Comparison of clinical and pathological tumor, node and metastasis staging of lung cancer: 15-year experience with 530 patients.

AIM: The prognosis of patients with lung cancer depends on early diagnosis and accurate staging. The present staging system for lung cancer is tumor (T), node (N), and metastasis (M) staging (TNM). We compared the accuracy of preoperative (clinical) and postoperative (pathological) TNM staging of lung cancer in this study and emphasized the preoperative mediastinoscopy is useful in selected patients. METHODS: We performed a retrospective comparison of the clinical and pathological TNM staging of 530 patients with lung cancer treated surgically. The preoperative clinical TNM staging of all patients was based on physical examination, radiological investigations and bronchoscopy. Mediastinoscopy was used routinely for all patients with an indication since 2000. RESULTS: We found the agreement between clinical and pathological TNM staging to be only 46.4%. The comparison between clinical and pathological TNM staging was 6.2-5.3% at stage Ia, 37.9%-36% at stage Ib, 0.7-0.9% at stage IIa, 23-25% at stage IIb, 27.1-16.2% at stage IIIa, and 3.2-14% at stage IIIb respectively. The frequency rates of the different clinical and pathologic stages were 6.2% and 5.3%, for stage Ia, 37.9% and 36% for stage Ib, 0.7% and 0.9% for stage IIa, 23% and 25% for stage IIb, 27.1% and 16.2% for stage IIIa, 3.2% and 14% for stage IIIb respectively. CONCLUSION: We compared the clinical and pathological staging in patients with non small cell lung cancer submitted to surgical treatment to identify the causes of any discordance. The clinical TNM and staging based on computerized tomography was found to be inaccurate.

The evaluation of carotid intima-media thickness and visceral obesity as an atherosclerosis predictor in newly-diagnosed polycystic ovary syndrome.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder which is associated with multiple risk factors for atherosclerosis. The aim of this study was to investigate the CIMT which is used in the early diagnosis of atherosclerosis and visceral obesity by ultrasound in newly diagnosed polycystic ovary syndrome with normal body mass index. MATERIALS AND METHODS: A case-control study was conducted on 25 PCOS women (18-30 years of age) and 25 controls. BMI was matched volunteer controls. Carotid intima media thickness (CIMT) and fat distribution as visceral fat thickness (VFT) with subcutaneous fat thickness (SFT) were measured by ultrasound. After, visceral fat ratio (VFR) fat ratio (VFR) was calculated using VFT divided by SFT. The variables were compared using the χ(2)-test and Student's t test. RESULTS: Comparing women with PCOS to the control group showed that CIMT was similar in both groups (p=0.84). The VFT in the PCOS group was higher than the control group (p=0.048). Whereas, the SFT was higher in the control group when compared to women with PCOS (p=0.007). The VFR was significantly higher in women with PCOS when compared to the control group (1.12 ± 0.38 vs. 0.81 ± 0.34; p=0.005). CONCLUSIONS: CIMT which used as early atherosclerosis predictors have not increased in newly diagnosed PCOS women. Body fat distribution was observed in visceral area in the newly diagnosed PCOS women. VFR follow up may provide benefit as a quantitative method for the assessment and follow up of visceral obesity in women with PCOS.