Evaluation of Pregnancy-Associated Plasma Protein-A Levels in Patients with Chronic Obstructive Pulmonary Disease and Associations with Disease Severity.

Chronic obstructive pulmonary disease (COPD) represents a systemic disorder characterized by chronic airflow limitation and an increased inflammatory response of the airways. Comorbidities are frequent in COPD and it is crucial to predict these in early stage for adequate management of COPD. Recent studies have reported that elevated levels of pregnancy-associated plasma protein-A (PAPP-A), a zinc-binding metalloproteinase, detected in patients with asthma, lung cancer, and pulmonary embolism and independently associated with cardiovascular events. We aimed to assess serum PAPP-A levels in COPD and the associations between disease severity. The study population consisted of 75 COPD patients and 35 healthy subjects as a control group. PAPP-A levels were measured by using ultrasensitive enzyme-linked immunosorbent assay. Elevated levels of PAPP-A were observed in patients with COPD on comparison with the controls (p = 0.000). The levels in stage 1 (34.73 ± 22.97) and stage 2 (48.29 ± 53.35) were significantly higher than stage 3 (20.58 ± 22.98) and stage 4 (27.36 ± 21.46) (p = 0.049). Increased PAPP-A levels may be a useful marker in management of COPD that seeks to prevent the development of comorbidities such as adverse cardiovascular diseases.

Contribution of ¹8Fluorodeoxyglucose positron emission tomography uptake and TTF-1 expression in the evaluation of the EGFR mutation in patients with lung adenocarcinoma.

AIM: The aim of this study is to evaluate the diagnostic value of PET-CT scan for the prediction of EGFR mutation status and the contribution of TTF-1 expression to PET-CT scan. METHODS: We retrospectively studied 218 cases with a diagnosis of pulmonary adenocarcinoma between 2012-2014 which underwent EGFR analysis, TTF-1 and PET-CT before treatment. RESULTS: The EGFR mutation was present in 28.9% (n= 63) of cases. TTF-1 positivity was 66.9% (n= 105). Standardized uptake value (SUV max) was 16.7 ± 6.8 in EGFR mutant type, 13.8 ± 7.6 in cases having no EGFR mutations. According to our evaluations, high SUVmax is positively correlated with EGFR mutation status. TTF-1 expression in multivariate analysis strengthens the accuracy of detecting an EGFR mutation. CONCLUSION: PET-CT FDG uptake may, together with TTF-1 expression, help diagnosis in lung adenocarcinoma cases when evaluating for EGFR mutation status.

Does CPAP therapy alter urinary albumin level in adult patients with moderate to severe obstructive sleep apnea syndrome?

BACKGROUND: Urinary albumin is a marker of cardiovascular morbidity and mortality, and also it has been viewed as a marker for vascular endothelial dysfunction in both the kidneys and systemic vasculature. Lowering urinary albumin is associated with fewer cardiovascular and renal diseases. We investigated the change in urinary albumin after 1 month of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea syndrome (OSAS). METHODS: Eighteen patients (four females) in the middle-age group with moderate to severe OSAS were enrolled, who received and were compliant to CPAP therapy. Patients did not have a systemic disease or use a medication that could influence urinary albumin. Blood and urine samples were obtained in the morning after polysomnography and after 1 month of CPAP therapy to measure urinary albumin excretion and urinary albumin-to-creatinine ratio. RESULTS: Urinary albumin excretion (UAE) and urinary albumin/creatinine ratio (UACR) decreased significantly after 1 month of CPAP therapy: UAE at baseline and 1 month, 50 (1.1-174.8) and 22.7 (4.1-55.9); UACR, 27 (18.5-51.6) and 10.6 (4.3-43.1). UAE alteration was significantly associated with proportion of sleep time spent below an SaO2 of 90%. Serum creatinine, serum total cholesterol, and creatinine clearance also decreased after 1 month of CPAP therapy. CONCLUSION: Albuminuria is not rare in patients with OSAS and can be corrected after CPAP therapy. Determination of urinary albumin level is a simple, inexpensive, and noninvasive method that could be a promising biomarker to identify a high-risk population in patients with OSAS who may benefit from closer medical follow-up and preventive therapy.

Can non-thyroid illness syndrome predict mortality in lung cancer patients? A prospective cohort study.

This study aims to evaluate the incidence of non-thyroid illness syndrome (NTIS) among patients diagnosed as lung cancer and its association with the stage of the disease, Eastern Cooperative Oncology Group (ECOG) performance score, nutritional parameters, and survival. We enrolled 120 patients that 71 of them with newly diagnosed and staged non-small cell lung cancer and 49 of them small-cell lung cancer. The cases were examined for thyroid function tests, ECOG performance score, and nutritional evaluation before treatment. Also, cases were evaluated for their overall survival rates. NTIS was identified in 30 (42 %) of the 71 non-small cell lung cancer patients and 22 (44 %) of the 49 small-cell lung cancer patients. NTIS was more frequent among advanced stage of cases. Serum albumin level, cholesterol level, lymphocyte level, and body mass index were detected to be significantly low and ECOG performance score was significantly high in cases with NTIS when compared to cases without NTIS. NTIS was found to be negatively correlated with body mass index, ECOG performance score, and serum albumin level, and it was positively correlated with disease stage. NTIS was detected significantly as a poor prognostic factor for lung cancer. NTIS was frequently seen in cases with non-small cell lung cancer and small-cell lung cancer. NTIS can be used as a predictor of poor prognosis for lung cancer patients.