC and NSCLC may prove useful in the immunohistochemical diagnosis of lung tumors. Gingival metastasis of large-cell lung cancer that produced G- CSF Miyatake K, Ueoka H, Tabata M, Shibayama T, Gemba K, Hiyama J et al. Department ofMedicine, Okayama University Medical School, 2- 5-1 Shikotacho, Okayama 700. Jpn J Thorac Dis 1995;33: 1283-7. A68year-oldman wasreferredtoourhospitalforfurtherexamination of a gingival mass. Chest radiographs and magnetic resonance imaging disclosed a bulky mass origmating in the upper portion of the left lung, in contact with a chronic empyema lesion that first occurred after resection for pulmonary tuberculosis. Examination of a specimen obtained by percutaneous needle biopsy of the mass led to the diagnosis of large-cell carcinoma. Laboratory findings on admission showed marked leukocytosis (48,100/l) without evidence of severe a bacterial infection. The level of G-CSF in serum was abnormally high (246 pgf ml, normal value: < 30 pglml). Chemotherapy with vindesine, ifosfamide, and cisplatin resulted in shrinkage of the gingival mass, and a decrease in the Cl-CSF level to 66 pglml. Immunohistochemical staining with an anti-Cl-CSF monoclonal antibody to the primary lung tumor and the gingival mass obtained at autopsy was positive for cytoplasmic G-CSF. New design of N-isopropyl-p[‘UI]iodoamphetamine (‘UI-IMP) lung imaging in the patient with lung cancer Tanaka E, Mishima M, Kawakami K, Sakai N, Sugiura N, Taniguchi T et al. Department of Clinical Physiology. Chest Disease Research
Transcript of CYFRA 21-1 determination in patients with non-small cell lung cancer: Clinical utility for the...
Abstracts/Lung Cancer I5 (19%) 139-157 141
adenocarcinomas, probably as tbeir common precursor. However, the two types of adenocarcinomas, despite their characteristic morphologic features, are indistinguishable using the biological indicators applied in this study.
Clinical assessment
CYFRA 21-1 determination in patients with non-small cell lung cancer: Clinical utility for the detection of recurrences Niklinski J, Funnan M, Rapellino M, Chycxewski L, Laudanski J, Oliaro A. Ruffmi E. Laboratory of Biological Chemistry, National Cancer Institute, National Imtitutes of Health, Bethesda. MD 20892. J Cardiovasc Surg 1995;36:501- 4.
The aim of this study was to evaluate serial determinations of CYFRA 21-l in the follow-up of patients treated surgically for non- small cell lung cancer in order to predict the risk of turnour recurrence. SerumIevelsofCYFRA21-1 weremeasurcdusinganimmunoradiometric assay (CIS bio) in 57 patients with operable non-small cell lung cancer (NSCLC): 2.5 with squamous cell carcinoma (SqCC), 20 with adenocarcinoma (AC), 12 with large cell carcinoma (LCC).and 30 with nonmalignant lung diseases. Elevated preoperative CYFRA21-1 levels were identified in 44% of all patients with NSCLC. The diagnostic specificity of the assay was 97%. Positive CYFRA 21-1 levels was observed in 30% of stage I, 33% of stage II, and 55% of stage IIIa. Statistically significant differences were obtained between stages I and IIIa, II and IIIa, but not between stages I and II. During follow-up recurrence wasobserved in 19 of 57 (33 46) NSCLC patients. Recurrence- free survival probability for patients with elevated serum CYFRA 21- 1 levels before surgery was 52% (13/25), versus 81% (26/32) for patients with normal serum CYFRA 21-l levels (p < 0.01). In 15 patients with increased trend forCYFRA21-1, elevatedserum CYFRA 21-I levels preceded (13 patients) or coincided (2 patients) with the clinical detection of tumour recurrence, providing a predictive value of an increased trend of 87 96. In the multivariate analysis the association of the increase of CYFRA 21-1 level with a higher risk of recurrence is statistically significant (p < 0.001). Our results indicate that serial determination of CYFRA 21-1 may be of value in assessing the efficacy to surgical treatment of patients with NSCLC.
Bronchogenic carcinoma: Incidence of metastases to normal sized lymph nodes Arita T, Kuramitsu T, Kawmura M, Matsumoto T, Matsunaga N, Sugi K et al. Department of Radiology, Yamaguchi University, School of Medicine, 1144 Kogushi, Ube, Yamaguchi 755. Thorax 1995;50: 1267- 9.
Background - The incidence of metastases to mediastinal lymph nodes was evaluated in patients with normal sized mediastinal nodes on thecomputed tomographic (CT) scan who underwent thoracotomy. The useof hilar lymph nodes in predicting mediastinal lymph node metastases was also assessed. Methods - Ninety patients with non-small cell lung cancer who later underwent thoracotomy were prospectively examined by CT scanning. Lymph nodes with a short axis diameter of 10 mm or more were considered abnormal. Results - Mediastinal lymph node metastases werepresent at thoracotomyin 19patients (21%). In 14 these Iymph node metastases were misdiagnosed because the nodes were normal in size on the CT scan. In only one of the 19 patients with N2 nodes was an N 1 lymph node enlarged, and four of the 19 patients with N2 nodes had metastases to these mediastinal nodes without Nl disease (‘skipping metastaaes’). Conclusionr - Metastases in normal sized nodes
seen on the CT scan are a major problem in staging. Hilar lymph nodes did not help to predict reliably the presence or absence of metastases to the mediastinal lymph nodes.
Lymphoid monoclonal antibodies reactive with lung tumors: Diagnostic applications Ioachim HL, Pambuccian SE, Hekimgil M, Giancotti FR, Dorsett BH. Department of Pathology, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10021. Am J Surg Patbol 1996;20:64-71.
In the course of investigating 30 monoclonal antibodies (MAbs) for their potential reactivity with 25 lung tumors of different histologic types, we found tbat three MAbs commonly used for their speciticities forIymphoidmarkerswerebighlyreactivewithnon-small-celIcarcinomas (NSCLC) and totally nonreactive with small-cell carcinomas (SCLC). Immunostaining was performed by the standard streptavidin-biotin- peroxidase methodafter microwaveantigen retrieval on formalin-fixed, paraffin-embedded tissue sections. LN2 (CD74). LN3 (HLA-DR), and BLA-36, which are commonly used for the identification of B- lymphocytes, strongly immunostained 19 of 25 squamous and adenocarcinomas and none of 34 small-cell carcinomas and carcinoids. Moreover, in combined tumors, these MAbs selectively stained the adenocarcinoma cells but not the adjacent small-cell carcinoma cells. A cocktail mixture of LN2, LN3, and BLA-36 assayed on 24 additional lung tumors produced similar results with even stronger and sharper stainings. Other Iympboid MAbs showed some selective staining but to a lesser degree. Among nonlymphoid MAbs, the results were as expected, with MAbs for cytokeratin (B72.3) and epithelial membrane antigen staining NSCLC but also some SCLC. The MAbs for chromogranin and neuron-specific enolase were not entirely specific, whereas sonic nerve-cell adhesion molecule MAbs showed good specificity for SCLC. In a field with few specific MAbs, tbe newly discovered ability of these lymphoid MAbs to discriminate between SCLC and NSCLC may prove useful in the immunohistochemical diagnosis of lung tumors.
Gingival metastasis of large-cell lung cancer that produced G-
CSF Miyatake K, Ueoka H, Tabata M, Shibayama T, Gemba K, Hiyama J et al. Department ofMedicine, Okayama University Medical School, 2- 5-1 Shikotacho, Okayama 700. Jpn J Thorac Dis 1995;33: 1283-7.
A68year-oldman wasreferredtoourhospitalforfurtherexamination of a gingival mass. Chest radiographs and magnetic resonance imaging disclosed a bulky mass origmating in the upper portion of the left lung, in contact with a chronic empyema lesion that first occurred after resection for pulmonary tuberculosis. Examination of a specimen obtained by percutaneous needle biopsy of the mass led to the diagnosis of large-cell carcinoma. Laboratory findings on admission showed marked leukocytosis (48,100/l) without evidence of severe a bacterial infection. The level of G-CSF in serum was abnormally high (246 pgf ml, normal value: < 30 pglml). Chemotherapy with vindesine, ifosfamide, and cisplatin resulted in shrinkage of the gingival mass, and a decrease in the Cl-CSF level to 66 pglml. Immunohistochemical staining with an anti-Cl-CSF monoclonal antibody to the primary lung tumor and the gingival mass obtained at autopsy was positive for cytoplasmic G-CSF.
New design of N-isopropyl-p[‘UI]iodoamphetamine (‘UI-IMP) lung imaging in the patient with lung cancer Tanaka E, Mishima M, Kawakami K, Sakai N, Sugiura N, Taniguchi T et al. Department of Clinical Physiology. Chest Disease Research
