Brain metastases are often site of recurrence in patients with NSCLC (IIIA-N2). Autonomous risk factors for brain metastases in this group of patients are non-squamous NSCLC, N1-N2 nodal status, postoperative radiotherapy without preoperative radiotherapy.
Background/Aim. Impulse oscillometry (IOS) is a technique valid for measuring the lung function in obstructive lung diseases and bronchial provocation tests. However, no consensus exists for its use. The aim of the study was to assess impulse oscillometry sensitivity for detection of early airways changes during bronchial provocation testing and to compare with changes obtained with spirometry and bodyplethysmography in male army recruits. Methods. Male military recruits were submitted to bronchial provocation test with histamine by the aerosol provocation system. Out of 52 male military recruits subjected to attempts to make the diagnosis of asthma the study included 31 subjects with fall of forced expiratory volume in one second (FEV1) above 20%. The changes of impulse oscillometry were measured one step before and after provocation dose (PD) of histamine and compared with the changes of bodyplethysmography and spirometry. Results. The average age of male army recruits was 23.3 year. After bronchoprovocation there was an average increase of the total resistance at 5 Hz (R5) by 66.6%, resonant frequency (Fres) by 102.2%, Goldman index (AX) by 912.1%, the arway resistance (Raw) by 121.5%, and a decrease in reactance at 5 Hz (X5) by 132.1% and FEV1 by 25.6%. One step before the last inhaled of PD20 there was an average increase of 26.7% in R5, 24.1% in Fres, 85.3% in AX, 11.9% in Raw and a decrease in X5 by 26.9% and FEV1 by 4.3%. A correlation between impulse oscillometry and bodyplethysmography parameters was obtained. Conclusion. This paper demonstrates a sufficient sensitivity of impulse oscillometry to detect changes in airways, so it may play a complementary role in the diagnosis of asthma in male military recruits.
There is a correlation with lung pathologic physical findings, lower values of FEV1 (in a range of normal values) and the degree of nonspecific bronchial sensitivity as objective indices of activity of bronchial asthma. There is no correlation of these parameters with patient's symptoms as subjective indices of bronchial asthma.
Background/Aim. Non-Small Cell Lung Cancer (NSCLC) is one of the most common malignant tumors and a leading cause of cancer-related deaths. The aim of this study was to evaluate impact of biological markers on the overall survival rate in surgically treated NSCLC patients who received adjuvant chemotherapy and/or radiation therapy. Methods. This retrospective case series study was conducted at the Pulmonology Clinic and the Clinic for Chest Surgery, Military Medical Academy, Serbia. Patients with NSCLC were treated in the time period between 2008 and 2017. The survival analysis performed was based on immunohistological findings, histology type and tumor, node, metastasis (TNM) stages. Results. The mortality rate was higher in the adenocarcinoma patient group compared to the squamous cell carcinoma group, albeit without statistical significance (58.3% vs. 31.2%, respectively, p=0.175). Overall survival was lower in the adenocarcinoma patient group compared to the squamous cell carcinoma group (by approximately 750 days). Likewise, overall survival was lower in the adenocarcinoma patient group compared to the squamous cell carcinoma group for CD31 positive (p=0.029), p-63 positive (p=0.049), MMP-9 positive (p=0.032) and MMP-2 positive patients (p=0.016). Conclusion. Adenocarcinoma is a more aggressive cancer type in comparison to squamous cell carcinoma with a lower overall survival. Our research showed a poorer overall survival in the adenocarcinoma group compared to the squamous cell carcinoma group in CD31, p-63, MMP-9 and MMP-2 positive patients.
Adverse drug reactions should be considered in patients with concomitant lung and liver disease. The mainstay of treatment is drug withdrawal and the use of immunosuppressive drugs in severe cases. Consideration should be given to monitor lung and liver function tests during long term nitrofurantoin therapy.
Background/Aim. Lung cancer is one of the most common malignant tumors. About 80% of all lung cancers are non-small cell lung cancer (NSCLC). According to histopathological characteristics, the most common types of NSCLC are squamous cell carcinoma and adenocarcinoma. The aim of this study was to evaluate the overall survival rate in the NSCLC patients initially received surgery according to its histopathological type and T-primary tumor, N-regional lymph nodes, M-distant metastasis (TNM) stages which were treated with surgical treatment, and after that, according to the TNM stage, chemotherapy protocols and/or radiation therapy. Methods. This retrospective case series study included all patients with NSCLC admitted to the Military Medical Academy in Belgrade in the period 2010-2015. A total number of selected patients was 85 (27 females and 58 males). Results. Out of 41 patients with squamous cell carcinoma, 19.5% deceased. On the other hand, in the group of patients with adenocarcinoma, 43.2% Ključne reči: pluća, nesitnoćelijski karcinom; adenokarcinom; karcinom skvamoznih ćelija; preživljavanje; recidiv.
Background/Aim. Serbia belongs to the group of countries with a high lung cancer incidence and mortality rate. p63 gene plays an important role in development of lung cancer and immunohistochemical expression of p63 is considered to be a reliable marker for squamous histology. The results of some in vitro studies show a significant association of p63 expression and cisplatin chemoresistance. The aim of this study was to estimate the significance of p63 expression as predictive and prognostic factor in advanced non-small-cell lung cancer (NSCLC). Methods. Expression of p63 in 85 NSCLC (stages III, and IV) was investigated by the use of immunohistochemistry. Four weeks after the completion of 2 cycles of platinum-based doublet chemotherapy all the patients were evaluated based on the treatment response. Kaplan-Meier analysis with log-rank tests were used for overall survival (OS) and progression free survival (PFS) calcultations. Results. The expression of p63 was present in 49.4% of the patients out of whom 38.8% were with positive expression (p63+) and 10.6% of the patients were with weak expression (p63+-). Positive expression of p63 was seen in 93.9% of squamous cell carcinomas (SQCC), 5% of adenocarcinomas (AC), and in no patient with not otherwise specified (NOS) NSCLC. Weak expression of p63 was found in 12.5% of AC, 25% of NOS and only in 3% of SQCC. Analysis of the impact of the presence of p63 expression on the initial response to chemotherapy showed no statistical significance. The patients with weak p63 expression had a significantly shorter OS than the patients with no p63 expression (p = 0.049), and the tendency of shorter OS than the patients with p63 expression (p = 0.068). Conclusion. This study shows that p63 expression has no predictive significance for tumor response to initial chemotherapy regimen gemcitabine/cisplatin or paclitaxel/cisplatin observed in advanced NSCLC. Weak expression of p63 have a negative prognostic effect in stage III and IV NSCLC.
Pseudomesotheliomataus carcinoma of the lungs can be a diagnostic problem. Its diagnosis is based on recognition of histopathological characteristics which enable its discernment from the epithelial variant of malignant pleural mesothelioma.
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