Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objective To evaluate the long-term effect of hepatic arterial embolization with pingyangmycin-lipiodol emulsion (PLE) in patients with cavernous hemangiomas of the liver (CHL)and its influence factors.Methods One hundred and fifty-six hemangiomas that were diagnosed by imaging examinations or confirmed pathologically by surgery in 105 patients with integral follow-up data were analyzed retrospectively in this paper.All hemangiomas were divided into 4 groups according to their size (the largest size of hemangioma)by the authors as follows; A group(≤3 cm, n=25); B group(>3 cm and<5 cm, n =32) ;C group(≥5 cm and<10 cm, n=58); and D group(> 10 cm, n=41) .According to the number of abnormal sinusoids filled with the contrast medium in the angiography, 156 hemangiomas of this series were further classified as three types: abundant type (n=90) ; sparse type (n=9) and the middle type (n=57) .Hepatic arterial embolization with PLE was performed in the 105 patients with total 135 procedures (including single procedure in 75 patients, twice procedures in 30 patients).All of the 105 patients were followed up 3 to 8 years(mean 4 years) using US, CT or MRI or DSA.The criteria for the evaluation of curative effect were classified as best, good, recovery and no change in this series, and the sum of best and good effects were defined as the total effective rate.Then, the total effective rate of single procedure between the A, B groups and C, D groups; and the total effective rate of single procedure and twice procedures in the D groups, were compared statistically by X~2 test respectively.And the influence factors, included of the variant size of hemangiomas, abundant or sparse of abnormal sinusoids and the number of treatment procedures, were also analyzed and evaluated respectively.Results The total effective rate of the 156 hemangiomas in 105 patients was 92.95% (145/156).After single procedure of hepatic arterial embolization with PLE, the total effective rate of A and B groups were 100% (57/57), that of C and D groups were 85.86% (85/99), and the difference reach significant (X ~2=8.8553, P<0.01).In the D group, the total effective rate in group with twice procedures (100.00%,30/30) was significant higher (X~2 =5.2642,P<0.05) than those of group with single procedure (72.73%,8/11).Of this series, during the period of following-up, no recurrent or severe complications were observed.Conclusions A best long-term curative effect (complete cure) is usually obtained in the small hemangiomas with abundant abnormal sinusoids, and a satisfactory long-term curative effect can also be achieved in the larger or multiple hemangiomas, particularly in those hemangiomas with abundant abnormal sinusoids by using the repeat procedures of hepatic arterial embolization with PLE.

Clostridium cellulolyticum, as one of obligate anaerobic bacteria capable of secreting cellulosome, has not been efficiently cultured due to its strict requirement of growing conditions. In this study, culture conditions of C. cellulolyticum were optimized using response surface methodology. Plackett-Burman design was first used to screen the dominant impact factors for the growth of C. cellulolyticum, which were determined as yeast extract concentration, cellobiose concentration and culture temperature. The steepest ascent path design was then applied to gain the suitable range close to the optimal culture conditions for obtaining high cell density. The central composite design and the response surface analysis were finally used to determine the optimal levels of the influential factors, which were 3 g/L for yeast extract concentration, 7 g/L cellobiose concentration and 34 degrees C for culture temperature. The optimized medium was used for flask culture, and OD600 of C. cellulolyticum was increased from 0.303 to 0.586. With a pH-controlled fermentor at batch mode, OD600 reached 3.432, which was 2.8 times higher than elsewhere reported. These results support further study on the high-density culture of C. cellulolyticum and its application.
Bacteriological Techniques ; methods ; Clostridium cellulolyticum ; growth & development ; Culture Media ; Population Density

BACKGROUND AND OBJECTIVESerum tumor markers play important roles in diagnosis, response and prognosis monitoring for lung cancer. The clinical significance of serum level of tissue polypeptide specific antigen (TPS) was investigated in diagnosis, response monitoring and prognosis in patients with lung cancer, compared with carcinoembryonic antigen (CEA), precursor of gastrin-releasing peptide (Pro-GRP) and cytokeratin-19-fragments (CYFRA21-1).

METHODSBlood samples of eighty-two patients with lung cancer before treatment and some after chemotherapy were measured by ELISA for four tumor markers.

RESULTSCompared with lung benign diseases group and health control group, the positive rates and levels of TPS, CEA and Pro-GRP in patients with lung cancer were higher, with statistically significant difference. TPS in extensive-small cell lung cancer was significant higher than that in limited-small cell lung cancer. The positive rates and levels of TPS, CEA and Pro-GRP in patients after treatment had significant decreases compared with before treatment. TPS was an independent prognostic factor of non-small cell lung cancer.

CONCLUSIONTPS is valuable to diagnosis, response monitoring for patients with lung cancer, moreover, it maybe a useful factor of prognosis of non-small cell lung cancer.

Adult ; Aged ; Aged, 80 and over ; Antigens, Neoplasm ; blood ; Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Keratin-19 ; blood ; Lung Neoplasms ; blood ; diagnosis ; Male ; Middle Aged ; Peptides ; blood ; Prognosis ; Protein Precursors ; blood ; ROC Curve

BACKGROUND AND OBJECTIVEResults of studies on genetic polymorphisms of ERCC1 gene in DNA repair pathway which may affect response to platinum-based chemotherapy and survival in patients with non-small cell lung cancer are conflicting. The aim of this study is to prospectively assess the association between single nucleotide polymorphisms of C8092A and codon118 in ERCC1 and drug response in 90 patients with advanced non-small cell lung cancer treated with cisplatin-based chemotherapy.

METHODSAll patients were treated with cisplatin-based chemotherapy. Genotypes of ERCC1 C8092A and codon118 were examined by sequencing, and the association between genotypes and response was evaluated.

RESULTSGenotype frequencies of ERCC1 C8092A were CC 40.0% (36/90), CA 48.9% (44/90) and AA 11.1% (10/90), frequencies of codon118 were CC 58.9% (53/90), CT 34.4% (31/90) and TT 6.7% (6/90). There was no significant difference in response rate of patients carrying with CC, compared with CA plus AA in C8092A (33.3% vs 29.6%, P = 0.71). Response rate of patients carrying with CC in ERCC1 118 was 32.1%, 24.3% with CT plus CC (P = 0.43). There was no difference in progression free survival between patients carrying with CC and CT plus TT in C8092A (5.2 months vs 5.4 months, P = 0.62). There was no difference in progression free survival between patients carrying with CC and CA plus AA (5.5 months vs 5.3 months, P = 0.59).

CONCLUSIONThe results suggest that there is no association between polymorphisms in ERCC1 C8092A and codon118 and response in patients with advanced non-small cell lung cancer receiving cisplatin-based chemotherapy.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; genetics ; mortality ; Cisplatin ; therapeutic use ; DNA-Binding Proteins ; genetics ; Disease-Free Survival ; Endonucleases ; genetics ; Female ; Genotype ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; mortality ; Male ; Middle Aged ; Polymorphism, Genetic ; genetics ; Prospective Studies

BACKGROUNDTo evaluate the values of a new tumor marker carbohydrate antigen (CA242) and combined determination of CA242, tissue polypeptide antigen (TPA), neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) in the diagnosis of malignant pleural effusion associated with lung cancer.

METHODSThe concentration of CA242, TPA, NSE and CEA in the serum and the pleural effusion was measured in 57 patients with malignant pleural effusion associated with primary lung cancer and 30 patients with tuberculous pleural effusion by enzyme-linked immunosorbent assay.

RESULTSThe levels of the four tumor markers in the serum and pleural effusion from patients with lung cancer were significantly higher than those with tuberculous pleural effusion (P < 0.01). The sensitivity of CA242 in the serum and the pleural effusion for lung cancer was 53.6% (31/57) and 61.4% (35/57) respectively; the sensitivity of CA242 for lung adenocarcinoma was 65.7% (23/36) and 66.7% (24/36) respectively. The specificity was 90.0%. Combined determination of the four tumor markers in serum and pleural effusion: If two or more of them were positive for evidence for diagnosis of lung cancer, the specificity for the serum and the pleural effusion was 96.7% (29/30) and 100.0% (30/30) respectively, with the sensitivity of 75.4% (43/57) and 77.2% (44/57) respectively.

CONCLUSIONSThe determination of the new tumor marker CA242 in serum and pleural effusion might be useful for the diagnosis of malignant pleural effusion associated with lung cancer, especially for adenocarcinoma. The combined determination of the four tumor markers can increase the specificity and the sensitivity in the diagnosis of malignant pleural effusion.

Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .

BACKGROUNDTopotecan is one of active agents for relapsed small cell lung can-cer (SCLC), some studies have shown that it is effective against SCLC as the first-line drug. This study is to assess the efficacy, toxicity and survival rate of topotecan plus cisplatin (TP) versus etoposide plus carboplatin (CE) in patients with previously untreated SCLC.

METHODSSixty-four patients with previously untreated SCLC were randomly assigned to receive either TP or CE. Topotecan 0.75 mg/(m²×d) via a 30-min intravenous infusion on days 1 to 5 and cisplatin 25 mg/(m²×d) on days 1 to 3 with hydration were given to patients in TP group. Carboplatin 300 mg/m² on day 1 and etoposide 100 mg/d on days 1 to 5 were given to patients in CE group. Treatment was repeated every 21 days. Responses and toxicities were evaluated in patients who received two cycles of chemotherapy. Patients with limited disease SCLC received thoracic irradiation or operation after the completion of chemotherapy.

RESULTSOverall response rate was 75.0% in TP group and 68.8% in CE group. The median survival time was 10.5 months in TP group and 9.6 months in CE group. 1-, 2- and 3-year survival rate were 40.6%, 18.8% and 9.4% in TP group and 34.4%, 15.6% and 9.4% in CE group respectively. There were no significant differences in response rate, median survival time and survival rate between two groups (P > 0.05). Myelosuppression, nausea and vomiting, and alopecia were the most common toxicities, there was no significant difference in grade III and IV toxicities between two groups (P > 0.05).

CONCLUSIONSTP has similar response rate and survivals with CE, and its toxicities are acceptable. TP regimen is an effective first-line treatment for SCLC.

BACKGROUNDTo evaluate the efficacy and toxicity of combined chemotherapy of domestic paclitaxel and vinorelbine plus cisplatin and carboplatin in the treatment of advanced non-small cell lung cancer (NSCLC).

METHODSA total of 181 initially treated patients with advanced NSCLC were enrolled in this study and treated by NP (vinorelbine plus cisplatin), TC (domestic paclitaxel plus carboplatin) and TP (domestic paclitaxel plus cisplatin). The efficacy and side effects were analysed after at least two cycles of chemotherapy.

RESULTSThe overall response rates (CR+PR) were 42.4% in the NP arm, 40.3% in the TC arm and 43.3% in the TP arm respectively. No significant statistical difference was found among the three groups ( Chi-square= 0.108 6 , P > 0.05). The median survival times were 8.4 months, 9.4 months and 8.9 months respectively in the NP, TC and TP groups ( P > 0.05). The 1-, 2-, 3-year survival rates were 39.0%, 16.9%, 5.1% in the NP group and 41.9%, 21.0%, 6.5% in the TC group and 40.0%, 18.3%, 5.0% in the TP group respectively. No significant statistical difference was found among the three groups ( Chi-square=0.140 4, P > 0.05). The major side effects were myelosuppression, alopecia and nausea/vomiting in the three groups. There were no chemotherapy-related death among the three groups.

CONCLUSIONSThe combined regimens of NP, TC and TP are effective and well-tolerated regimens for advanced NSCLC.

Objective To explore the relationship between plasma adiponectin, visfatin, leptin, and resistin levels, and the onset of colonic polyps in prediabetes subjects. Methods A total of 468 prediabetes subjects, who received colonoscopy examination, were enrolled in this study, including 248 cases of colon polyps (polyps group with prediabetes) and 220 cases without colonic mucosal lesions ( polyps-free group with prediabetes). According to the clinical characteristics of colonic polyps, colonic polyps patients with prediabetes were subdivided into single polyp group, multiple polyps group, low-risk polyps group, and high-risk polyps group, respectively. In addition, 108 subjects with normal glucose tolerance, who were matched with prediabetes subjects on gender and age, were selected as control group, and 46 cases of them were refered to polyps group with normal glucose tolerance and 62 cases were refered to polyps-free group with normal glucose. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all subjects, and related risk factors of colonic polyps in prediabetes patients were analyzed. Results Not only in normal glucose tolerance subjects, but also in prediabetes subjects, plasma visfatin levels in polyps group were significantly higher than those in polyps-free group (P＜0.05), and plasma adiponectin levels were significantly lower than those in polyps-free group [normal glucose tolerance (9.8±4.8 vs 13.3±3.9)mg/L, P＜0.05; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4)mg/L, P＜0.01], respectively. However, no significant difference in the plasma leptin and resistin levels were observed between polyps-free group and polyps group ( both P＞0. 05), respectively. In addition, in prediabetes subjects, plasma visfatin levels increased (P＜0.05) and adiponectin levels decreased significantly [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P＜0.05] in multiple polyps group than in single polyp group. Nevertheless, there were no significant differences in plasma leptin and resistin levels between two groups (both P＞0.05). Moreover, plasma adiponectin levels decreased significantly in high-risk polyps group with prediabetes than in low-risk polyps group with prediabetes[(3.7±2.9vs7.4±3.5)mg/L,P＜0.05].Meanwhile,noneofplasmavisfatin,leptin,andresistinlevels had shown significant difference between two groups (all P＞0.05). The multivariate logistic regression analysis found that adiponectin was an independent protective factor for colon polyps, multiple colon polyps and high-risk colon polyps. Conclusion The changes of plasma adiponectin levels might be associated with onset of colonic polyps in prediabetes.