Preoperative monocyte count is a predictor of recurrence after Stage I lung adenocarcinoma resection

Open in a separate window OBJECTIVESHigh-grade tumours are observed even in Stage I lung adenocarcinomas. Tumour spread through air spaces (STAS) is a risk factor for recurrence after resection. However, there is no ideal predictive biomarker for STAS in high-grade Stage I lung adenocarcinoma. This study assessed the prognostic impact of the preoperative peripheral monocyte count in lung adenocarcinoma.METHODSWe retrospectively analysed the data of 444 patients with resected Stage I lung adenocarcinoma during 2006–2016. Univariable and multivariable Cox proportional analyses of recurrence-free probability (RFP) and overall survival (OS) were used to analyze preoperative complete peripheral blood cell count data. Since monocyte count was associated with poor prognosis, the relationship between preoperative peripheral monocyte count and clinicopathological factors, including STAS, was assessed. In addition, immunohistochemical CD68 staining was performed to evaluate tumour-associated macrophages (TAMs).RESULTSA higher preoperative peripheral monocyte count was a predictor of lower RFP (P = 0.004) and lower OS (P < 0.001). In multivariable analysis, a higher peripheral monocyte count was an independent prognostic factor for RFP and OS (hazard ratio: 1.88, 95% confidence interval: 1.07–3.31, P = 0.029; hazard ratio: 2.13, 95% confidence interval: 1.22–3.75, P = 0.008, respectively). A higher peripheral monocyte count was associated with a higher frequency of STAS (P = 0.017) and higher number of CD68+ TAMs (P = 0.013).CONCLUSIONSA higher preoperative peripheral monocyte count was an independent marker for a poor prognosis in Stage I lung adenocarcinoma and was associated with a higher frequency of STAS.     

Chemotherapy with low-dose CDDP and continuous 5-FU for the treatment of advanced gastric cancers]

INTRODUCTION: 5-fluorouracil (5-FU) has been widely used for the treatment of gastrointestinal cancers. On the basis of recent findings, low-dose Cisplatin (CDDP) and continuous venous infusion of 5-FU have shown additive or synergistic antitumor effects in experimental models. We evaluated clinical effects of low-dose CDDP and 5-FU (low-dose FP therapy) in patients with advanced gastric cancers. PATIENTS AND METHODS: In December 1993 and June 1998, 52 patients with advanced gastric cancer were entered in this study. Patients were considered eligible if they had a bidimensionally measurable tumor. 5-FU (160 mg/m2/day) was continuously infused over 24 hours using an implantable port, and CDDP (3 mg/m2/day) was infused for half an hour. The administration schedule consisted of 5-FU for 7 consecutive days and CDDP for 5 days followed by a 2-day rest every four weeks according to response and tolerance. RESULTS: Low-dose FP therapy was given 44 patients (85%). The response rate was 65.9% and median survival time was 249 days. The responder group showed good survival compared with the non-responder group. The regimen was tolerable, and the most common toxicity was anorexia (40.3%). Three patients suffered from grade 3 anorexia, leukopenia and mucositis. On the other hand, renal dysfunction occurred in 50% (two of four patients administered over 1,000 mg CDDP). These results raise the possibility that the dose-limiting factor of low-dose FP therapy may account for the total dosage of CDDP. CONCLUSION: Low-dose FP therapy promises to be effective in the clinical management of advanced gastric cancer.     

PET assessment of disease activity in children with juvenile idiopathic arthritis

Background  

The degree of 18-fluorodeoxyglucose (FDG) uptake is previously reported to correlate with physical examination and laboratory tests for evaluating disease activity in patients with rheumatoid arthritis. The clinical validity of ¹⁸F-FDG positron emission tomography (PET) has not been evaluated in juvenile idiopathic arthritis (JIA).     

Improvement of Image Quality Using Hybrid Iterative Reconstruction with Noise Power Spectrum Model in Computed Tomography During Hepatic Arteriography

Objectives:In CT during hepatic arteriography (CTHA), the addition of a noise power spectrum (NPS) model to conventional hybrid iterative reconstruction (HIR) may improve spatial resolution and reduce image noise. This study aims at assessing the image quality provided by HIR with a NPS model at CTHA.Methods:This institutional review board-approved retrospective analysis included 26 patients with hepatocellular carcinomas (HCCs) who underwent CTHA. In all acquisitions, images were reconstructed with filtered back projection (FBP), adaptive iterative dose reduction 3D (AIDR), and AIDR enhanced (eAIDR) with the NPS model. Four radiologists analyzed the signal-to-noise ratio (SNR) of HCC nodules and its associated feeding arteries. The radiologists used a semiquantitative scale (–3 to +3) to rate the subjective image quality comparing both the FBP and eAIDR images with the AIDR images.Results:The feeding arteries’ attenuation was significantly higher in eAIDR compared to AIDR [514.3 ± 121.4 and 448.3 ± 107.3 Hounsfield units (HU), p < 0.05]. The image noise of eAIDR was significantly lower than that of FBP (15.2 ± 2.2 and 28.5 ± 4.8 HU, p < 0.05) and comparable to that of AIDR. The SNR of feeding arteries on eAIDR was significantly higher than on AIDR (34.1 ± 7.9 and 27.4 ± 6.3, p < 0.05). Subjective assessment scores showed that eAIDR provided better visibility of feeding arteries and overall image quality compared to AIDR (p < 0.05). The HCC nodule visibility was not significantly different among the three reconstructions.Conclusion:In CTHA, eAIDR improved the visibility of feeding arteries associated with HCC nodules without compromising nodule detection.