[The intralymphatic administration of adoptive immunotherapy (LAK) in the treatment of patients with metastatic cancer and resistant to conventional therapies. Apropos 50 patients]. / Administración intralinfática de inmunoterapia adoptiva (LAK) en el tratamiento de enfermos de cáncer metastásico y resistentes a las terapéuticas convencionales. A propósito de 50 enfermos.

Between January 1990 to December 1993, we administered LAK immunotherapy using intralymphatic route to 50 patients with metastatic cancer resistant to conventional therapies. In the preparations of the immunotherapy, followed the technique described by Pizza G. et al. The age of our patients ranged between 50 to 75 years and their Karnosfsky's indexes were above 70%. The histological type of the metastasis was determined by cytology and the size by Rx, ECO and/or TAC before and after the administration of the immunotherapy. In the intralymphatic administration, we followed the technique described by Pizza G. et al. The immunological therapy was administrated on days 1, 21, 90 and 111 and the clinical responses were assessed by RC, RP, SD and F. The immunological behaviour of the host was assessed through the determination of lymphoid populations (CD2, CD3, CD4, CD5 and CD8) and natural killer cells were studied with monoclonal antibodies CD3 and CD16. Such immunological study was carried out before the administration of each immunotherapy series. In 12 out of 50 patients (24%), we were able to administer the four LAK series. Such patients were subsequently studied, observing that although tumoral lesions did not increase in size, they did not disappear and, thus, they were classified as clinical stables. Clinical and analytical toxicity were null. The immunological study showed changes in immunological parameters, however these changes were not statistically significant.

[A prospective study of thyroid nodules]. / Estudio prospectivo de los nódulos tiroideos.

OBJECTIVE: To evaluate a procedure for studying thyroid nodules (TN) by means of echography and puncture aspiration with a fine needle (PAFN) in order to select those patients best suited for surgery. DESIGN: Prospective and descriptive. SITE. The counties of Terra Alta, Baix Ebre and Montsià with TN referred for investigation to out-patient clinics of Internal Medicine at Tortosa hospital. PARTICIPANTS: 71 patients with TN were studied. MEASUREMENT AND MAIN RESULTS: Application of the procedure between 1990 and 1992. 94.4% of the TN were benign and 5.6% malignant. PAFN sensitivity was 50% and its specificity, 88%. 25% of the total number of patients underwent a surgical intervention. 22% of those patients operated on had a carcinoma. The concordance between the cytology of the surgical and non-surgical TN and their histology was 0.54 (Kappa Index). CONCLUSIONS: Applying the procedure allowed patients with malignant or suspect nodules to be selected for surgical intervention, leading to a considerable reduction in surgical morbidity and expenditure.