The usefulness of routinely used malnutrition screening tools in predicting anemia in lung cancer patients.

BACKGROUND: Anemia and malnutrition are frequently observed during lung cancer development, and the associations between them have been researched. However, no study concerning the utility of routinely used nutritional screening tools in predicting anemia in lung cancer has been performed. OBJECTIVES: The aim of this study was to assess the usefulness of routinely used malnutrition screening tools in predicting anemia in lung cancer patients. MATERIAL AND METHODS: Eighty-five male patients were recruited to this study. Blood counts, serum iron concentration, total iron binding capacity (TIBC) and serum transferrin saturation (STS), measurements of selected anthropometric parameters, Mini Nutritional Assessment (MNA) and Glasgow Prognostic Score (GPS) were performed for the subjects. To evaluate the differences in the distribution of hematological and iron status parameters according to nutritional status, a t-test (Mann-Whitney U test for non-parametric data) and an analysis of variance (ANOVA) were performed. Tukey's post hoc test was performed for intergroup comparison of parametric data. The sensitivity, specificity, positive and negative predictive values of MNA and GPS were compared to blood counts and biochemical parameters of iron status. RESULTS: Using the MNA test, we observed that ca. 60% of subjects had deteriorated nutritional status. About half of the patients had inflammation cumulated with malnutrition. A similar part of the subjects had anemia. The MNA test showed a significant difference in the distribution of Hb and Htc, while GPS showed the distribution of Fe and TIBC among lung cancer patients. We did not observe any influence of fat-free mass index (FFMI) on hematological and iron status parameters. The MNA test had very high specificity and positive predictive values (PPV) for all the hematological parameters evaluated as well as GPS for serum Fe concentration and TIBC. CONCLUSIONS: Our data demonstrates that an evaluation of nutritional status with the MNA test can provide additional predictive information regarding anemia, while GPS may do the same with type of anemia in lung cancer patients.

Total antioxidant status in lung cancer is associated with levels of endogenous antioxidants and disease stage rather than lifestyle factors - preliminary study.

AIM OF THE STUDY: Decreased total antioxidant capacity (TAC) has been reported in different neoplasms, including lung cancer. However, no study concerning the relationship between endogenous antioxidants, lifestyle factors, and TAC has been conducted among lung cancer patients. The purpose of the study was to investigate the associations between endogenous antioxidants, severity of disease, lifestyle factors, and TAC in lung cancer patients. MATERIAL AND METHODS: The study was conducted among 59 lung cancer patients. The levels of total antioxidant status (ATBS method), endogenous antioxidants, and C-reactive protein were measured in patients' sera automatically. Dietary habits of the subjects were evaluated based on the Food Frequency Questionnaire (FFQ) on the day of admission to hospital. RESULTS: We found a positive correlation between serum albumin, uric acid (UA), and TAC and a negative correlation between CRP and TAC. Moreover, TAC was significantly positively associated with disease stage. We did not find any significant relationship between the frequency of selected food consumption and TAC in lung cancer patients, except for a positive correlation between the frequency of refined cereal products consumption and TAC level. Smoking status did not correlate with TAC. CONCLUSIONS: Total antioxidant status of lung cancer patients results from their disease stage and levels of endogenous antioxidants rather than from lifestyle factors. The lack of influence of diet and smoking on the TAC presumably result from disturbed homeostasis in which cancer, while developing, could determine the redox state to a greater extent than lifestyle factors.

Dietary habits of lung cancer patients from the Lower Silesia region of Poland.

AIM OF THE STUDY: Assessment of lung cancer patients' dietary habits before treatment enable medical staff to provide more individual, precise and complex care to patients, taking into consideration their nutritional status. The aim of this study was, therefore, to evaluate dietary habits related to lung cancer risk of lung cancer patients in comparison with controls from the Lower Silesia region of Poland. MATERIAL AND METHODS: Assessments of dietary habits, based on a validated questionnaire related to lung cancer risk were performed on 92 lung cancer patients and compared with the results obtained in 157 controls. Dietary patterns were evaluated concerning on eating frequency of high- and low- glycemic index products, vegetables and fruits, vegetable and fruit juices, green tea, liquid dairy products, meat and fried products over the previous year. Alcohol consumption was assessed on a dichotomous scale (yes or no). RESULTS: Majority of patients had inappropriate dietary habits, such as low consumption of low GI cereal products, vegetables, fruit and green tea, and a high consumption frequency of fried products. CONCLUSIONS: Reported dietary mistakes indicate the need for dietary education among people at lung cancer risk and with newly diagnosed disease, to enhance their nutritional status.

Lung cancer in patients under the age of 40 years.

AIM OF THE STUDY: In the paper clinical cases of individuals diagnosed with lung cancer below the age of 40 years have been analyzed. MATERIAL AND METHODS: THE ANALYSIS INCLUDED: sex, age, clinical symptoms found before and at the moment of diagnosis, character of changes visible in radiological imaging, time that passed from the first symptoms to reporting to a doctor and to establishing a diagnosis, type of diagnostic method used in establishing the final diagnosis, histopathologic type of cancer, degree of cancer progression. RESULTS: The results have been compared with a peer group who had been diagnosed 20 years earlier. Currently 7% of patients were diagnosed at the age of 25 or younger, whereas in the previous cohort patients in this age constituted 2%. The predominant pathological type was adenocarcinoma (currently 33%, previously 4%) in contrast to the earlier group in which 57% of patients had small cell lung cancer (57%). The incidence is equally distributed between both sexes, although there is an evident increase in female lung cancer cases. In the majority of patients the clinical presentation is a peripheral mass on chest X-ray. 20% of patients present pleural effusion on diagnosis. Patients reported the following complaints: breathlessness, chest pain, weight loss and fatigue. The majority of cases were diagnosed in advanced stages on the basis of a bronchoscopy acquired specimen. Time course from symptoms to diagnosis tends to be shorter than 20 years ago.

Galectin-3 and cyclin D1 expression in non-small cell lung cancer.

INTRODUCTION: Lung cancer is a major cause of mortality and morbidity worldwide. Galectin-3 is multifunctional protein, which is involved in regulation of cell growth, cell adhesion, cell proliferation, angiogenesis and apoptosis. Cyclin D1 together with other cyclin plays an important role in cell cycle control. Cyclin D1 regulates the G1-to-S phase transition. The aim of this study was the evaluation of correlations between clinicopathological findings and cyclin D1 and galectin-3 expression in non-small cell lung cancer (NSCLC). We wanted also to analyze the prognostic value of cyclin D1 and galectin-3 expression. Moreover we tried to evaluate the correlations between galectin-3 and cyclin D1 expression in tumor tissue. MATERIALS AND METHODS: We used the immunochemistry method to investigate the expression of galectin-3 and cyclin D1 in the paraffin-embedded tumor tissue of 47 patients (32 men and 15 women; mean age 59.34 ± 8.90). years. We used monoclonal antibodies to cyclin D1 (NCL-L-cyclin D1-GM clone P2D11F11 NOVO CASTRA) and to galectin-3 (mouse monoclonal antibody NCL-GAL3 NOVO CASTRA). RESULTS: Galectin-3 expression was positive in 18 cases (38.29%) and cyclin D1 in 39 (82.97%). We showed only weak trend, that galectin-3 expression was lower in patients without lymph node involvement (p = 0.07) and cyclin D1 expression was higher in this group (p = 0.080). We didn't reveal differences in cyclin D1 and galectin-3 expression in SCC and adenocarcinoma patients. We didn't demonstrated also differences in galectin-3 and cyclin D1 expression depending on disease stage. Moreover we analyzed the prognostic value of cyclin D1 expression and galectin-3 in all examinated patients and separately in SCC and in adenocarcinoma and in all stages, but we didn't find any statistical differences. We demonstrated that in galectin-3 positive tumors cyclin D1 expression was higher (96.55% vs 61.11%, Chi2 Yatesa 7.53, p = 0.0061) and we revealed negative correlation between cyclin D1 and galectin-3 expression (R Spearman -0.458, p = 0.0011). In squamous cell lung cancer we didn't observed correlations between these both examinated markers (R = -0.158, p = 0.460), and in adenocarcinoma the negative correlation was very strong (R = -0.829 p = 0.000132). CONCLUSIONS: We didn't reveal any important correlations between clinicopathological findings and galectin-3 and cyclin D1 expression and in non small cell lung cancer. We didn't observed also prognostic value of cyclin D1 or galectin-3 expression. But we showed higher cyclin D1 expression in galectin-3 negative tumor tissues. We revealed also differences in correlations between galectin-3 and cyclin D1 expression in two main histopathological types of NSCLC.

[Assessment of sociodemographic and nutritional status of lung cancer patients]. / Ocena statusu socjodemograficznego i stanu odzywienia chorych z rakiem pluca.

Low sociodemographic status positively correlates with the risk of lung cancer. Nutritional status assessed during diagnosis of cancer may be a useful predictive factor for response to therapy and influences the quality of life and life expectancy after oncological therapy. The aim of this study was to assess the sociodemographic and nutritional status of patients. Lower Silesian Centre of Lung Diseases, diagnosed with lung cancer. 81 cases and 125 subjects formed the control group were included in this study. The questionnaire about sociodemographic status was performed among all respondents as well as MNA questionnaire and anthropometric measurements for evaluating nutritional status. Lower level of education, lower employment status and more frequent tobacco addiction was found in patient group then in control individuals. Nutritional status of patients was worse than the control group, which has been demonstrated mainly through a MNA questionnaire and arm circumference measurements. The risk of malnutrition or diagnosed malnutrition found in most patients assessed by MNA test may increase the likelihood of complications during treatment.

[Nutritional knowlegde and lifestyle of obese patients with diagnosed obturative sleep apnea]. / Wiedza zywieniowa oraz wybrane elementy stylu zycia otylych osób z rozpoznanym obturacyjnym bezdechem w czasie snu.

The study was aimed, therefore, at evaluating the nutritional knowledge and selected elements of lifestyle of obese patients with diagnosed obstructive sleep apnea (OSA), treated at the Lower Silesia Center of Pulmonary Diseases in Wroclaw. Assessment of nutritional knowledge was conducted among 49 patients including 12 women and 37 men with diagnosed obstructive sleep apnea (OSA), treated at the Lower Silesia Center of Pulmonary Diseases in Wroclaw. The nutritional knowledge and selected elements of lifestyle were evaluated by means of own-construct, standardized questionnaire elaborated at the Chair of Human Nutrition, Wroclaw University of Life and Environmental Sciences. It included questions from different fields referring to, among others: knowledge on rational nutrition, type of physical activity, frequency of cigarette smoking, etc. Despite the demonstrated some knowledge of good nutrition, its use by patients with OSA in everyday life raises many objections. This could possibly result from the message is not binding on the correct nutrition to their own health. Found in the studied group of patients with OSA obesity and low physical activity, evidence of the need to integrate into the process of treatment of individual dietary counseling.

[Leptin serum levels in cachectic and non-cachectic lung cancer patients]. / Stezenie leptyny w surowicy krwi wyniszczonych i niewyniszczonych chorych na raka pluca.

INTRODUCTION: Leptin, protein taking part in body mass regulation, might play a role in cancer cachexia development. The aim of the study was to measure leptin serum levels in cachectic, non-cachectic lung cancer patients, healthy controls and to correlate leptin concentration with nutritional status markers. MATERIAL AND METHODS: 40 lung cancer patients were enrolled into the study: 20 with cachexia, 20 without cachexia, and 10 healthy controls. Leptin serum concentration, body mass, BMI, arm circumference and skin triceps fold thickness were measured in each subject. RESULTS: Serum leptin level in cachectic cancer patients was significantly lower than in non-cachectic and healthy controls. Leptin concentration correlated with body mass, arm circumference and skin triceps fold thickness. CONCLUSIONS: Cachectic lung cancer patients have significantly lower serum leptin concentrations than non-cachectic patients and healthy controls which may suggest, that leptin does not play an important role in cancer cachexia development. Leptin levels positively correlate with good nutritional status markers. Non-cachectic lung cancer patients have similar leptin serum levels as healthy controls.

[The incidence and pathogenesis of cancer anorexia-cachexia syndrome in lung cancer]. / Wystepowanie oraz patogeneza zespolu jadlowstretu i wyniszczenia nowotworowego w raku pluca.

The cachexia-anorexia syndrome (CACS) is common and important implication of cancer. It occurs in 30% to 80% cancer patients. At the time of diagnosis of lung cancer CACS is not yet very important problem, but the weight loss increases with progression of the cancer. CACS is characterized by anorexia, weight loss, weakness, impaired immune system and metabolic dysfunction. Weight loss is a potent stimulus to food intake in normal humans. The persistence of anorexia in cancer patients, therefore, implies a failure of this adaptive feeding response. The weight loss in patients with CACS differs from that in simple starvation or anorexia nervosa. Most research effort has focused on the role of cytokines as mediators of CACS. The role of TNF-alpha, IL-1 and IL-6 in CACS development has been evaluated and confirmed in many research, but some investigators suggest that the changes in cytokines' levels could be the result rather than the cause of CACS. A few of the latest studies concentrate on the role of nuclear factor kappa B and prevention of CACS by its inhibitors. CACS is an independent predictor of shorter survival and increases the risk of treatment failure and toxicity.

[Serum levels analysis of TGF-Beta and VEGF in patients with cancer anorexia-cachexia syndrome in lung cancer]. / Analiza stezen TGF-Beta I VEGf w surowicy u chorych z wyniszczeniem nowotworowym w przebiegu raka pluca.

UNLABELLED: The pathogenesis of cancer anorexia-cachexia syndrome (CACS) is very complicated. In development of this syndrome play a role: metabolism of glucose, tumor necrosis factor (TNF), interleukin 1, interleukin 6, interferon a, interferon y, the oncological treatment and many other factors. Vascular endothelial growth factor (VEGF) is the most important proangiogenic factor. It promotes new vessels development, enhances vascular permeability and recruits monocytes. Many factors play a role in regulation of VEGF level. One of the most important is transforming growth factor beta (TGF-beta). Vascular endothelial growth factor and TGF-beta play a role in inflammation reaction too. The aim of this study was the evaluation of correlation between VEGF and TGF-beta in CACS in lung cancer. MATERIAL AND METHOD: We measured the serum level of VEGF and TGF-beta in 40 patients with lung cancer (20 with and 20 without CACS) and in control group. The serum level was measured by ELISA method. RESULTS: The correlation between VEGF and TGF-beta was not statistically significant in patients with CACS (p = 0.67), but the statistical significance was in patients without CACS (p = 0.006) and in control group (p = 0.035). CONCLUSION: Results suggest, that VEGF regulation in CACS may be more complicated.

[VEGF in the cancer anorexia-cachexia syndrome in patients with lung cancer]. / VEGF w zespole jadlowstretu i wyniszczenia nowotworowego chorych na raka pluca.

Cancer anorexia-cachexia syndrome( CACS) occurs in 30-80% of patients with cancer. CACS is connected with poor prognosis and higher risk of treatment complications. CACS belongs to the common cause of death in cancer patients. Main role in the development of this syndrome play cytokines like TNF, interleukin 1 and 6 and interferon alpha and gamma. The importance of a lot of other substances is still unknown. VEGF promotes new vessels development,enhance vascular permeability and plays a role in inflammatory reaction. The aim of this study was comparison of VEGF levels in patients with lung cancer with and without CACS and in control group. The serum levels of VEGF were measured by ELISA method. The VEGF was significatly higher in patients with lung cancer then in control group (p = 0.004). There were no correlations between VEGF and weight lost, histological type and stage of disease. This suggest that VEGF doesnt play a role in development of CACS.

[Treatment of nicotine dependence based on bupropion SR and educational support--one year observation and analysis of the reasons of relapses]. / Leczenie uzaleznienia od nikotyny w oparciu o bupropion SR i program edukacyjny--obserwacja roczna i analiza przyczyn powrotu do nalogu.

Tobacco dependence is a chronic, relapsing disease causing an enormous burden of deaths. The aim of the study was a one year evaluation of the efficacy of bupropion SR supported by an educational program in the treatment of nicotine dependence and analysis of the reasons of relapses. 54 smokers were enrolled. The 12-month continuous abstinence rate was 28.3%. The most common cause of relapses in the treatment period was craving for cigarettes, in the post-treatment period stress.

[Smoking cessation program based on pharmacological support (bupropion SR). Our own experience]. / Intensywny program leczenia uzaleznienia od nikotyny oparty na stosowaniu bupropionu SR-doswiadczenia wlasne.

Smoking constitutes the gravest, yet avoidable, deadly threat to health in Poland. Near the end of the 90-ies it was discovered that the antidepressant -bupropion- has positive effects in the treatment of addiction to nicotine. The aim of the study was the evaluation of the efficacy of ambulatory, intensive smoking cessation program based on bupropion SR with educational support. 54 smokers (18 men and 36 women) were enrolled, age 22-59 yr. (mean 45.5 +/- 8.7), smoking 10-50 cigarettes daily. Early abstinence rate (7 weeks after quitting) was 61.1%, after 6 months 45.2% of the participants were still non-smokers. The most common adverse effects of bupropion SR therapy were mouth dryness and sleep disturbances, 13% of patients had to stop using bupropion because of side effects. High percentage of abstinence indicates that intensive smoking cessation programs should be used as a part of antinicotine strategy. The pharmacological support in the nicotine dependence treatment should be performed under careful physician supervision.

[Elastase and alpha-1 proteinase inhibitor complex in broncho-alveolar lavage fluid in patients with bronchial asthma and sarcoidosis]. / Kompleks elastazy i inhibitora alpha 1-proteinaz w materiale z plukania oskrzelowo-pecherzykowego u chorych na astme oskrzelowa i sarkoidoze.

Forty-three patients were enrolled into this study, twenty-eight with sarcoidosis in various radiological stages (I, II, III) and activity of disease (active or non-active) and fifteen with bronchial asthma. Elastase and alpha 1-proteinase inhibitor complex (E-alpha 1IP) concentrations and percentage of neutrophils in broncho-alveolar lavage fluid (BALF) were measured in all groups of patients. There were no significant differences in E-alpha 1IP levels in patients with various activity of sarcoidosis. We noticed significant differences between radiological stages of sarcoidosis. E-alpha 1IP concentration in the pulmonary stage was significantly higher than in stage I hilar adenopathy and stage II hilar adenopathy plus pulmonary opacities. E-alpha 1IP concentrations in BALF were significantly higher in patients with bronchial asthma in comparison to patients with sarcoidosis.

[Anticancer chemotherapy containing cisplatin in patients with lung cancer and kidney function]. / Chemioterapia przeciwnowotworowa zawierajaca cisplatyne u chorych na raka pluca a czynnosc nerek.

To carry out safe anticancer chemotherapy one should consider the kidney function. Insufficiency of that main organ responsible for drugs excretion, caused either by neoplastic disease or by chemotherapy, can diminish the possibility or even make impossible of carrying out a complete treatment cycle. The aim of our work was to evaluate the kidney function in patients with lung cancer during anticancer chemotherapy containing cisplatin. The tubular function was studied by estimation the activity of N-acetyl-beta-D-glucosaminidase in urine and glomerular function was studied by estimation the concentration of creatinine in urine, urea, uric acid and electrolytes in plasma. The observations have recorded that neoplastic process, as well as chemotherapy impaired the tubular function. It has showed that it does exist a necessity of detailed estimation of kidney excretory function before, during and after the end of anticancer therapy. Determination of NAG activity in urine may be helpful for the recognition of the patients at high nephrotoxicity risk, who need special care.

[Wegener's granulomatosis--a disease of many faces]. / Ziarniniakowatosc Wegenera, choroba o wielu obliczach.

We describe a case of Wegener's granulomatosis. The first symptoms included severe headache subsiding only after administration of dexamethasone. Despite a great number of diagnostic tests involving CT and MR of the head, the cause of the headache remained unknown. Because a chest x-ray revealed a nodule in the right lung, the patient was sent to our Clinic. Reevaluation of CT and MR pointed to a massive ethmoid sinusitis. 7-days' course of antibiotics and corticosteroids induced remission of the lung nodule. Several diagnoses were made: neoplasm, bacterial ethmoid sinusitis, trigeminal neuritis, thrombotic cavernous sinusitis and tuberculosis. Results of the ethmoid sinus biopsy together with a high c-ANCA concentration gave the correct diagnosis.

[Soluble interleukin 2 receptor (SIL-2R) in bronchoalveolar lavage fluid (BALF) of patients with sarcoidosis and atopic bronchial asthma]. / Rozpuszczalny receptor dla interleukiny 2 w popluczynach oskrzelowo--pecherzykowych (BALF) u chorych na sarkoidoze i astme oskrzelowa atopowa.

The aim of the study was assessment of sIL-2R in BALF in asthma and sarcoidosis patients. Forty three patients were enrolled in this study. Twenty eight with sarcoidosis (S) in different stages (I, II, III) and activity of disease: active (AS) or nonactive (NAS) and fifteen with atopic bronchial asthma (AO). BALF sIL-2R levels were measured in both groups. The level of sIL-2R was similar in sarcoidosis patients independently to activity of disease. Significantly lower level of sII-2R in BALF was observed in patients with AO in comparison to S, SII and NAS (p < 0.005). We didn't find significant differences in sIL-2R levels between AO and SI, SIII, AS.