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1.
Medicine (Baltimore) ; 99(5): e18968, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000424

RESUMO

BACKGROUND: Lung cancer is one of the most common cancers worldwide, and approximately half of the patients with lung cancer receiving chemotherapy suffer from cancer-related fatigue (CRF). Herbal medicines (HMs) have been used in Oriental countries for centuries as tonics. Various beneficial effects of HM on fatigue and cancer have been reported. However, the effectiveness and safety of HM for CRF in lung cancer patients have not been synthesized. The purpose of this systematic review is to evaluate the effectiveness and safety of HM for CRF in patients with lung cancer, regardless of their cancer type or stage. METHODS AND ANALYSIS: A comprehensive search will be conducted in 12 electronic medical databases including 5 English-language databases (Medline via PubMed, EMBASE via Elsevier, the Cochrane Central Register of Controlled Trials [CENTRAL], the Allied and Complementary Medicine Database [AMED] via EBSCO, and the Cumulative Index to Nursing and Allied Health Literature [CINAHL] via EBSCO), 4 Korean-language databases (Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Research Information Service System [RISS], and Korea Citation Index [KCI]), 2 Chinese-language databases (China National Knowledge Infrastructure [CNKI] and Wanfang Data), and 1 Japanese-language database (CiNii). Only randomized controlled trials (RCTs) and quasi-RCTs on HM for CRF will be allowed. The severity of fatigue assessed using a validated tool will be considered as theprimary outcome. The secondary outcomes will include the patients' quality of life, activities of daily life, incidence of adverse events, and total effective rate. Two independent researchers will perform the study selection, data extraction, and quality assessment. RevMan version 5.3 will be used for data synthesis. The methodological quality of the included RCTs will be assessed using the Cochrane Collaboration's risk of bias tool. In the meta-analysis, for dichotomous data and continuous data, risk ratio and mean difference, respectively, will be estimated with their 95% confidence intervals. According to the heterogeneity, either a fixed-effects or a random-effects model will be used. ETHICS AND DISSEMINATION: Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentation. PROSPERO REGISTRATION NUMBER: CRD42019141660.


Assuntos
Sobreviventes de Câncer , Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/tratamento farmacológico , Fadiga/etiologia , Medicina Herbária/métodos , Neoplasias Pulmonares/complicações , Medicina Tradicional do Leste Asiático/métodos , Revisão Sistemática como Assunto , Humanos , Projetos de Pesquisa
3.
World Neurosurg ; 133: 256-259, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31629135

RESUMO

BACKGROUND: Endovascular embolization of the middle meningeal artery (MMA) is effective for recurrent chronic subdural hematoma (CSDH). CSDH associated with dural metastasis is generally refractory to burr hole surgery and has poor prognosis even if any interventions are applied. To the best of our knowledge, this study is the first to report a case of refractory CSDH associated with dural metastasis that was successfully treated with embolization of the MMA. CASE DESCRIPTION: A 66-year-old man with a 1-year history of lung adenocarcinoma had also undergone whole-brain irradiation for multiple brain metastases 5 months before presentation, surgical removal of relapse of brain metastases 3 months prior, and stereotactic radiotherapy for the relapses 1 month prior. He was admitted to our institution with speech disturbance, severe headache, and right-sided motor weakness. Head computed tomography on admission revealed left-sided CSDH, and emergency burr hole irrigation surgery was performed. However, CSDH recurred twice in a short period after hospitalization. Histological examination revealed adenocarcinoma cells in the dura mater and in hematoma samples during the first surgery; therefore, the patient was diagnosed with refractory CSDH associated with dural metastasis of lung adenocarcinoma. We performed endovascular embolization of the MMA, followed by systemic chemotherapy at 1 month after embolization, and no recurrence of the CSDH was observed. CONCLUSIONS: Embolization of the MMA has few surgical risks and could be a treatment option for refractory CSDH associated with dural metastasis because it might prolong the therapeutic time window until radical therapies are administered.


Assuntos
Adenocarcinoma de Pulmão/secundário , Dura-Máter/patologia , Embolização Terapêutica/métodos , Hematoma Subdural Crônico/terapia , Neoplasias Pulmonares/patologia , Artérias Meníngeas , Neoplasias Meníngeas/secundário , Adenocarcinoma de Pulmão/complicações , Idoso , Hematoma Subdural Crônico/complicações , Humanos , Neoplasias Pulmonares/complicações , Masculino , Neoplasias Meníngeas/complicações , Resultado do Tratamento
4.
J Oncol Pharm Pract ; 26(1): 209-211, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30791855

RESUMO

Opsoclonus-myoclonus syndrome is a rare disease and traditionally described as "dancing eyes, dancing feet syndrome." It is characterized by opsoclonus (oscillations of the eyes in either horizontally or vertically) and myoclonus (spontaneous jerky movements of the limbs and trunk). There are numerous etiological factors defined such as paraneoplastic, para-infectious, toxic-metabolic, and idiopathic causes. The experience of opsoclonus-myoclonus syndrome in adults is very limited. Here, we present a case of treatment-refractory paraneoplastic opsoclonus-myoclonus syndrome associated with small-cell carcinoma of the lung.


Assuntos
Neoplasias Pulmonares/complicações , Síndrome de Opsoclonia-Mioclonia/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/complicações , Humanos , Masculino , Pessoa de Meia-Idade
5.
Int J Radiat Oncol Biol Phys ; 106(1): 100-107, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31627177

RESUMO

PURPOSE: In patients with non-small cell lung cancer (NSCLC), concurrent chemoradiation therapy (CRT) exacerbates a cluster of difficult-to-manage symptoms, especially cancer-related fatigue. Minocycline is a readily available, low-cost antibiotic with antiinflammatory properties. We conducted a phase 2 randomized, double-blinded, placebo-controlled trial to investigate the effect of minocycline in reducing CRT-symptom burden in NSCLC. METHODS AND MATERIALS: Patients with NSCLC scheduled to receive CRT provided consent and were randomized to receive either minocycline (100 mg twice daily) or a matching placebo during 6 to 7 weeks of CRT. Patient-reported fatigue and other symptoms were assessed on MD Anderson Symptom Inventory weekly from the start of CRT for 12 weeks. The primary outcome was 12-week (±2 days) area under the curve for symptom burden, which was compared between treatment groups. RESULTS: Forty of 49 enrolled patients (80%) were evaluable (19 on minocycline and 21 on placebo). There were no grade 3 + adverse events related to the study medication. Fatigue was significantly reduced in the minocycline group compared with placebo group during the 12-week trial period (area under the curve = 31.2 ± 14.2 vs 45.0 ± 20.9, P = .011), with a large effect size (Cohen's d = 0.77). Pain (Cohen's d = 0.54) and shortness of breath (Cohen's d = 0.55) were also significantly reduced in the minocycline group (all P < .05). CONCLUSIONS: Minocycline during CRT for NSCLC was feasible, had a low toxicity profile, and yielded a clinically and statistically significant positive signal in reducing symptom burden related to NSCLC and CRT. This study is a proof of concept so a larger trial in CRT patients is warranted.


Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Quimiorradioterapia/efeitos adversos , Fadiga/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Minociclina/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Carcinoma Pulmonar de Células não Pequenas/complicações , Método Duplo-Cego , Dispneia/tratamento farmacológico , Fadiga/etiologia , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Estudo de Prova de Conceito , Estudos Prospectivos , Qualidade de Vida
7.
Medicine (Baltimore) ; 98(50): e18316, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852116

RESUMO

To describe the characteristics of concomitant lung cancer and pulmonary cryptococcosis (PC) cases.A total of 8 patients with lung cancer and coexisting PC, who were admitted to Fuzhou Pulmonary Hospital of Fujian from 1st January 2009 to 31st December 2015 and whose diagnoses were confirmed by pathological examinations, were studied.One patient had a history of diabetes mellitus and 1 had a history of treated with surgery. The lesions in 7 cases manifested as nodular shadows; only 1 case showed the lesion of the 2 diseases mergedmixed together, and it manifested as a large flake-like infiltrated shadow in the same lobe. The histological type in all of the patients was lung adenocarcinoma. Lung cancer stage was advanced (III-IV) in 25.0% of the cases. The 5 patients who received surgery and drug treatment are presently healthy following resection. Recurrence and metastasis of lung cancer following surgery occurred in 2 patients in whom the tumor was controlled again after anti-tumor treatment. One patient with advanced lung cancer and PC was treated with antifungal therapy in combination with antineoplastic chemotherapy, but she failed to improve and died 10 months after symptom onset during the follow-up period.PC coexisting with pulmonary carcinoma is rare. PC can manifest as pulmonary nodules and mimic malignant lesions, so it must be considered during a differential diagnosis of pulmonary nodules, especially in immunosuppressed patients.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Criptococose/diagnóstico , Biópsia Guiada por Imagem/métodos , Pneumopatias Fúngicas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Adenocarcinoma de Pulmão/complicações , Adenocarcinoma de Pulmão/cirurgia , Adulto , Idoso , Criptococose/complicações , Criptococose/cirurgia , Feminino , Seguimentos , Humanos , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/cirurgia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Pneumonectomia/métodos , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X
9.
Medicina (B Aires) ; 79(5): 411-414, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31671395

RESUMO

Hyperthyroidism is a relatively frequent condition with multiple causes. The most common cause is Graves' disease; followed by hyperthyroid multinodular goiter and toxic adenoma. Association between hyperthyroidism and cancer is infrequent in daily practice. We present the case of a 42-year-old man who developed severe symptoms of hyperthyroidism within a period of two months. Physical examination revealed significant hepatomegaly. Testicular examination proved normal. Imaging studies showed the presence of multiple hepatic solid lesions consistent with metastases. After discarding the most common causes of hyperthyroidism and primary thyroid gland neoplasm, the possibility of molecular mimicry was considered through human chorionic gonadotrophin production. Critical high values of this hormone were found and choriocarcinoma histological diagnosis was confirmed through a liver biopsy. We consider that the recognition of this rare mechanism of hyperthyroidism may be a clue permitting a faster diagnosis, particularly when extragonadal tumors are present.


Assuntos
Coriocarcinoma não Gestacional/complicações , Hipertireoidismo/etiologia , Adulto , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Coriocarcinoma não Gestacional/patologia , Gonadotropina Coriônica/sangue , Evolução Fatal , Humanos , Hipertireoidismo/patologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Masculino , Tireotropina/sangue , Tomografia Computadorizada por Raios X
10.
Medicine (Baltimore) ; 98(44): e17717, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689808

RESUMO

BACKGROUND: Cancer-related fatigue (CRF) is a major symptom experienced by lung cancer patients receiving chemotherapy and radiation therapy. Since CRF has a multidimensional influence on cancer patients, they may experience physical weakening, a decline in cognitive function, and depression from emotional consequences. Kyung-Ok-Ko is used for improving fatigue or weak physical constitution. It is known to be effective in immune activation, reducing fatigue, and enhancing cognitive function. Although Kyung-Ok-Ko is clinically used for the treatment of CRF, its efficacy and safety against CRF in lung cancer patients are yet to be studied. Therefore, we aimed to investigate the efficacy and safety of Kyung-Ok-Ko. METHODS: This is a randomized, placebo-controlled, patients-assessor blind, parallel-group, single-center clinical trial. Lung cancer patients with CRF, after termination of chemo or radiation therapies, are randomized in a 1:1 ratio to receive either Kyung-Ok-Ko or placebo for 6 weeks. The primary outcome is Brief Fatigue Inventory (BFI). The secondary outcomes include Visual Analog Fatigue Scale (VAFS), Functional Assessment of Cancer Therapy (FACIT) Fatigue scale, Hospital Anxiety Depression Scale (HADS), Montreal Cognitive Assessment Korean version (MoCA-K), and Korean pattern identification questionnaire. Adverse events are evaluated by Common Terminology Criteria for Adverse Events (CTCAE). All outcomes and adverse events are assessed at the baseline, mid-treatment, post-treatment, and at 1-month follow-up. DISCUSSION: This study investigates whether Kyung-Ok-Ko can alleviate CRF in lung cancer patients. The results of this study will provide clinical evidence for the application of Kyung-Ok-Ko in the treatment of CRF in lung cancer patients. TRIAL REGISTRATION: Korean Clinical Trial Registry (http://cris.nih.go.kr; registration number: KCT000666).Trial status: Currently, participant recruitment is ongoing.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/tratamento farmacológico , Neoplasias Pulmonares/complicações , Adulto , Fadiga/etiologia , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
11.
Medicine (Baltimore) ; 98(48): e18158, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770259

RESUMO

RATIONALE: Acute myocardial infarction is usually caused by coronary atherosclerotic plaque disruption (rupture or erosion), also including other uncommon etiologies. Pulmonary epithelioid hemangioendothelioma (PEH) is a rare low to intermediate malignant vascular tumor originating from vascular endothelial cells. Here, we report a rare case of acute ST-segment elevation myocardial infarction (STEMI) due to extrinsic compression of left coronary artery from PEH. PATIENT CONCERNS: A 63-year-old woman with pulmonary nodules received left pulmonary nodulectomy, and the pathological examination indicated PEH. Five months after the pulmonary nodulectomy, the patient was admitted due to progressive dyspnea. DIAGNOSIS: Electrocardiography showed the obvious ST-segment elevation in the leads I, aVL, and V1-3, and laboratory tests revealed the elevated level of cardiac troponin T. Emergent coronary angiography and the contrast-enhanced computed tomography scan conformed STEMI due to extrinsic compression of left coronary artery from PEH. INTERVENTIONS: The patient did not undergo further therapy after the pulmonary nodulectomy. During the present hospitalization, she received basic life support and nutritional support treatment. OUTCOMES: The patient deteriorated rapidly into multi-organ failure and eventually died. LESSONS: Acute STEMI could be caused by extrinsic compression of the coronary artery from the mass effects of PEH, and active therapy and close follow-up should be considered for patients with PEH.


Assuntos
Vasos Coronários/diagnóstico por imagem , Hemangioendotelioma Epitelioide , Neoplasias Pulmonares , Infarto do Miocárdio com Supradesnível do Segmento ST , Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/fisiopatologia , Síndromes Compartimentais/terapia , Angiografia Coronária/métodos , Eletrocardiografia/métodos , Evolução Fatal , Feminino , Hemangioendotelioma Epitelioide/complicações , Hemangioendotelioma Epitelioide/patologia , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/terapia , Cuidados Paliativos/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/etiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia
13.
BMC Complement Altern Med ; 19(1): 267, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615487

RESUMO

BACKGROUND: Cancer cachexia is a cancer-induced multifactorial debilitating syndrome directly accounting for 20% of cancer deaths without effective therapeutic approaches. It is extremely urgent to explore effective anti-cachexia drugs to ameliorate muscle and fat loss in cachexia patients. METHODS: Lewis lung carcinoma bearing C57BL/6 mice were applied as the animal model to examine the therapeutic effect of Coix seed oil (CSO) on cancer cachexia. The food intake and body weight change were monitored every 3 days throughout the experiment. The IL-6 and TNF-α levels in serum were detected by ELISA assay. Several key proteins involved in muscle wasting and fat lipolysis were tested by Western blot to identify the potential mechanism of CSO. RESULTS: Administration of CSO through gavage significantly prevented body weight loss and ameliorated systemic inflammation without affecting food intake and tumor size. The weight and histological morphology of gastrocnemius muscle and epididymal adipose tissue in CSO-treated mice were also improved. In mechanism, we found that CSO decreased the expression of MuRF1 and the ratio of phospho-p65 (Ser536) to p65 in muscle tissue. Meanwhile, cancer-induced activation of HSL and AMPK was also inhibited by CSO administration. CONCLUSION: Coix seed oil exerts an anti-cachexia pharmaceutical effect by counteracting muscle and adipose tissue loss most likely through regulating NF-κB-MuRF1 and AMPK-HSL pathway.


Assuntos
Tecido Adiposo/metabolismo , Caquexia/tratamento farmacológico , Coix/química , Lipólise/efeitos dos fármacos , Neoplasias Pulmonares/complicações , Atrofia Muscular/tratamento farmacológico , Óleos Vegetais/administração & dosagem , Tecido Adiposo/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Caquexia/etiologia , Caquexia/metabolismo , Caquexia/fisiopatologia , Feminino , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Atrofia Muscular/etiologia , Atrofia Muscular/metabolismo , Atrofia Muscular/fisiopatologia , NF-kappa B/genética , NF-kappa B/metabolismo , Sementes/química
14.
Nutr. hosp ; 36(5): 1101-1108, sept.-oct. 2019. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-184633

RESUMO

Purpose: the main purpose of this study was to diagnose pre-sarcopenia in cancer patients who had lack of computed tomography (CT) abdominal images, with a newly discovered method based on cervical images. Material and methods: a sample of 37 patients with either lung cancer or a cancer that affected the upper digestive system underwent radiotherapy computed simulation which included measurements at C3 and L3 regions. Skeletal muscle mass (SMM) and skeletal muscle index (SMI) were determined by Hounsfield units and compared in both regions. Pre-sarcopenia was identified according to the cut-points currently established: ≤ 41 cm2/m2 in females, ≤ 43 cm2/m2 in males with a BMI ≤ 25 kg/m2, and ≤ 53 cm2/m2 in males with a BMI > 25 kg/m2. Results: the correlation of SMM and SMI between the C3 and L3 regions was R2 = 0.876 and R2 = 0.805, respectively. Moreover, there was a positive association (86.49%) in terms of the diagnosis of pre-sarcopenia according to both regions. In total, eleven pre-sarcopenic patients (29.37%) were identified; three of them being overweight (27.27%) and two of them being obese (18.18%). Conclusion: a single sectional cross at the level of C3 can be used for the diagnosis of pre-sarcopenia. This new method avoids unnecessary irradiation, saves hospital costs and detects malnutrition before starting radiotherapy treatment in cancer patients who have lack of CT abdominal imaging


Propósito: el propósito de este estudio fue diagnosticar la presarcopenia en pacientes con cáncer que no disponen de imágenes por tomografía computarizada (TC) a nivel abdominal mediante un método novedoso basado en cortes a nivel cervical. Material y métodos: se analizaron y se compararon mediante unidades la masa muscular y la masa muscular esquelética en 37 pacientes con cáncer de pulmón y neoplasias del aparato digestivo superior que incluían cortes en la TC de planificación a nivel de C3 y L3. La presarcopenia se identificó de acuerdo con los puntos de corte establecidos actualmente: ≤ 41 cm2/m2 para mujeres, ≤ 43 cm2/m2 en hombres con un IMC ≤ 25 kg/m2 y ≤ 53 cm2/m2 en hombres con IMC > 25 kg/m2. Resultados: la correlación de la masa muscular y el índice musculoesquelético entre las regiones C3 y L3 fue R2 = 0.876 y R2 = 0.805, respectivamente. Además, hubo una asociación positiva (86,49%) en términos del diagnóstico de presarcopenia según ambas regiones. En total, se identificaron once pacientes con presarcopenia (29,37%); tres de ellos con sobrepeso (27,27%) y dos con obesidad (18,18%). Conclusión: un solo corte transversal a nivel de la vértebra C3 puede diagnosticar la presarcopenia. Este nuevo método evita la irradiación innecesaria, ahorra costos hospitalarios y detecta la desnutrición antes de iniciar el tratamiento de radioterapia en pacientes con cáncer que no disponen de imágenes a nivel abdominal


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico por imagem , Sarcopenia/radioterapia , Estudos de Coortes , Projetos Piloto , Tomografia Computadorizada de Emissão , Estudos Retrospectivos , Força Muscular/fisiologia , Composição Corporal , Neoplasias Pulmonares/complicações
16.
Anticancer Res ; 39(9): 4603-4612, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519557

RESUMO

BACKGROUND/AIM: Sarcopenia describes the loss of skeletal muscle mass. While this condition is associated with a high mortality in cancer patients, its influence on survival is still underestimated. PATIENTS AND METHODS: A systematic review for articles was performed using the PubMed database, Cochrane Library, Biomed Central, Science Direct and by manual search. We used data of overall survival in sarcopenic patients for assessing the death risk. We extracted hazard ratio estimates from univariate and multivariate Cox proportional hazards models for meta-analysis. RESULTS: A total of 15 studies were eligible for meta-analysis including a total of 2,521 lung cancer patients. Univariate meta-analysis revealed a two-fold increased death risk in sarcopenic patients; multivariate meta-analysis yielded a significant, three-fold elevated risk of death. This higher mortality is independent of tumour stage. CONCLUSION: Muscle loss is an independent risk factor for increased death risk in lung cancer patients independent of cancer stage. This argues for implementing screening for sarcopenia into cancer care.


Assuntos
Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/mortalidade , Sarcopenia/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Músculo Esquelético/patologia , Estadiamento de Neoplasias , Tamanho do Órgão , Prognóstico , Modelos de Riscos Proporcionais , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
17.
Anticancer Res ; 39(9): 5219-5223, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519636

RESUMO

AIM: This study evaluated the prognostic value of soluble mesothelin-related protein (SMRP) levels in pleural effusions (PE) from patients with pleural mesothelioma (MPM). PATIENTS AND METHODS: SMRP level in PE was tested using an enzyme-linked immunosorbent assay (ELISA) in 109 patients with MPM at diagnosis before any treatment. The Kaplan-Meier method and the Cox regression were applied to compare overall survival probabilities across tertile categories of SMRP level. RESULTS: No significant differences in Kaplan-Meier overall survival probabilities among the SMRP categories were found. A statistically non-significant trend for increased death rate ratio (RR) was computed (p=0.327) when the higher (>46.5 nM, RR=1.38) and intermediate (8.5-46.5 nM, RR=1.18) SMRP categories were compared to the lower category (<8.5 nM, RR=1.00). Cox regression modelling including a restricted cubic spline showed a moderately rising non-linear trend in death rate. CONCLUSION: The SMRP level in PE does not appear to have prognostic significance and its detection is not recommended in routine clinical management of patients with MPM.


Assuntos
Proteínas Ligadas por GPI/metabolismo , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/mortalidade , Mesotelioma/complicações , Mesotelioma/mortalidade , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/metabolismo , Neoplasias Pleurais/complicações , Neoplasias Pleurais/mortalidade , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Masculino , Mesotelioma/diagnóstico , Mesotelioma/terapia , Pessoa de Meia-Idade , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/terapia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/terapia , Prognóstico , Curva ROC , Resultado do Tratamento
18.
Zhonghua Yi Xue Za Zhi ; 99(34): 2681-2686, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31505719

RESUMO

Objective: To investigate the phenomenon of small airway epithelial-mesenchymal transition (EMT) in patients with normal pulmonary function and chronic obstructive pulmonary disease (COPD) who received surgical treatment for lung tumors. Methods: In this study, 52 patients undergoing surgical treatment for lung tumors admitted to the General Hospital of Ningxia Medical University were included from January 2018 to January 2019. According to the preoperative pulmonary function and smoking history, patients were divided into group A (non-smoking with normal pulmonary function group, 15 patients), group B (smoking with normal pulmonary function group, 21 patients), group C (COPD stable phase group, 16 patients). HE staining was performed to observe the pathological changes in small airway and lung tissue. Immunohistochemistry was used to detect the localization and expression of E-cadherin, α-smooth muscle actin (α-SMA) and Vimentin in small airway. Western blot was used to detect the levels of E-cadherin, α-SMA and Vimentin. Results: (1) There were no significant differences in age, gender, and the ratio of disease composition among the three groups (P>0.05), but forced expiratory volume in one second (FEV(1)) as percentage of predicted value (FEV(1)%pred) and FEV(1)/forced vital capacity (FEV(1)/FVC) in group C were lower than those in groups A and B (all P<0.01), while there was no significant difference between group A and group B (P>0.05); (2) the bronchial wall thickness in group B and group C were higher than that of group A [(32.4±2.4) and (54.6±4.9) vs (22.4±2.2) µm], and group C was significantly higher than group B (P=0.003); (3) the expression levels of E-cadherin in the epithelial cells of small airway in group B and group C were lower than those in group A (0.021±0.008 and 0.018±0.007 vs 0.062±0.010) (all P<0.05), while the levels of mesenchymal cell markers such as α-SMA and Vimentin in group B and group C were higher than group A, and group C was higher than group B (α-SMA: 0.641±0.113, 0.780±0.133 vs 0.404±0.123; Vimentin: 0.064±0.033, 0.083±0.022 vs 0.030±0.021) (P=0.002 and P=0.003). Conclusion: In patients undergoing surgical treatment of lung tumors, there is EMT in the small airways of patients with COPD, and EMT has occurred in the small airways of smokers with normal pulmonary function.


Assuntos
Neoplasias Pulmonares , Doença Pulmonar Obstrutiva Crônica , Transição Epitelial-Mesenquimal , Humanos , Pulmão , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/cirurgia , Testes de Função Respiratória
19.
Zhonghua Yi Xue Za Zhi ; 99(34): 2696-2700, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31505722

RESUMO

Objective: To investigate the clinical features of lung natural killer (NK)/T cell lymphoma. Methods: The clinical data of patients with lung NK/T-cell lymphoma confirmed by pathology who were hospitalized due to lung shadow and initially treated as pneumonia from the First Affiliated Hospital of Zhengzhou University was collected from June 2013 to January 2019. The clinical manifestations, laboratory tests, chest CT findings, treatment procedures, outcomes, and misdiagnosis were retrospectively analyzed. Results: Among the 15 enrolled patients with lung NK/T-cell lymphoma, 5 were primary and the other 10 were secondary. There were 8 males and 7 females, aged 20-76 years. Fever presented in 14 cases, dyspnea was observed in 4 cases and 2 cases had cough. A total of 12 cases had leukopenia, 10 cases had mononuclear cell increase, 10 cases had liver dysfunction, 13 cases had elevated serum lactate dehydrogenase (LDH), and 2 cases of primary lung NK/T-cell lymphoma had increased pleural LDH and adenosine deaminase. Five cases of primary lung NK/T-cell lymphoma had multiple lung lesions, with diffuse multiple solid shadows, ground glass and patchy shadows, some with nodules; 10 cases of secondary lung NK/T-cell lymphoma showed nodular masses, some were accompanied by patchy shadows, and most patients had multiple lesions scattering in the lung. All the fifteen patients were misdiagnosed as pneumonia in the early stage, and then were diagnosed by percutaneous lung biopsy or transbronchial biopsy. Six patients underwent chemotherapy, of which 1 achieved complete response, 4 were in follow-up and 1 died of respiratory failure; 5 patients died of respiratory failure after diagnosis and 4 patients discharged and died within half a year. Conclusions: The lung NK/T-cell lymphoma are rare. The clinical manifestations and pulmonary imaging findings are indistinguishable from pulmonary inflammatory lesions. They are easily misdiagnosed as pneumonia. Early CT-guided percutaneous lung biopsy or transbronchial biopsy can improve the diagnostic accuracy.


Assuntos
Neoplasias Pulmonares , Linfoma de Células T , Pneumonia , Adulto , Idoso , Erros de Diagnóstico , Feminino , Humanos , Neoplasias Pulmonares/complicações , Linfoma de Células T/complicações , Masculino , Pessoa de Meia-Idade , Pneumonia/etiologia , Estudos Retrospectivos , Adulto Jovem
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