平顶山市老年恶性肿瘤发病现状分析

目的:初步了解平顶山市老年恶性肿瘤发病现状及特点。方法:收集平顶山市4家三级医院和2家市级专科医院2012年-2013年恶性肿瘤住院病例资料,应用ICD－10规则统一编码、归类,3位数类目统计恶性肿瘤分类构成并排序,统计发病例数、病种分布情况。结果:平顶山市老年恶性肿瘤患病率高,约占平顶山市全部恶性肿瘤病人的三分之二,男性多于女性,占据前五位是肺恶性肿瘤、食管恶性肿瘤、结直肠恶性肿瘤、胃恶性肿瘤、肝原发恶性肿瘤,占老年恶性肿瘤病人三分之二以上。高龄老年恶性肿瘤农村与市区患病趋势与老年组整体一致,肺恶性肿瘤、食管恶性肿瘤依然位居农村与市区的患病前两位。结论:肺恶性肿瘤、食管恶性肿瘤等是威胁平顶山市老年人的主要肿瘤,普及健康教育的同时,还应加大肿瘤筛查工作力度,力争早发现早诊断早治疗。     

2003～2012年辽宁省肿瘤医院恶性肿瘤住院患者病种及年龄分析

[目的]分析辽宁省肿瘤医院首次住院的恶性肿瘤患者病种构成及年龄构成,为开展肿瘤防治工作提供参考依据。[方法]对2003～2012年首次住院的89319例恶性肿瘤患者病案资料进行统计分析。运用Excel及SPSS13.0统计软件进行数据处理。[结果]前10位恶性肿瘤依次为肺癌、乳腺癌、结直肠癌、子宫癌、胃癌、食管癌、肝癌、卵巢癌、膀胱癌、甲状腺癌,占10年来恶性肿瘤总例数的81.17%。其中肺癌构成比居男性恶性肿瘤第1位,占男性恶性肿瘤的26.79%。乳腺癌构成比居女性恶性肿瘤第1位,占女性恶性肿瘤的30.71%。肿瘤发病年龄相对集中,高发于40岁以上的中老年人群。[结论]肿瘤发病存在年龄、性别差异,应针对高危人群做好癌症的三级预防工作。     

扬中市人民医院住院恶性肿瘤患者构成分析及对策

目的 了解恶性肿瘤住院患者的主要病种和构成情况,为医院管理及改革提参.方法 分析2002-2007年我院住院患者病案资料,了解疾病构成及变化趋势.结果 前12位肿瘤为子宫肌瘤、贲门癌、食管癌、胃癌、肺癌、甲状腺良性肿瘤、结直肠癌、白血病、卵巢良性肿瘤、乳腺癌、肝癌、宫颈癌.子宫肌瘤是我院住院患者最主要的肿瘤类型,占住院肿瘤患者的19.17%,食管癌、贲门癌、胃癌作为我市主要的恶性肿瘤,占住院肿瘤患者41.3%.结论 我院肿瘤患者构成与我市恶性肿瘤发病谱基本一致.     

河南省肿瘤医院10年住院死亡病例分析

[目的]分析河南省肿瘤医院10年间常见恶性肿瘤住院死亡病例情况,为研究降低住院恶性肿瘤患者病死率提供信息服务.[方法]利用我院1993～2002年10年间536例常见恶性肿瘤住院死亡病例资料,重点统计前10种恶性肿瘤住院死亡病例455例,分析不同恶性肿瘤的病死率、构成比、动态趋势、年龄、性别等分布特征.[结果]10年间前10种恶性肿瘤住院死亡病例455例,占同期住院恶性肿瘤死亡人数的84.9%,男女比例为2.8:1;40～80岁的居多.肺癌死亡病例最多,占34.7%.胰腺癌和肝癌病死率最高,分别为5.6%和4.8%.总的恶性肿瘤病死率和前10位恶性肿瘤病死率分别以2.45%和3.89%的速度下降.[结论]胰腺癌、肝癌、肺癌、胃癌等是住院恶性肿瘤死亡的主要疾病,10年期间恶性肿瘤病死率有逐年递减趋势,诊疗水平有待再度提高,以进一步降低恶性肿瘤患者病死率.     

延安地区1997年～2001年3360例恶性肿瘤住院病例构成分析

目的　了解陕北地区恶性肿瘤的发病构成比 ,为我区恶性肿瘤的“三早”预防提供依据。方法　对延安大学医学院附属医院 1997年～ 2 0 0 1年所有住院恶性肿瘤患者的疾病类型、总体构成、年龄及职业构成进行分析。结果　 5年间我区前 7位恶性肿瘤构成无明显变化趋势 ,分别是胃癌、肺癌、子宫颈癌、肝癌、大肠癌、乳腺癌、食管癌。非农业人口以肺癌占第一位 ,农业人口以宫颈癌占第一位。结论　我区恶性肿瘤以消化道肿瘤为防治重点 ,妇女宫颈癌及乳腺癌应从 30岁开始进行普查 ,加强个人卫生宣教 ,做到早发现 ,早诊断 ,早治疗。     

中国2003-2007年鼻咽癌发病与死亡分析

目的:分析中国2003-2007年鼻咽癌的发病和死亡情况.方法:计算数据符合标准的32个肿瘤登记处的鼻咽癌发病率、死亡率和构成比,以此作为描述中国鼻咽癌流行情况的统计指标.结果:2003-2007年鼻咽癌的总发病率为4.20/10万,中国人口标化率(简称中标率)为2.54/10万,世界人口标化率(简称世标率)为3.08/10万,在恶性肿瘤新发病例构成中排列第17位,占全部恶性肿瘤新发病例的1.58％.鼻咽癌的粗死亡率为2.24/10万,中标率为1.26/10万,世标率为1.61/10万,在恶性肿瘤死亡构成中排列第14位,占全部恶性肿瘤死亡总数的1.31％.鼻咽癌的发病率和死亡率高于全国平均水平的肿瘤登记处均集中在广东省和广西壮族自治区.2003-2007年肿瘤登记地区鼻咽癌发病率和死亡率的变化幅度均不大.结论:鼻咽癌的发病率和死亡率差距相对较大,在中国的分布具有明显的地域特征.     

云南省肿瘤医疗2003～2006年恶性肿瘤住院病例构成比分析

[目的]了解云南省肿瘤医院恶性肿瘤的疾病构成比,为恶性肿瘤的预防提供一定的理论依据。[方法]以云南省肿瘤医院2003～2006年所有恶性肿瘤住院病例为研究对象,分析病例的年龄特征、性别及疾病构成。[结果]构成比居前10位的恶性肿瘤分别为:肺癌、乳房恶性肿瘤、女性生殖器官恶性肿瘤、直肠、肛门和肛管恶性肿瘤、结肠恶性肿瘤、鼻咽恶性肿瘤、胃恶性肿瘤、泌尿道恶性肿瘤、肝和肝内胆管恶性肿瘤及食管恶性肿瘤。2003～2006年各主要肿瘤及各年龄阶段的病例数均呈逐年上升趋势,女性乳房恶性肿瘤和生殖器官恶性肿瘤病例数高且肿瘤发病年龄较早。[结论]云南省应以肺癌作为肿瘤防治重点,女性应以乳房恶性肿瘤和生殖器官恶性肿瘤作为防治重点。     

延安大学附院恶性肿瘤住院病例分析

目的 了解陕北地区恶性肿瘤的发病构成比，为恶性肿瘤的预防提供依据。方法 对延安大学医学院附属医院1997年至2001年所有住院恶性肿瘤患者的疾病类型，总体构成，年龄及职业构成进行分析。结果 5年间前7位恶性肿瘤构成无明显变化趋势，分别是胃癌，肺癌，子宫颈癌，肝癌，大肠癌，乳腺癌，食管癌，非农业人口以肺癌占第一们；农业人口以宫颈癌占第一位。结论 陕北地区恶性肿瘤以消化道肿瘤为防治重点，妇女宫颈癌及乳腺癌应从30岁开始进行为普查，加强个人卫生宣教，做到早发现，早诊断，早治疗。     

延安地区1997年—2001年3360例恶性肿瘤住院病例构成分析

目的：了解陕北地区恶性肿瘤的发病构成比，为我区恶性肿瘤的“三导”预防提供依据。方法：对延安大学医学院附属医院1997年－2001年所有住院恶性肿瘤患的疾病类型、总体构成、年龄及职业构成进行分析。结果：5年间我区前7位恶性肿瘤构成无明显变化趋势，分别是胃癌、肺癌、子宫颈癌、肝癌、大肠癌、乳腺癌、食管癌。非农业人口以肺癌占第一位，农业人口以宫颈癌占第一位。结论：我区恶性肿瘤以消化道肿瘤为防治重点，妇女宫颈癌及乳腺癌应从30岁开始进行普查，加强个人卫生宣教，做到是早发现、早诊断、早治疗。     

1808例老年口腔颌面部肿瘤构成比分析

[目的]探讨目前我国老年人口腔颌面肿瘤的构成比及发展趋势。[方法]收集本院20世纪90年代以来口腔颌面外科老年住院肿瘤患者1808例,并针对发病年龄、性别、部位与不同病种构成比的相关性进行统计分析。[结果]1990年1月-1999年6月,老年肿瘤患者1808例,占患者总数的11.73%。其中恶性肿瘤1235例,占68.31%;良性肿瘤573例,占31.69%;恶性肿瘤中鳞癌占78.14%,涎腺恶性肿瘤中腺样囊性癌占28.4%;良性肿瘤中腺源性肿瘤占54.80%,其中多形性腺瘤占34%;腺淋巴瘤占28%,发生于腮腺的占50.61%。[结论]口腔颌面外科住院肿瘤患者总数呈上升趋势。60岁-69岁年龄段老年患者占主要比例。女性有增加趋势;腮腺为高发部位,提示老年人腮腺区应作为普查项目;恶性肿瘤中,鳞癌居首位;腺源性良性肿瘤最多见,其中以多形性腺瘤居首位,其次为腺淋巴瘤,两者发病率的差距缩小。     

miR-10b与乳腺癌侵袭及预后的相关性研究

背景与目的:miR-10b通过增加其下游转移基因RHOC的表达,影响肿瘤的转移和侵袭能力。本研究探讨miR-10b在乳腺癌石蜡组织中的表达及其与乳腺癌侵袭转移及预后的关系。方法:采用实时定量PCR(real-time qPCR)对60例乳腺癌患者原发肿瘤蜡块提取的RNA进行miR-10b表达水平的测定,MannWhitney-U非参数检验比较miR-10b表达水平和乳腺癌临床病理参数的关系,预后分析采用Kaplan-Meier生存分析和log-rank计算。结果:miR-10b表达水平与乳腺肿瘤的大小、淋巴结转移、组织学分级、激素受体状态、肿瘤病理分期、组织类型及是否复发等无明显关系(P>0.05)。Kaplan-Meier生存分析表明,miR-10b表达水平并不影响乳腺癌患者的生存期(P=0.485)。结论:miR-10b表达在乳腺癌侵袭转移中的作用有限,并不是影响预后的主要因素,尚不足以作为基于石蜡组织标本的乳腺癌预测预后指标。     

Independent value of tumor size and DNA ploidy for the prediction of disease progression in patients with organ-confined renal cell carcinoma

BACKGROUND: Greater than 20% of patients with apparently localized renal cell carcinoma (RCC) present with disease progression after surgery. The objective of the current study was to improve the ability of clinicians to predict prognosis in patients with localized RCC. METHODS: The authors studied 154 patients with organ-confined RCC classified as pT1 to pT2-pN0-M0 who underwent radical nephrectomy. Follow-up ranged from 24-128 months (median, 72 months). Several morphologic parameters of the tumor were considered. DNA content was analyzed by flow cytometry and tumor size was determined from the surgical specimen. A Cox proportional hazards regression model was used to identify significant independent prognostic factors for disease progression. RESULTS: At 5 and 10 years of follow-up, disease free survival was found to be 87% and 86%, respectively. Univariate analysis revealed that DNA content, Furhman grade, and tumor size had a statistically significant predictive value for disease progression, whereas, with regard to grade, the difference was significant only between patients with Grade 3 tumors and all other patients with Grade 1-2 tumors (P < 0. 0001). Although DNA content was found to correlate with tumor size (P < 0.0001), multivariate analysis showed that these were the only significant independent predictors of disease progression. The sum of DNA content and tumor size therefore was considered to distinguish separate risk groups. For a patient with diploid RCC, the risk of progression increased from 4% if the tumor size was 3 cm to 43% if the tumor size was 10 cm. For a patient with nondiploid RCC, this risk was 32% if the tumor size was 3 cm, increasing to 99% for tumors measuring 10 cm. CONCLUSIONS: Stratification of organ-confined RCC according to tumor size and DNA content could possibly provide more information that could be useful in the selection of individuals with significantly different risks of disease progression.     

Malignant peripheral nerve sheath tumor: analysis of treatment outcome

Purpose: To analyze the results of therapy for malignant peripheral nerve sheath tumor (MPNST) and to identify prognostic factors of survival, and of local and distant control of disease.Methods and Materials: From 1975 through 1993, 134 MPNSTs were diagnosed and treated at our institution. Tumor sites included extremities in 36 (27%) cases and non-extremities in 98 (73%). Median follow-up for survivors was 53 months (range: 7–280). There were 14 tumors of histologic grade I disease (10%), 43 of grade II disease (32%), 43 of grade III disease (32%), and 32 of grade IV (24%). Seventy-three patients (54%) underwent radiation therapy (RT) as part of their initial treatment of the primary tumor, including 14 (10%) who had brachytherapy and 16 (12%) who had intraoperative electron irradiation (IOERT) as part of their radiation course.Results: The 5- and 10-year survival rates were 52% and 34%, respectively. Local and distant failure rates at 5 years were both 49%. On univariate analysis, prognostic factors significantly related to survival (log-rank: p < 0.05) included tumor size, location of disease, history of neurofibromatosis type 1 (NF-1), history of prior irradiation, surgical margin status, use of IOERT or brachytherapy, disease stage, histologic grade and tumor subtype, as well as mitotic rate and the presence or absence of necrosis. On multivariate analysis, only history of prior irradiation (p = 0.023), and surgical margin status (p = 0.0044) remained significant. For local control of disease, univariate analysis showed location of disease, surgical margin status, history of NF-1, history of prior irradiation, mitotic rate, radiation dose ≥ 60 Gy, and use of IOERT or brachytherapy to be significant prognostic factors. On multivariate analysis, only surgical margin status (p = 0.0024), RT dose (p = 0.021), and use of IOERT or brachytherapy (p = 0.016) remained significant. For distant control of disease, significant prognostic factors on univariate analysis included tumor size, stage, tumor grade, mitotic rate, presence or absence of necrosis, and histologic subtype. On multivariate analysis, tumor size (p = 0.0065), grade (p = 0.036), and histologic subtype (p = 0.001) remained significant. Patients with perineurial MPNSTs had a much lower rate of distant metastasis and a better overall survival as compared with other histologic subtypes.Conclusion: Management of patients with MPNST involves a multi-modality approach. The goal of surgery is complete resection with negative margins. Adjuvant irradiation to doses ≥ 60 Gy and the inclusion of IOERT or brachytherapy are associated with improved local control of disease.     

Influence of radiation therapy delay on abdominal tumor recurrence in patients with favorable histology Wilms' tumor treated on NWTS-3 and NWTS-4: a report from the National Wilms' Tumor Study Group

PURPOSE: This study was undertaken to determine whether radiation therapy (RT) delay of >or=10 days had an adverse impact on abdominal tumor recurrence among children with favorable histology (FH) Wilms' tumor enrolled in National Wilms' Tumor Study (NWTS) 3 and 4. METHODS AND MATERIALS: A total of 1226 patients with Stage II-IV FH tumors who received flank or abdominal RT in NWTS-3 and NWTS-4 were included in this analysis. Recurrent disease in the operative bed was classified as flank recurrence. Abdominal recurrence included all infradiaphragmatic tumor recurrences, including flank recurrences. This analysis included all flank/abdominal tumor recurrences, regardless of whether they might have been the initial or subsequent site of relapse. Based on the NWTS-1 results, RT delay was analyzed in two categories: 0-9 days and >or=10 days. RESULTS: The mean RT delay was 10.9 days; median delay was 9 days (range: 1-277 days). The RT delay was concentrated in a relatively narrow range of 8 to 12 days after nephrectomy in the majority of patients (59%). Univariate and multivariate analysis did not reveal RT delay of >or=10 days to significantly influence flank and abdominal tumor recurrence rates in NWTS-3 or NWTS-4. The 8-year flank tumor recurrence rates for 0-9 days and 10+ days RT delay were 1.9% and 1.2%, respectively (p value = 0.3). The 8-year abdominal tumor recurrence rates for 0-9 days and 10+ days RT delay were 4.8% and 5.3%, respectively (p value = 0.7). CONCLUSIONS: RT delay of >or=10 days did not significantly influence flank or abdominal tumor recurrence rates among children with FH tumors treated on NWTS-3 and NWTS-4. However, we were unable to test for a meaningful difference, because of the concentration of RT delay close to 10 days.     

Microsatellite analysis at 10q25-q26 in Sardinian patients with sporadic endometrial carcinoma: identification of specification patterns of genetic alteration

BACKGROUND: Loss of heterozygosity (LOH) at chromosome 10q25-q26 has been reported previously in endometrial carcinoma (EC), suggesting the presence of tumor suppressor gene(s). Nevertheless, frequency of genome-wide microsatellite instability (MSI) has been demonstrated higher in EC than in other common malignancy, mostly due to defective DNA mismatch repair. The authors further evaluated the role of the chromosome 10q25-q26 in endometrial tumorigenesis as well as the clinical significance of any observed genetic alteration in sporadic EC. METHODS: Paired normal and tumor samples from 94 Sardinian patients with sporadic EC at various stages of disease were screened by polymerase chain reaction (PCR)-based microsatellite analysis. Genomic DNA was isolated from paraffin embedded tissues and amplified by PCR using microsatellite markers spanning approximately 14 cM at 10q25-q26. Microsatellite instability was studied at four loci mapping to different chromosomal locations. RESULTS: Thirty-two (34%) EC patients were found negative for genetic alterations within the 10q25-q26 region. Among the remaining 62 (66%) EC cases, the authors identified 1) a minimum consensus region of LOH of approximately 1 cM, between D10S610 and D10S542 markers; and 2) a subset of tumors with prevalence of instability at 10q25-q26 (10qMI+), as expression of the presence of a MSI+ phenotype. CONCLUSIONS: The authors' data establish the existence of significant correlations between disease stages and 10qMI+ (with or without MSI+). However, longer follow-up and additional studies are required to define the clinical significance of these findings as prognostic factors. Moreover, the minimum region of LOH at 10q25-q26 will be further analyzed for identifying the putative tumor suppressor gene involved in EC pathogenesis.     

Prognostic significance of an increased number of micrometastatic tumor cells in the bone marrow of patients with first recurrence of breast carcinoma

BACKGROUND: Using cytokeratin (CK) as a histogenetic marker of epithelial tumor cells in the bone marrow of patients with primary breast carcinoma, a subgroup of patients with decreased survival can be identified. This study was designed to evaluate the frequency and prognostic relevance of such cells in patients with recurrent breast carcinoma. METHODS: Bone marrow aspirates from 65 patients were analyzed immunocytochemically for the presence of CK positive cells. A quantitative immunoassay with monoclonal anti-CK antibody A45-B/B3 was used and 2 x 10(6) bone marrow cells per patient were evaluated. For prognostic evaluation the authors calculated a cutoff value of micrometastatic tumor cells by analogy to classification and regression tree (CART) analysis. Patients were monitored prospectively for a median of 37 months (range, 11-63 months). RESULTS: Bone marrow micrometastases were present in 5 of 32 patients (16%) with locoregional recurrence and in 24 of 33 patients (73%) with distant recurrence. The bone marrow status yielded no prognostic indication for patients with locoregional recurrence. In contrast, a cutoff value of 2.5 tumor cells per 1 million bone marrow cells analyzed (2.5 x 10(-6) tumor cells) correlated with a significantly different prognosis for women with distant disease. Patients with metastatic disease and a micrometastatic tumor load of > 2.5 x 10(-6) tumor cells survived for a mean of 6 months (95% confidence interval [95% CI], 2.0-9.1) compared with 17 months (95% CI, 11.6-22.0) for patients with < or = 2.5 x 10(-6) tumor cells (P < 0.0001). Multivariate analysis, allowing for hormone receptor status, disease free interval prior to recurrence, manifestation site of metastases, age, and micrometastases in bone marrow, revealed that bone marrow involvement was an independent risk factor, with a hazard ratio of 7.4 (95% CI, 1.6-13.3) for disease-related death. CONCLUSIONS: An increased number of micrometastases identified in the bone marrow of patients with metastatic breast carcinoma represents an independent prognostic factor that may influence future therapeutic strategies for patients with metastatic breast carcinoma.     

Prognostic significance of frequent acidophilic nuclear inclusions in adenocarcinoma of the lung with immunohistochemical and ultrastructural studies

BACKGROUND: Adenocarcinoma of the lung occasionally has acidophilic nuclear inclusions (ANIs). Some studies have reported that the incidence of ANIs was higher in well differentiated tumor types and have suggested that adenocarcinoma patients with ANIs might have a more favorable prognosis; however, to the authors' knowledge, statistically significant prognostic findings were not reported. The objective of the current study was to assess the prognostic significance of ANI in patients with pulmonary adenocarcinoma and, moreover, to characterize ANI immunohistochemically and ultrastructurally. METHODS: Surgically resected tumor specimens from 147 patients with primary pure adenocarcinoma of the lung were examined. Only obvious ANIs surrounded by a clear halo on hematoxylin and eosin-stained slides were counted; the authors classified cases with > or = 10 ANIs per 10 high-power fields (/10 HPF) as frequent-ANI cases, cases with < 10 ANIs/10 HPF as infrequent-ANI cases, and cases without ANIs as non-ANI cases in the current study. RESULTS: Nineteen frequent-ANI cases (12.9%) and 16 infrequent-ANI cases (10.9%) were found; the remaining 112 cases (76.2%) were considered to be non-ANI cases. The majority of ANIs immunohistochemically contained surfactant apoprotein and ultrastructurally corresponded to invagination of the inner nuclear membrane, showing a tubular or amorphous configuration. Frequent-ANI patients showed significantly better prognosis than the other two groups on both overall univariate analysis and univariate analysis limited to patients with International Union Against Cancer Stage I disease (P = 0.0096 and P = 0.0095, respectively). However, on the multivariate analysis only disease stage was shown to be a significant prognostic factor and frequent-ANI showed borderline significance (P = 0.0956). CONCLUSIONS: Frequent ANIs appear to be of limited value in clarifying the prognosis of patients with lung adenocarcinoma.     

Prognostic value of human kallikrein 10 expression in epithelial ovarian carcinoma.

PURPOSE: Human kallikrein 10 (hK10; also known as the normal epithelial cell-specific 1 gene and protein) is a secreted serine protease, which belongs to the human kallikrein family. It has been reported that hK10 is down-regulated in breast and prostate cancer cell lines and that it may function as a tumor suppressor. Recently, we developed a highly sensitive and specific immunoassay for hK10 and found that this protein is abundantly expressed in ovarian tissue. In this study, we measured quantitatively hK10 levels in ovarian cancer cytosolic extracts and evaluated the prognostic value of this biomarker in ovarian cancer. EXPERIMENTAL DESIGN: Specimens from eight normal ovarian tissues, eight ovarian tissues with benign disease, and 182 ovarian tumors were investigated. RESULTS: hK10 concentration in ovarian tumor cytosols ranged from 0 to 84 ng/mg of total protein, with a median of 2.6. This median was highly elevated in comparison with normal and benign ovarian tissues (P < 0.001). A cutoff of 1.35 ng/mg was selected to categorize tumors as hK10 high and hK10 low. With chi(2) test and Fisher's exact test, high concentration hK10 was found to be associated with advanced disease stage, serous histological type, suboptimal debulking, and large residual tumor (>1 cm; all P < 0.05). hK10 status was additionally correlated with clinical outcome, including progression-free (PFS) and overall survival (OS) using the Cox model. In univariate analysis, we found that patients with hK10 high tumors were more likely to die and relapse, in comparison with patients with hK10 low tumors (hazards ratios for PFS and OS were 1.93 and 2.42, respectively; P < 0.05). Although this correlation disappeared after the entire patient population was subjected to multivariate analysis, it remained significant in the subgroup of patients with stage III/IV ovarian cancer (hazards ratios for PFS and OS were 1.98 and 2.12, respectively; P < 0.05). CONCLUSIONS: Our results indicate that hK10 is a new, independent, unfavorable prognostic marker, especially for late-stage ovarian cancer.     

A comparative study on ferritin concentration in serum and bilateral bronchoalveolar lavage fluid of patients with peripheral lung cancer versus control subjects

OBJECTIVES: To assess the diagnostic value of bronchoalveolar lavage fluid (BALF) ferritin as a lung tumor marker by comparing serum and BALF ferritin concentrations in patients with peripheral lung cancer versus control subjects with benign lung disease, and to examine the theory of ferritin compartmentalization around the tumor area by comparing ferritin concentrations in serum and bilateral (affected and unaffected side) BALF in cancer patients. METHODS: Four groups of patients were investigated: 10 control nonsmokers, 10 control smokers, 10 smokers with chronic obstructive pulmonary disease (COPD), and 22 patients with primary bronchogenic carcinoma. A bronchoalveolar lavage (BAL) was performed in all subjects (both sides in 13 oncological patients, one side in the others) and samples of BALF and blood were submitted to biochemical analysis. RESULTS: As a lung tumor marker, BALF ferritin showed 54% sensitivity and 93% specificity and serum ferritin 22% sensitivity and 93% specificity. A significant difference was observed between the two sides in the cancer patients (p = 0.033), and between BALF ferritin from the affected side and COPD patients (p = 0.025). Greater differences were obtained when BALF ferritin in the affected side of cancer patients was compared with values in both control nonsmokers (p < 0.0001) and control smokers (p < 0.001). CONCLUSIONS: These findings seem to confirm the relative diagnostic value of BALF ferritin as a lung tumor marker and the theory of ferritin compartmentalization. However, further studies are required to clarify the relations between iron and ferritin on the one hand and inflammation, tumorigenesis and host response on the other.     

Clear cell sarcoma of tendons and aponeuroses: a study of 75 patients

BACKGROUND: Clear cell sarcoma (CCS) of tendons and aponeuroses (malignant melanoma of soft parts) is a rare melanocytic soft tissue sarcoma. The objective of this study was to determine the clinical features, prognostic factors, and optimal treatment policy for patients with this rare disease. METHODS: Seventy-five consecutive patients with histologically confirmed CCS who received treatment between 1980 and 2004 were analyzed retrospectively. RESULTS: There were 41 men and 34 women, and the median age was 36 years. Sixty-five tumors were located in the extremities, and 10 tumors were located in the trunk. The median tumor size was 4 cm. Seventy-one patients underwent surgical excision, and 56 patients received chemotherapy. Sixteen patients developed local recurrences, and 52 patients developed metastasis. The overall patient survival rates was 47% at 5 years and 36% at 10 years. Univariate analysis showed that sex (P = .018), tumor size (P = .001), tumor depth (P = .002), TNM classification (P = .001), and surgical margin (P = .042) were significant prognostic factors. Among the 52 patients who presented with localized disease, sex (P = .023), tumor size (P = .002), tumor depth (P = .011), TNM classification (P = .004), and chemotherapy (P = .032) were identified as significant prognostic factors. Multivariate analysis showed that tumor size remained an independent prognostic factor in both groups. CONCLUSIONS: The current results supported the contention that early diagnosis and initial wide excision are essential for a favorable outcome of CCS. The role of chemotherapy for CCS should be investigated further.