Prognostic significance of flow cytometry in non-small-cell lung cancer.

To clarify the value of deoxyribonucleic acid (DNA) ploidy analysis, we prospectively studied single-parameter flow cytometric findings of fresh tissue from 272 patients with primary non-small-cell lung cancer from whom adequate tissue from the lung cancer was available. The mean age of the patients was 65.5 years; 65.8% were men. Histologic types were as follows: adenocarcinoma, 107 (39.3%); squamous cell, 100 (36.8%); large cell, 56 (20.6%); adenosquamous, 8 (2.9%); and giant cell, 1 (0.4%). Histologic grades were as follows: I (well differentiated), 15 (5.5%); II, 100 (36.8%); and III, 157 (57.7%). American Joint Committee on Cancer stages were as follows: I, 151 (55.5%); II, 38 (14%); III, 74 (27.2%); and IV, 9 (3.3%). Survivals at 1 year and 3 years were 74.2% +/- 2.8% and 52.4% +/- 4.8%, respectively. For non-squamous cell lung cancer, multivariate analyses with the Cox proportional hazards regression model for survival showed (1) that increasing American Joint Committee on Cancer stage (p < 0.001), male gender (p = 0.02), and histologic grades II and III (p = 0.04) were of independent (negative) prognostic significance and (2) that the presence and absence of DNA aneuploidy (p = 0.91), the classification of DNA histogram (p = 0.81), the DNA index (p = 0.46), and the results of cell cycle analysis in tumors with no aneuploidy (S phase, p = 0.23; S + G2M, p = 0.62) were of no prognostic significance. For squamous cell lung cancer, multivariate analyses showed that increasing American Joint Committee on Cancer stage (p = 0.003) and increasing DNA index (p = 0.009) were of independent (negative) prognostic significance.

Adverse reactions associated with ticrynafen use.

Three hypertensive patients receiving ticrynafen, a new uricosuric diuretic, experienced adverse reactions. One patient experienced acute renal failure, the second experienced a renal stone, and the third had a fatal hemorrhage while receiving anticoagulation therapy with warfarin sodium. All complications can be explained by known actions of the drug and are preventable. However, these reactions illustrate the potential hazards from widespread substitution of ticrynafen for thiazide diuretics in the treatment of hypertension.

Metastatic carcinoma of the pancreas simulating primary bronchogenic carcinoma.

A retrospective study of 294 patients with biopsy- or autopsy-proven adenocarcinoma of the pancreas was done. The initial diagnosis of ten patients (3.4%) was primary lung cancer. All ten patients were cigarette smokers. Hilar adenopathy with mediastinal widening was the most common roentgenographic appearance. Tumors of the body and tail of the pancreas more often appeared to be primary lung tumors than did tumors of the head of the pancreas (about 10% vs. about 1%). Adverse consequences of this unrecognized phenomenon may include unnecessary lung surgery for some cancer patients and overreporting of deaths from lung cancer.