BACKGROUNDRecent studies suggest that circulating DNA may be a potential tumor marker for lung cancer, but most of these studies are conducted between healthy controls and lung cancer patients, with few or no benign lung disease patients included. The objective of this study was to evaluate the performance of plasma DNA quantification in discriminating lung cancer from the healthy and benign lung disease.

METHODSPlasma DNA was extracted with a QIAamp DNA Blood Midi kit and quantified by a PicoGreen dsDNA quantitation kit in 44 healthy individuals, 36 benign lung disease patients and 67 lung cancer patients. Discrimination power was evaluated by the receiver operating characteristic curve.

RESULTSPlasma DNA values were significantly increased in lung cancer patients, especially in those with metastases, and in benign lung disease patients compared with that in the healthy individuals (P < 0.001, respectively). The values in lung cancer patients were significantly increased compared with that in the benign lung disease patients (P < 0.001). The area under the curve was 0.96 [95% confidence interval (CI) 0.92 - 0.99] for the healthy versus lung cancer, 0.73 (95% CI 0.64 - 0.83) for lung cancer versus benign lung disease, and 0.86 (95% CI 0.80 - 0.91) for lung cancer versus the healthy and benign lung disease.

CONCLUSIONSPlasma DNA quantification has a strong power to discriminate lung cancer from the healthy and from the healthy and benign lung disease, less power to discriminate lung cancer from benign lung disease. Plasma DNA quantification may be useful as a screening tool for lung cancer.

DNA ; blood ; Humans ; Lung Neoplasms ; blood ; diagnosis ; pathology ; Neoplasm Staging

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of various quantitation methods using F-18-fluorodeoxyglucose (FDG) in patients with malignant or benign lung lesion. MATERIALS AND METHODS: 22 patients (13 malignant including 5 bronchoalverolar cell cancer; 9 benign lesions including 1 hamartoma and 8 active inflammation) were studied after overnight fasting. We performed dynamic PET imaging for 56 min after injection of 370 MBq (10 mCi) of FDG. Standardized uptake values normalized to patients body weight and plasma glucose concentration (SUVglu) were calculated. The uptake rate constant of FDG and glucose metabolic rate were quantified using Patlak graphical analysis (Kpat and Mrpat), three compartment-five parameter model (K5p, MR5p), and six parameter model taking into account heterogeneity of tumor tissue (K6p, MR6p), Areas under receiver operating charac-teristic curves (ROC) were calculated for each method. RESULTS: There was no significant difference of rate constant or glucose metabolic rate measured by various quantitation methods between malignant and benign lesions. The area under ROC curve were 0.73 for SUVglu, 0.66 for Kpat, 0.77 for Mrpat, 0.71 for KSp, 0.73 for MRSp, 0.70 for K6p, and 0.78 for MR6p, No significant difference of area under the ROC curve between these rnethods v;as observed except the area between Kpat vs. Mrpat (p<0.05). CONCLUSION: Quantitative methods did not improve diagnostic accuracy in comparison with nonkinetic methods. However, the clinical utility of these methods needs to be evaluated further in patients with low pretest likelihood of active inflammation or bronchoalveolar cell carcinoma.
Blood Glucose ; Body Weight ; Fasting ; Glucose ; Hamartoma ; Humans ; Inflammation ; Lung Neoplasms ; Lung* ; Population Characteristics ; ROC Curve

A method for one-lung anesthesia in which a 14 Fogarty emboiectomy catheter is used to occlude a main bronchus is described. The method is quick, simple, effective and reliable. It eliminates most of the problems which occurs with the standard technique of using a double-lumen cuffed endotracheal tube. During one-lung mannual ventilation, anesthesia was maintained with ketamine I.V. infusion and pancuronium. Before and after one-lung anesthesia, halothane-nitrous oxide-oxygen and pancuronium were used. No significant problems regarding blood pressure, pulse rate, EKG and arterial blood gases were encountered in 3 lung cancer cases who had a pneumonectomy, a lung biopay and a left lower lobectomy.
Anesthesia* ; Blood Pressure ; Bronchi ; Catheters* ; Electrocardiography ; Gases ; Heart Rate ; Ketamine ; Lung ; Lung Neoplasms ; Pancuronium ; Pneumonectomy ; Ventilation

To investigate the clinical value of serum tumor marker isocitrate dehydrogenase 1(IDH1)in the diagnosis of lung cancer. The general data were collected in lung cancer patients and non-lung cancer patients.The serum level of IDH1 was detected by enzyme-linked immunosorbent assay to evaluate its clinical significance in diagnosing lung cancer. The serum IDH1 level was significantly higher in lung cancer patients than in non-lung cancer patients [(7.12±6.98)ng/ml (2.09±1.83)ng/ml,=11.540,<0.001].The serum IDH1 level in patients with adenocarcinoma or squamous cell carcinoma was significantly higher than that in patients with small cell lung cancer [(7.91±7.26)ng/ml (2.76±2.27)ng/ml, =6.345,<0.001].The sensitivity of IDH1 in detecting lung cancer,stage Ⅰ/Ⅱ lung cancer,and stage Ⅲ/Ⅳ lung cancer was 47.4%,49.1%,and 46.3%,respectively. Serum IDH1 has high sensitivities and specificities in the diagnosis and differential diagnosis of non-small cell lung cancer(squamous cell carcinoma and adenocarcinoma)and small cell lung cancer as well as the auxiliary diagnosis of stage Ⅰ and Ⅱ lung cancer.It is a valuable marker for the auxiliary diagnosis of lung cancer.
Biomarkers, Tumor ; Carcinoma, Non-Small-Cell Lung ; Humans ; Isocitrate Dehydrogenase ; blood ; Lung Neoplasms

BACKGROUNDFolate plays a critical role in nucleotide synthesis and DNA methylation, and was considered to be associated with anti-carcinogenesis.

RESULTSfrom studies that concern the relationship between the folate intake or serum folate levels and lung cancer risk showed no consistency, which requires our further comprehensive meta-analysis.

METHODSSystematic literature search was conducted to identify the relevant studies (published prior to February 2013) according to standard protocol. Estimated effects were calculated under both random-effects and fixed-effects models. Heterogeneity between studies and publication bias were also evaluated.

RESULTSA total of 4390 cases and 6138 controls from 6 case-control studies revealed a significant overall inverse association between folate intake and lung cancer risk (OR = 0.74, 95%CI = 0.65 - 0.84, P < 0.001). Summary of 1438 cases and 2582 controls from 4 case-control studies and 44 cases out of a cohort of 1988 participants suggested a marginal association without significance (OR = 0.78, 95%CI = 0.60 - 1.02, P = 0.075) between high serum folate levels and less lung cancer susceptibility; however, subgroup analysis about population-based case-control studies showed that high serum folate levels significantly associated with the reduced lung cancer risk (OR = 0.76, 95%CI = 0.58 - 1.00, P = 0.048).

CONCLUSIONHigher folate intake can be a protective factor against lung cancer risk, and higher serum folate level is probably associated with reduced lung cancer risk in marginal manner, though more studies are warranted to confirm these associations.

Folic Acid ; administration & dosage ; blood ; Humans ; Lung Neoplasms ; blood ; epidemiology ; Risk Factors

OBJECTIVETo explore the risk factors for pulmonary metastasis after curative resection of colorectal cancer in order to improve the effectiveness of follow-up and the rate of early diagnosis for the high-risk patients.

METHODSThe clinicopathological and follow-up data of 268 patients with colorectal cancer undergoing radical resection from January 2004 to December 2006 in the Beijing Cancer Hospital were analyzed retrospectively. Patients were divided into study group including 16(6.0%) patients who developed lung metastasis and control group without lung metastasis. The high-risk variables associated with lung metastasis were reviewed by univariate analysis and multivariate analysis.

RESULTSLung metastasis developed in 16 patients, including 10 cases with unilateral lung metastasis and 6 with bilateral. The median duration from colorectal surgery to identification of lung metastasis was 13.9 months. The diagnosis rate of pulmonary metastasis by enhanced chest CT was 81.3%(13/16). Univariate analysis identified the following associated with significant factors associated with pulmonary metastasis: primary tumor location(P=0.003), adjuvant chemotherapy(P=0.034), TNM stage(P=0.005) and preoperative serum carcinoembryonic antigen(CEA) level (P=0.001). Multivariate analysis revealed that primary tumor location(rectum) and preoperative serum CEA level(≥5 μg/L) were independent risk factors for pulmonary metastasis(both P<0.05).

CONCLUSIONSPrimary tumor location and elevated preoperative CEA level are independent risk factors for pulmonary metastasis. Strict postoperative follow-up and routine chest enhanced CT examination is necessary for this particular patient population.

Carcinoembryonic Antigen ; blood ; Colorectal Neoplasms ; Humans ; Lung Neoplasms ; diagnosis ; Prognosis ; Risk Factors

OBJECTIVETo explore the diagnostic value of carcinoembryonic antigen (CEA) and cytokeratin-19-fragment (CYFRA21-1) in lung cancer patients.

METHODSThe levels of serum CEA and CYFRA21-1 were measured in 102 patients with lung cancer, 45 patients with benign lung disease and 36 health controls by electrochemiluminescence.

RESULTSThe level of serum CEA and positive rate [(25.77 ± 15.34) ng/ml, 47.1%] were significantly higher in the lung cancer group than that in the benign lung disease group [(4.67 ± 2.21) ml, 7.7%; P < 0.05] and controls [(3.98 ± 3.00) ng/ml, 3.8%; P < 0.05], The level of serum CYFRA21-1 and positive rate [(14.08 ± 8.34) ng/ml, 62.7%] were also significantly higher in the lung cancer group than that in the benign lung disease group [(3.27 ± 2.87) ml, 7.7%; P < 0.05] and controls [(2.69 ± 2.02 ng/ml, 3.8%; P < 0.05]. The difference of level of CEA and CYFRA21-1 between the benign lung disease group and controls was statistically not significant (P > 0.05). Both tumor markers were increased to a different degree in the lung cancer patients at various TNM stages [(CEA: stage II (17.78 ± 8.71) ng/ml, stage III (25.84 ± 7.34) ng/ml, stage IV (34.85 ± 6.99) ng/ml; and CYFRA21-1: stage II (10.05 ± 6.76) ng/ml, stage III (15.93 ± 6.66) ng/ml, stage IV (22.78 ± 4.12) ng/ml]. Combined use of both makers showed a significant higher sensitivity (77.5% vs. 47.1%, 62.8%), but reduced specificity (86.8% vs. 94.0%, 95.6%), and not significantly changed accuracy (83.5% vs. 77.1%, 83.8%) in the diagnosis of lung cancer.

CONCLUSIONSCEA and CYFRA21-1 employed separately are helpful in the diagnosis of lung cancer. Combined detection of these two tumor markers can improve the positivity for diagnosis of lung cancer.

Adult ; Aged ; Aged, 80 and over ; Antigens, Neoplasm ; blood ; Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; pathology ; Case-Control Studies ; Female ; Humans ; Keratin-19 ; blood ; Lung Diseases, Obstructive ; blood ; Lung Neoplasms ; blood ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonia ; blood ; Small Cell Lung Carcinoma ; blood ; diagnosis ; pathology ; Tuberculosis, Pulmonary ; blood

OBJECTIVE: To construct a technological platform of 2-dimensional tumor microvascular architecture phenotype (2D-TAMP) expression. METHODS: Thirty samples of non-small cell lung cancer (NSCLC) were collected after surgery. The corresponding sections of tumor tissue specimens to the slice of CT perfusion imaging were selected. Immunohistochemical staining,Gomori methenamine silver stain, and electron microscope observation were performed to build a technological platform of 2D-TMAP expression by detecting the morphology and the integrity of basement membrane of microvasculature, microvascular density, various microvascular subtype, the degree of the maturity and lumenization of microvasculature, and the characteristics of immunogenetics of microvasculature. RESULTS: The technological platform of 2D-TMAP expression was constructed successfully. There was heterogeneity in 2D-TMAP expression of non-small cell lung cancer. The microvascular of NSCLC had certain characteristics. CONCLUSION 2D-TMAP is a key technology that can be used to observe the overall state of micro-environment in tumor growth.
Capillaries ; ultrastructure ; Carcinoma, Non-Small-Cell Lung ; blood supply ; pathology ; Humans ; Lung Neoplasms ; blood supply ; pathology ; Neovascularization, Pathologic ; pathology ; Phenotype ; Regional Blood Flow ; physiology

BACKGROUND: Current research shows that platelet to lymphocyte ratio (PLR) has important prognostic value in renal cell carcinoma, esophageal cancer, gastric cancer, liver cancer and colon cancer. The aim of the study is to evaluate the prognostic value of PLR in non-small cell lung cancer (NSCLC) through meta-analysis. METHODS: Literature search for PubMed, EMBASE, Web of Science, Medline, Cochrane Library, China National Knowledge Internet (CNKI), China Biomedical Medicine disc (CBMdisc), VIP, Wanfang Database using computer electronic system to study the association between PLR and overall survival (OS) and disease-free survival (DFS). Each eligible study data is extracted and a meta-analysis is performed using the hazard risk (HR) and 95% confidence interval (95%CI) to assess the prognostic value of PLR, the time limit for the search is to build the library until November 2018. RESULTS: We include a total of 15 research literatures involving 5,524 patients for meta-analysis. According to the results of the meta-analysis: The OS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.69, 95%CI: 1.45-1.97, P<0.000,01, I²=46.2%, Pheterogeneity=0.026); the DFS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.41, 95%CI: 1.14-1.74, P=0.001, I²=46.2%, Pheterogeneity=0.026). Subgroup analysis show that the OS of the higher PLR group is still significantly lower than the lower PLR group (P<0.05) after grouping by ethnicity, sample size, PLR cutoff value and treatment. CONCLUSIONS Increased PLR is associated with poor prognosis in NSCLC, so PLR may be an important biological predictive marker for NSCLC patients, however, its clinical application still needs to be verified through more research in the future.
Blood Platelets ; cytology ; Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; pathology ; Humans ; Lung Neoplasms ; blood ; diagnosis ; pathology ; Lymphocytes ; cytology ; Platelet Count ; Prognosis

BACKGROUND: MicroRNA is a kind of single-stranded non-coding RNA whose length is about 22 nucleotides and its abnormal expression is related to disease closely. This study is aiming to explore the relative expression of miR-34b-3p and miR-302a-5p in the plasma of non-small cell lung cancer (NSCLC) patients and its clinical value. METHODS: The levels of miR-34b-3p and miR-302a-5p in plasma were detected by real-time polymerase chain reaction (RT-PCR) in 86 patients with NSCLC, 64 patients with pulmonary tuberculosis (PTB) and 39 healthy subjects. Analyze their value in diagnosing NSCLC by contrasting and combining carcino-embryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragments 21-1 (CYFRA21-1). RESULTS: The levels of plasma miR-34b-3p and miR-302a-5p in NSCLC group were significantly higher than those in the PTB group and the healthy group (P<0.05). In patients with NSCLC, the levels of plasma miR-34b-3p was correlated with the diameter of tumor (P<0.01). When using one plasma marker to diagnose NSCLC, miR-302a-5p had the highest sensitivity (82.6%) and CEA had the highest specificity (81.6%). While combined two plasma markers, miR-34b-3p+miR-302a-5p had the highest sensitivity (80.2%) and miR-34b-3p+CEA had the highest specificity (81.4%). As detected multiple markers, miR-302a-5p+NSE+CYFRA21-1 had the highest sensitivity (81.4%) and miR-34b-3p+CEA+NSE had the highest specificity (90.3%). The combination of miR-34b-3p, miR-302a-5p and CEA obtained the highest area under the curve (AUC), which was 0.832. Logistic regression model indicated that miR-34b-3p was independent risk factor for NSCLC compared to control groups. CONCLUSIONS Plasma miR-34b-3p and miR-302a-5p could be used as biological markers for the diagnosis of NSCLC.
Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; blood ; diagnosis ; Male ; MicroRNAs ; blood ; Middle Aged ; Prognosis