Identification of Small and Non-Small Cell Lung Cancer Markers in Peripheral Blood Using Cytokinesis-Blocked Micronucleus and Spectral Karyotyping Assays.

Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer. There is an urgent need to develop tools to identify individuals at high risk of developing SCLC. We have previously reported that the cytokinesis-blocked micronucleus (CBMN) assay is a strong predictor of non-small cell lung cancer (NSCLC). Here, we investigate the sensitivity of the CBMN endpoints as predictors of SCLC risk. We conducted the CBMN assay on SCLC patients (n = 216), NSCLC patients (n = 173), and healthy controls (n = 204). Per sample, 1,000 binucleated cells (BN) were scored, and 3 endpoints, micronuclei (BN-MN), nucleoplasmic bridges (BN-NPB), and nuclear buds(BN-BUD), were recorded. Spectral karyotyping was also conducted on SCLC patients (n = 116) and NSCLC patients (n = 137) to identify genomic regions unique to each disease. Significantly higher levels of CBMN endpoints were observed in both cancer groups compared to controls. BN-NPBs were significantly higher among SCLC patients compared to NSCLC patients (p < 0.001). Chromosomes 5 and 17 were associated with BN-MN, and chromosomes 5, 18, 20, and 22 were associated with BN-NPBs in SCLC patients. Given the high frequency of chromosome aberrations observed in SCLC, events such as reinsertion of the micronucleus and chromothripsis may be potential mechanisms for the genetic instability in these patients.

A Cost Analysis of Preoperative Breast MRI Use for Patients with Invasive Lobular Cancer.

BACKGROUND: Whereas the impact of magnetic resonance imaging (MRI) of the breast on the surgical management of breast cancer patients is well documented, less is known about its effect on health care costs. This study aimed to evaluate whether MRI use for women with invasive lobular carcinoma (ILC) significantly changes the cost of care. METHODS: Patients with ILC were recruited to a prospective registry study of breast MRI. Women who met the same inclusion criteria but had not undergone breast MRI were retrospectively identified for comparison. A micro-costing analysis using institutional billing records was conducted. Nonparametric bootstrapping was used to compare the unadjusted cost differences between the patients receiving MRI and those receiving no MRI. RESULTS: Of the patients in this study, 51 had preoperative MRI, and 60 did not. Method of diagnostic biopsy, disease stage, oncologic procedure, and rates of contralateral prophylactic mastectomy were similar between the two groups. The patients in the MRI group were younger (median age 55 vs. 64 years; p = 0.01) and more likely to undergo reconstruction (45.1 vs. 25 %; p = 0.03). The median costs of care were significantly higher in the MRI group ($24,781 vs. $18,921; p < 0.01). After adjustment for clinical factors, MRI remained significantly associated with increased cost (p = 0.03). Other factors associated with increased cost included type of oncologic procedure (mastectomy vs. lumpectomy; p < 0.01), number of operations required to achieve negative margins (1 vs. >1; p < 0.01), and use of reconstruction (p < 0.01). CONCLUSION: Preoperative breast MRI increases the median total cost of care per patient. However, the contribution to the overall cost of care is modest compared with the cost of other interventions.

The influence of psoriatic plaques pretreatment with crude coal tar vs. petrolatum on the efficacy of narrow-band ultraviolet B: a half-vs.-half intra-individual double-blinded comparative study.

BACKGROUND/PURPOSE: The value of psoriatic plaques pretreatment with specific topical preparations in the setting of NB-ultraviolet-B (UVB) therapy is debatable. It may be clarified through a comparative assessment between crude coal tar and petrolatum as pretreatment candidates. METHODS: A prospective study included 40 patients with plaque psoriasis undergoing NB-UVB therapy. We compared among three treatment regimens: NB-UVB alone (control group; n=20) as well as NB-UVB preceded by crude coal tar 3% on one side and petrolatum on the other side (cases group I and II; n=20). Tar and petrolatum were topically applied thrice/day the day before NB-UVB exposure. Applications were removed using olive oil directly before NB-UVB exposure. Regimens' frequency was thrice/week and the clinical outcome was assessed, through both psoriasis area and severity index (PASI) and physician global assessment (PGA) scores, at baseline and 3 months later. RESULTS: There were significant (P<0.01) decreases in both PASI and PGA scores in all the groups. In comparison with the controls, cases revealed significantly (P<0.05) higher improvement percentages in both PASI and PGA scores for both tar and petrolatum. This influence, through the PGA score, was significantly (P<0.05) in favor of petrolatum. CONCLUSION: The pretreatment of psoriatic plaques with either petrolatum or crude coal tar may enhance the therapeutic outcome of NB-UVB, which appeared to favor petrolatum.