Cirugía incompleta del carcinoma adenoide quístico bronquial: una alternativa terapéutica / Incomplete surgery for bronchial cystic adenoid carcinoma: A therapeutic alternative

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Valor pronóstico de la expresión del factor de crecimiento endotelial vascular A y del factor inducible por la hipoxia 1α en pacientes operados de cáncer de pulmón no microcítico / Prognostic value of the expression of vascular endothelial growth factor A and hypoxia-inducible factor 1alpha in patients undergoing surgery for non-small cell lung cancer

Fundamento y objetivo: Estudios recientes evidencian que la expresión del hypoxia-inducible factor 1α (HIF-1α, «factor inducible por la hipoxia 1α») favorece la expresión del vascular endothelial growth factor A (VEGF-A, «factor de crecimiento endotelial vascular A»), así como la proliferación celular, angiogénesis y metástasis en diferentes cánceres, incluido el cáncer de pulmón. El objetivo de este estudio fue investigar la correlación de la expresión del VEGF-A y del HIF-1α con las características clinicopatológicas y el pronóstico de pacientes operados por cáncer de pulmón no microcítico. Pacientes y método: Estudio prospectivo para analizar la expresión de VEGF-A y HIF-1α mediante reacción en cadena de la polimerasa en tiempo real en 66 pacientes operados de cáncer de pulmón no microcítico. Resultados: La edad media (DE) fue de 62,7 (9,8) años y la relación varón:mujer de 7,3:1. Según la nueva clasificación TNM de 2009, los estadios i , ii y iii incluyeron a 27 (40,9%), 21 (31,8%) y 18 (27,3%) pacientes, respectivamente. La histología fue: 47% carcinomas escamosos, 33,3% adenocarcinomas y 19,7% otros. El seguimiento medio fue de 42,3 meses, la mediana de supervivencia de 43,2 meses y la supervivencia estimada a los 5 años del 42,4%. No hubo correlación entre VEGF-A y HIF-1α (p = 0,306). La sobreexpresión de VEGF-A fue más frecuente en el estadio avanzado y cuando hubo metástasis ganglionares (p = 0,034 y p = 0,059, respectivamente). En el análisis multivariante, el descriptor T y el VEGF-A fueron factores pronóstico independientes (odds ratio [OR] 2,37, p = 0,016, y OR 2,51, p = 0,008, respectivamente), mientras que HIF-1α no mostró significación estadística (p = 0,172), con una OR 0,540. Conclusiones: La sobreexpresión de VEGF-A resultó ser un factor pronóstico independiente adverso en pacientes intervenidos de cáncer de pulmón no microcítico. Por el contrario, la sobreexpresión del HIF-1α mostró una tendencia hacia un efecto protector sobre la supervivencia, pero sin significación estadística (AU)

Background and objective Studies suggest that hypoxia-inducible factor 1α (HIF-1α) expression favours expression of vascular endothelial growth factor A (VEGF-A) involving cellular proliferation, angiogenesis, and metastasis in different cancers including lung cancer. We investigated the correlation of HIF-1α and VEGF-A with clinicopathologic parameters and clinical outcomes in surgically resected non-small cell lung cancer patients. Patients and method Prospective study to analyze the expression of VEGF-A and HIF-1α with real time-polymerase chain reaction in 66 patients operated on non-small cell lung cancer. Results Mean age was 62.7 ± 9.8 and male:female ratio was 7.3:1. According to the new 2009 TNM classification, stage i , ii , and iii included 27 (40.9%), 21 (31.8%) and 18 (27.3%) patients, respectively. Histological subtypes were: 47% squamous cell carcinoma, 33.3% adenocarcinoma, and 19.7% others. Mean follow-up time was 42.3 months. Median survival was 43.2 months and 5-year overall survival was 42.4%. There was no correlation between HIF-1α and VEGF-A (P = .306). The overexpression of VEGF-A was found more frequent in advanced stage and in lymph nodes metastasis (P = .034 and P = .059, respectively). In multivariate analysis, T descriptor and VEGF-A overexpression were independent prognostic factors (odds ratio [OR] = 2.37, P = .016, and OR = 2.51, P = .008, respectively). HIF-1α overexpression showed an OR = 0.540, but without statistical significance (P = .172). Conclusions The present study revealed that VEGF-A overexpression was an adverse independent prognostic factor. On the contrary, HIF-1α overexpression showed a tendency to a protective effect on survival of surgically treated non-small cell lung cancer patients, although without statistical significance (AU)

Analysis of Expression of Vascular Endothelial Growth Factor A and Hypoxia Inducible Factor-1alpha in Patients Operated on Stage I Non-Small-Cell Lung Cancer.

Objectives. Recent studies show that expression of hypoxia inducible factor-1alpha (HIF-1α) favours expression of vascular endothelial growth factor A (VEGF-A), and these biomarkers are linked to cellular proliferation, angiogenesis, and metastasis in different cancers. We analyze expression of HIF-1α and VEGF-A to clinicopathologic features and survival of patients operated on stage I non-small-cell lung cancer. Methodology. Prospective study of 52 patients operated on with stage I. Expression of VEGF-A and HIF-1α was performed through real-time quantitative polymerase chain reaction (qRT-PCR). Results. Mean age was 64.7 and 86.5% of patients were male. Stage IA represented 23.1% and stage IB 76.9%. Histology classification was 42.3% adenocarcinoma, 34.6% squamous cell carcinoma, and 23.1% others. Median survival was 81.0 months and 5-year survival 67.2%. There was correlation between HIF-1α and VEGF-A (P = 0.016). Patients with overexpression of HIF-1α had a tendency to better survival with marginal statistical significance (P = 0.062). Patients with overexpression of VEGF-A had worse survival, but not statistically significant (P = 0.133). Conclusion. The present study revealed that VEGF-A showed correlation with HIF-1α. HIF-1α had a tendency to protective effect with a P value close to statistical significance. VEGF-A showed a contrary effect but without statistical significance.

[Prognostic value of the expression of vascular endothelial growth factor A and hypoxia-inducible factor 1alpha in patients undergoing surgery for non-small cell lung cancer]. / Valor pronóstico de la expresión del factor de crecimiento endotelial vascular A y del factor inducible por la hipoxia 1α en pacientes operados de cáncer de pulmón no microcítico.

BACKGROUND AND OBJECTIVE: Studies suggest that hypoxia-inducible factor 1α (HIF-1α) expression favours expression of vascular endothelial growth factor A (VEGF-A) involving cellular proliferation, angiogenesis, and metastasis in different cancers including lung cancer. We investigated the correlation of HIF-1α and VEGF-A with clinicopathologic parameters and clinical outcomes in surgically resected non-small cell lung cancer patients. PATIENTS AND METHOD: Prospective study to analyze the expression of VEGF-A and HIF-1α with real time-polymerase chain reaction in 66 patients operated on non-small cell lung cancer. RESULTS: Mean age was 62.7±9.8 and male:female ratio was 7.3:1. According to the new 2009 TNM classification, stage i, ii, and iii included 27 (40.9%), 21 (31.8%) and 18 (27.3%) patients, respectively. Histological subtypes were: 47% squamous cell carcinoma, 33.3% adenocarcinoma, and 19.7% others. Mean follow-up time was 42.3 months. Median survival was 43.2 months and 5-year overall survival was 42.4%. There was no correlation between HIF-1α and VEGF-A (P=.306). The overexpression of VEGF-A was found more frequent in advanced stage and in lymph nodes metastasis (P=.034 and P=.059, respectively). In multivariate analysis, T descriptor and VEGF-A overexpression were independent prognostic factors (odds ratio [OR]=2.37, P=.016, and OR=2.51, P=.008, respectively). HIF-1α overexpression showed an OR=0.540, but without statistical significance (P=.172). CONCLUSIONS: The present study revealed that VEGF-A overexpression was an adverse independent prognostic factor. On the contrary, HIF-1α overexpression showed a tendency to a protective effect on survival of surgically treated non-small cell lung cancer patients, although without statistical significance.

The Spanish Society of Pulmonology and Thoracic Surgery Lung Cancer Cooperative Group-II registry. A descriptive study.

INTRODUCTION AND OBJECTIVES: The seventh edition of the TNM classification, together with undeniable advantages, has limitations. The International Association for the Study of Lung Cancer (IASLC) Staging Committee has designed an international prospective study to improve this classification. A group of thoracic surgeons and pulmonologists was established in the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) Oncology area, and created a registry of new lung cancer (LC) cases to participate in this project. The aim of this paper is to describe the main characteristics of the patients included. MATERIALS AND METHODS: Prospective, observational, multicentre, multiregional data collection (epidemiological, clinical, therapeutic and, especially, anatomical extension) study, according to the IASLC protocol, to analyse its prognostic value. RESULTS: Two thousand, four hundred and nineteen patients (83.6% men) from 28 hospitals were included. Ninety-six percent of the men and 54% of the women were smokers or ex-smokers. Chest/abdominal computed tomography (CT) scanning was performed in over 90% and positron emission tomography (PET)/CT scanning in 51.5% of cases. Among the 1035 patients who underwent surgery, 77% had early stages (ia to iib), and 61.6% of those treated using other methods had stage iv. Respiratory comorbidity was higher in men (47.9% versus 21.4%). The most common histological subtype was adenocarcinoma (34%), especially in non-smoking women (69.5%). CONCLUSIONS: The proportion of women and adenocarcinomas, as well as those resected at an early stage, increased among LC cases in Spain.

Elastofibroma dorsi bilateral: una muy rara presentación para una rara patología / Bilateral Elastofibroma Dorsi: a Very Rare Presentation for a Rare Pathology

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Condroma costal de la primera costilla. Abordaje transclavicular con reconstrucción de la clavícula / Chondroma of the first rib. Transclavicular approach with clavicle reconstruction

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Amiloidosis nodular pulmonar / Pulmonary nodular amyloidosis

La amiloidosis es una enfermedad sistémica originada por la acumulación extracelular de material amiloide en distintas partes del organismo. La afectación pulmonar es infrecuente y su presentación en forma nodular, extremadamente rara. Presentamos el caso de un varón de 72 años con enfermedad pulmonar obstructiva crónica en el que se descubrió, en un control radiológico rutinario, un nódulo pulmonar de 3 cm de diámetro. Tras la realización de diferentes pruebas complementarias sin poder filiar su etiología, se realizó una exéresis quirúrgica, y en el estudio histopatológico posterior se demostró la presencia de material amiloide y en el microscopio de luz polarizada, una birrefringencia verde con rojo-Congo característica (AU)

Amyloidosis is a systemic disease caused by extracellular accumulation of amyloid in different parts of the body. Pulmonary involvement is infrequent and nodular amyloidosis is extremely rare. We present the case of a 72-year-old man with chronic obstructive pulmonary disease in whom a 3-cm pulmonary nodule was discovered during routine radiological follow-up. After various complementary investigations failed to identify the etiology of the nodule, surgical excision was performed. Subsequent histopathological study revealed the presence of amyloid deposits with characteristic apple-green birefringence when stained with Congo-red under polarized light microscopy (AU)

[Bilateral Chylothorax after delivery: an infrequent case treated with videothoracoscopic talc pleurodesis]. / Quilotórax bilateral posparto: un caso infrecuente resuelto mediante pleurodesis con talco por videotoracoscopia.

Bilateral chylothorax after delivery is a highly infrequent entity. We present the case of a 28-year-old woman who developed progressive dyspnea due to bilateral milky pleural effusion several months after delivery. The effusion was found to contain chylomicrons in the biochemical analysis. Initial conservative treatment failed twice and the chylothorax was successfully treated through sequential bilateral videothoracoscopy with an interval of 6 days between the two interventions and pleurodesis with spray talc.