A more sensitive detection of micrometastases of NSCLC in lymph nodes using the one-step nucleic acid amplification (OSNA) method.

BACKGROUND: Detection of tumor cells in lymph nodes (LNs) removed during the treatment of pulmonary tumor by radical surgery is limited by the possibilities of standard histopathological methods. The goal of this study was to obtain more accurate pTNM status by a more sensitive detection of micrometastases in LNs. METHODS: A total of 885 LNs, an average of 13.8 LNs per patient, were removed during 64 surgeries. LNs from the same zone were pooled together as a group, five groups of LNs were examined in each patient. A total of 320 groups of LNs were examined. One-step nucleic acid amplification (OSNA) method was compared to standard histopathological examination with haematoxylin-eosin (H&E) staining and CK19 immunohistochemistry, specifically by an ultimate analysis of all intraoperatively removed LNs. RESULTS: Identical results for H&E and OSNA examinations were recorded in 286 groups of LNs (89.4%). In total, positive examinations were recorded in 27 groups of LNs (8.4%) using the OSNA method, which were H&E negative. In seven groups of LNs (2.2%), the H&E examination was positive, while OSNA method produced negative results. CONCLUSIONS: The OSNA examination led to a higher pTNM stage classification in 14 (21.9%) patients. The clinical significance remains the subject of follow-up research.

Solitary Fibrous Tumor - Less Common Neoplasms of the Pleural Cavity.

PURPOSE: solitary fibrous tumors (SFT) represent a heterogeneous group of primary pleural neoplasms with a low incidence rate and of which the biological origin, which consists of mesenchymal cells, is uncertain. METHODS: The authors present herewith a retrospective analysis of 22 patients with SFTs who were diagnosed and surgically treated between the years 2000-2015. The preoperative tumors were successfully verified morphologically by transthoracic core needle biopsy under CT control in 27.3% of patients. Surgical approaches were either posterolateral thoracotomy or videothoracoscopy. The follow-up median was 45 months (range 1-188 months). RESULTS: Twenty tumors were surgically removed radically, two tumors were found to be unresectable due to the considerable tumor size. From histological point of view 81.8% of tumors were SFT with low malignant potential, 18.2% of tumors with high malignant potential. Despite the radical extirpation of the SFT, it relapsed in two patients. CONCLUSION: The gold standard of SFT treatment is radical surgical removal; however, patients at risk of recurrence require additional follow-ups. The results of adjuvant therapy in recurrent and malignant forms of SFTs are the subject of discussion and further study.

Do Weather Phenomena Have Any Influence on the Occurrence of Spontaneous Pneumothorax? / ¿Tienen los fenómenos meteorológicos alguna influencia en la aparición de neumotórax espontáneo?

INTRODUCTION: The objective of this study was to assess the impact of weather phenomena on the occurrence of spontaneous pneumothorax (SP) in the Plzen region (Czech Republic). METHODS: A retrospective analysis of 450 cases of SP in 394 patients between 1991 and 2013. We observed changes in average daily values of atmospheric pressure, air temperature and daily maximum wind gust for each day of that period and their effect on the development of SP. RESULTS: The risk of developing SP is 1.41 times higher (P=.0017) with air pressure changes of more than±6.1hPa. When the absolute value of the air temperature changes by more than±0.9°C, the risk of developing SP is 1.55 times higher (P=.0002). When the wind speed difference over the 5 days prior to onset of SP is less than 13m/sec, then the risk of SP is 2.16 times higher (P=.0004). If the pressure difference is greater than±6.1hPa and the temperature difference is greater than±0.9°C or the wind speed difference during the 5 days prior to onset of SP is less than 10.7m/s, the risk of SP is 2.04 times higher (P≤.0001). CONCLUSION: Changes in atmospheric pressure, air temperature and wind speed are undoubtedly involved in the development of SP, but don't seem to be the only factors causing rupture of blebs or emphysematous bullae.

Surgical treatment of colorectal cancer pulmonary metastases: 12-year results.

UNLABELLED: The objective of the present study was to retrospectively analyze a cohort of patients who underwent surgery for colorectal cancer pulmonary metastases during a 12-year period. PATIENTS AND METHODS: The sample included 75 patients who were monitored in terms of overall survival (OS) and disease-free interval (DFI) in relation to patient's age, preoperative values of biomarkers, type of surgery, number and size of metastases, occurrence of complications and length of hospitalisation. RESULTS: A total of 95 surgical interventions were performed and 133 metastases were removed. Out of these, 28% of patients were free of any signs of relapse or disease progression for 5 years after metastasectomy. Those with two or more metastases are 2.3-times more at risk of disease progression. Tissue polypeptide specific antigen (TPS) values above the 140 IU/l cut-off point increase the risk of progression 3.9-times. The five-year survival rate among the group was 45%. Patients with 2 or more metastases are 2.7-times more at risk of death. TPS values above the 140 IU/l cut-off increase the risk of death 5.5 times, and carbohydrate antigen CA19-9 values above the 28 IU/ml cut-off point increase the risk of death by 3.2 times. CONCLUSION: The number of metastases and the preoperative TPS values are decisive prognostic factors influencing both OS and DFI.

Effects of intestinal surgery on pulmonary, glomerular, and intestinal permeability, and its relation to the hemodynamics and oxidative stress.

PURPOSE: To investigate the pattern of changes of gut mucosal, glomerular, and pulmonary permeability in response to major resectional intestinal surgery, and to evaluate whether these changes are related to oxidative stress. METHODS: Eight patients undergoing elective intestinal surgery. Lactulose/mannitol ratio (LMR), urinary albumin/creatinine ratio (MACR), and extravascular lung water and its ratio to intrathoracic blood volume (EVLW/ITBV) were measured preoperatively and at different time points postsurgery. The oxidant/antioxidant balance was assessed by measuring thiobarbituric acid-reactive species, reduced glutathione, plasma total antioxidant capacity, superoxide dismutase, and glutathione peroxidase. RESULTS: Uncomplicated intestinal surgery was associated with early increase in LMR and MACR. The EVLW/ITBV ratio increased, but still remained within the normal range. The amount of EVLW was not affected. While renal permeability changes resolved rapidly, increased intestinal permeability persisted longer postoperatively. There was no evidence for any marked disturbances in the oxidant/antioxidant balance. CONCLUSIONS: This pilot study indicated that a moderate increase in gut and renal permeability, even in the absence of clinical sequelae, is an early feature of uncomplicated intestinal surgical trauma. These alterations are not accompanied by any clinically detectable changes in pulmonary permeability.