Smoking, hormonal factors and molecular markers in female lung cancer.

There has been substantial argumentation about differences in lung cancer occurrence and characteristics between men and women. Lung cancer incidence suggests that gender-related factors may influence lung cancer risk. The carcinogenic effect of tobacco smoke and the use of hormone replacement therapy could result in susceptibility to lung cancer among women. Mutations in EGFR and HER-2/neu genes, and ROS1 gene fusions may also play a role in gender-based survival rate differences. This review summarizes the latest data of disease markers and its usefulness in female lung cancer.

Incidence of lung cancer among patients with tuberculosis: a nationwide cohort study in Lithuania.

SETTING: Although studies have found a relationship between tuberculosis (TB) and lung cancer, results for the long-term risk and the role of confounding factors remain inconclusive. OBJECTIVE: To examine the risk of lung cancer in a Lithuanian cohort of 21 986 TB patients. DESIGN: During follow-up (1998-2012), 477 patients developed lung cancer. Standardised incidence ratios (SIRs) and 95% confidence intervals (95%CIs) were calculated to compare the incidence of lung cancer among cohort participants with the general population. Cox regression was used to estimate the effect of risk factors on lung cancer risk among TB patients. RESULTS: Lung cancer SIRs were 3.55 (95%CI 3.24-3.89) among all cohort participants, 4.48 (95%CI 4.04-4.96) among smokers and 1.93 (95%CI 1.56-2.36) among non-smokers. SIRs declined substantially >3 years after TB diagnosis in non-smokers, although they remained significantly elevated for ⩾10 years among smokers. In the multivariable analysis, smoking, male sex and older age substantially increased the risk of lung cancer. A statistically significant association with education, employment, site of TB and alcohol consumption did not persist in the lag-time analysis. CONCLUSION: Most of the observed excess risk of lung cancer in the TB cohort possibly reflects the confounding effects of reverse causation, closer medical surveillance and shared risk factors, particularly smoking.

Radical surgery for large-sized slow-growing neuroendocrine tumor of the pancreas.

An unresectable neuroendocrine tumor (NET) of the pancreas was diagnosed in a male patient in 1997. The tumor was bleeding and the patient underwent tumor embolisation with complete control of the bleeding. In December 2001 the patient presented again with gastric bleeding at the Emergency Hospital of Vilnius University, where the case was considered inoperable. In January 2002 the patient was transfered to the Lithuanian Oncology Center and was radically and succesfully operated.

The value of MMP-9 for breast and non-small cell lung cancer patients' survival.

PURPOSE: Matrix metalloproteinases (MMPs) are implicated in cancer cells invasion and metastasis processes and have been investigated as potential cancer biomarkers. In this study MMP-9 gene expression and MMP-9 -1562 C/T polymorphism in breast and non-small cell lung cancer patients' blood and tumor samples and its correlation with clinicopathological parameters were investigated. MATERIAL/METHODS: MMP-9 gene expression was assessed by reverse transcription - polymerase chain reaction method in 108 cancer patients' blood and tumor samples. MMP-9 -1562 C/T polymorphism was determined by the polymerase chain reaction - based restriction fragment length polymorphism method. RESULTS: Significant relationship of MMP-9 gene expression and tumor differentiation grade was found only between groups with G1 and G3 breast tumors. Low survival rates were identified among positive MMP-9 expression in blood and ductal carcinoma of the breast (p=0.01) and negative progesterone receptor reaction (p=0.04). Significant differences in the distribution among genotypes were found between groups with stage I and stages III/IV (p=0.005) as well as between groups with lymph node status N0 and N1 (p<0.001). Breast cancer patients with tumor differentiation grade G3 and identified CC variant had a longer survival time (p=0.014). Shorter survival time was found among positive MMP-9 expression in tumor and stage I non-small cell lung cancer patients with negative lymph node (p=0.012) and squamous cell carcinoma (p=0.019). CONCLUSIONS: Expression of MMP-9 in blood and tumor together indicates worse prognosis for breast cancer patients.

Outcome and treatment strategy in female lung cancer: a single institution experience.

PURPOSE: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. MATERIALS AND METHODS: During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. RESULTS: The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). CONCLUSIONS: The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of the disease at the time of diagnosis and choice of treatment options of female lung cancer in the country still remains an issue.

Limited resection of lung cancer.

AIM: Follow-up results after a limited resection (segmentectomy, wedge resection of lung) are represented in this paper according to the TNM classification and histological type of tumour. METHODS: Since 1980 until 1997, 1173 patients (pts) with lung cancer were treated surgically. 42 (36 males and 6 females) of them underwent a limited resection of lung. Distribution of pts according to the TNM classification was: T1N0 was found in 12 pts and T2N0 in 11 pts, T2N0 in 11pts, T2N1 in 7 pts, other 12 pts had N2. Sqamous cell carcinoma was in 19 pts, Adenocarcinoma in 13 pts, Small cell carcinoma in 9 pts, one pt--Carcinosarcoma. After the operation 9 pts received radiation therapy, 9 pts--chemotherapy. RESULTS: The best follow-up results were in pts with T1-2N0 who received adjuvant therapy: median survival was 45.7 months. The pts, treated only surgically, lived 36.7 months. The pts with N2 lived only 9 months. CONCLUSION: 1. A limited resection of lung with lymph nodes dissection can be performed only in cases T1-2N0. 2. In cases with N0 of undifferentiated carcinoma (anaplastic, small cell) adjuvant therapy ought to be given after operation. 3. In cases of N1, N2 we recommend adjuvant therapy regardless of histological type of tumour.

An evaluation of laryngeal cancer morbidity time trends in Lithuania.

PURPOSE: To make assessments of the rates of cases of larynx cancer in Lithuania in the years 1978-2001 as well as possible trends of changes in the future. MATERIAL AND METHODS: The data contained in the Lithuanian Cancer Register for the period 1978-2001 about new cases as well as the data compiled by the Lithuanian Department of Statistics on the average number of population of Lithuania within the same period in the same age groups have been used in the course of the study. The data have been standardized by age using direct method, in accordance with the European standard; a regression analysis of larynx cancer case rates was made. RESULTS: After standardization of data for the period 1978-2001, tendencies of increase have been registered both among men and women: in 1978 the case rate per 100,000 population was 10.73 among men and 0.26 among women, in 2001 the corresponding data were 11.6 among men and 0.7 among women. Throughout the period the investigated case rate for men was higher than for women. An increasing average age of men and women suffering from this disease has been noticed: average age for men is annually increasing by 0.1566 years and for women--0.0602 years. The forecast for men in the year 2006 is 13.88 cases per 100,000 population and 0.54 for women. CONCLUSIONS: The increase of larynx cancer case rates is growing more rapidly among women than among men, and also average age of the patients is increasing. The forecast is that in 2006 the case rate will be growing up, and both men and women will get ill at older age.