RESUMO
BACKGROUND: We measured thymidylate synthase (TS) activity, dihydropyrimidine dehydrogenase (DPD) activity and TS inhibition rate (TSIR) in tumor tissue and lymph node metastasis, considered predictors of response to DIFs, in patients with lung cancer. PATIENTS AND METHODS: Fourteen patients with non-small cell lung cancer (NSCLC) were given UFT for 1-2 weeks before surgery. Total TS activity (total TS), TSIR and DPD activity were measured in tumors, lymph node metastases and normal lung and lymph nodes. RESULTS: Total TS activity and DPD activity were significantly higher in lung tumors than in normal lung (TS, p = 0.0225; DPD, p < 0.0001). Total TS activity was slightly but not significantly higher in lymph node metastases than in normal lymph nodes. DPD activity and TSIR were similar in the other tissues. CONCLUSION: After preoperative treatment with UFT, TS and DPD activities are significantly higher in lung tumor tissue than in normal lung tissue in patients with NSCLC.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/enzimologia , Di-Hidrouracila Desidrogenase (NADP)/metabolismo , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/enzimologia , Timidilato Sintase/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Terapia Combinada , Fluoruracila/sangue , Fluoruracila/farmacocinética , Humanos , Neoplasias Pulmonares/cirurgia , Metástase Linfática , Tegafur/administração & dosagem , Uracila/administração & dosagemRESUMO
OBJECTIVE: We worked to devise a new way to prevent postoperative persistent air leaks in high-risk pulmonary surgery patients. METHODS: From November 1993 to June 2002, 60 patients with difficult to control intraoperative pulmonary air leakage were treated using bioabsorbable polyglycolide felt patches soaked in fibrin glue to cover the leakage site. RESULTS: After application, the felt patch adhered tightly to the lung surface without peeling off, enabling good leakage closure with only 2 ml of fibrin glue used. Air leakage was controlled successfully in 52 (86.7%) of the 60. Four of the 8 patients in whom this method failed to stop air leakage also developed mild pyothorax, with 2 requiring a second operation by video-assisted thoracic surgery. Leakage was eventually controlled in all patients, with no postoperative deaths relating to air leakage. CONCLUSIONS: Fibrin-glue-soaked bioabsorbable felt patches effectively seal intraoperative intractable air leaks. Felt patch use may increase the risk of postoperative infection. It should be considered for use on patients with fistulas that cannot be controlled by direct closure or otherwise intraoperatively and who may potentially develop uncontrollable air leakage postoperatively.