Retrospective assessment of the Lung-RADS performance in the Silesian Lung Cancer Screening Pilot Study

Background. A high percentage of false positive results, observed in lung cancer screening studies with low-dose computed tomography (LDCT), caused the modification of radiological assessment methods. According to the International Early Lung Cancer Action Program (IELCAP) all non-calcified nodules with a dimension ≥ 4 mm were considered as positive. Implementation of classification the Lung CT screening Reporting and Data System (Lung-RADS®) recommends additional testing only for nodules ≥ 6 mm, which reduced of false positive results. Methods. We provided a retrospective analysis of 601 LDCT scans, in asymptomatic volunteers of Pilot Silesian Study of Early Lung Cancer Detection, with at least 20 pack-years of cigarette smoking. The analysis of non- and invasive interventions was done. Assessment of nodules according to the Lung-RADS® system was done. Then the percentage of interventions that could be avoided using the Lung-RADS® criteria was estimated. Results. In total, 1016 nodules were identified in 265 participants. The positive result of screening was defined as a presence of solid or part-solid nodule ≥ 5 mm and ≥ 8 mm in the case of a nonsolid nodule in line with the IELCAP protocol. Screening based on the IELCAP protocol resulted in 200 positive results and based on Lung-RADS® in the 116 positives. The frequency of lung cancers among participants with a positive result was 7 of 200 (4.0%) (95% CI: 1.0%, 6.0%) for IELCAP and 7 of 116 (6.0%) (95% CI: 2.7%, 9.3%) for Lung-RADS®. The Lung-RADS® criteria reduced number of non- and invasive procedures by 48.8% and 24.1%, compared to IELCAP protocol. Conclusions. Adopting the Lung-RADS® classification system may reduce harms and improve the efficiency of lung cancer screening programs.xx

Experimental infections of different carp strains with the carp edema virus (CEV) give insights into the infection biology of the virus and indicate possible solutions to problems caused by koi sleepy disease (KSD) in carp aquaculture

Outbreaks of koi sleepy disease (KSD) caused by carp edema virus (CEV) may seriously affect populations of farmed common carp, one of the most important fish species for global food production. The present study shows further evidence for the involvement of CEV in outbreaks of KSD among carp and koi populations: in a series of infection experiments, CEV from two different genogroups could be transmitted to several strains of naïve common carp via cohabitation with fish infected with CEV. In recipient fish, clinical signs of KSD were induced. The virus load and viral gene expression results confirm gills as the target organ for CEV replication. Gill explants also allowed for a limited virus replication in vitro. The in vivo infection experiments revealed differences in the virulence of the two CEV genogroups which were associated with infections in koi or in common carp, with higher virulence towards the same fish variety as the donor fish. When the susceptibility of different carp strains to a CEV infection and the development of KSD were experimentally investigated, Amur wild carp showed to be relatively more resistant to the infection and did not develop clinical signs for KSD. However, the resistance could not be related to a higher magnitude of type I IFN responses of affected tissues. Despite not having a mechanistic explanation for the resistance of Amur wild carp to KSD, we recommend using this carp strain in breeding programs to limit potential losses caused by CEV in aquaculture

The Analysis of Receptor-binding Cancer Antigen Expressed on SiSo Cells (RCAS1) immunoreactivity within the microenvironment of the ovarian cancer lesion relative to the applied therapeutic strategy

RCAS1 is involved in generating the suppressive profile of the tumor microenvironment that helps cancer cells evade immune surveillance. The status of the cells surrounding the cancer nest may affect both the progression of the cancer and the development of metastases. In cases of ovarian cancer, a large number of patients do not respond to the applied therapy. The patient’s response to the applied therapy is directly linked to the status of the tumor microenvironment and the intensity of its suppressive profile. We analyzed the immunoreactivity of RCAS1 on the cells present in the ovarian cancer microenvironment in patients with the disease; these cells included macrophages and carcinoma-associated fibroblasts. Later we analyzed the immunoreactivity levels within these cells, taking into consideration the clinical stage of the cancer and the therapeutic strategy applied, such as the number of chemotherapy regiments, primary cytoreductive surgery, or the presence of advanced ascites. In the patients who did not respond to the therapy we observed significantly higher immunoreactivity levels of RCAS1 within the cancer nest than in those patients who did respond; moreover, in the non-responsive patients we found RCAS1 within both macrophages and carcinoma-associated fibroblasts. RCAS1 staining may provide information about the intensity of the immuno-suppressive microenvironment profile found in cases of ovarian cancer and its intensity may directly relate to the clinical outcome of the disease

The need of lung cancer screening — new evidence, new expectations

Rak płuca to najczęściej występujący nowotwór w Polsce i na świecie, jest główną przyczyną zgonów z powodu nowotworów złośliwych. W ciągu ostatnich 30 lat nie zaobserwowano zwiększenia odsetka 5-letnich przeżyć wśród chorych na ten nowotwór, udało się natomiast poprawić wyniki leczenia takich nowotworów jak rak piersi, jelita grubego czy szyjki macicy. Jest to niewątpliwie związane z przeprowadzaniem skutecznych badań przesiewowych. Wprowadzenie badań populacyjnych w kierunku wczesnego wykrywania raka płuca wydaje się uzasadnione. W latach 70. XX wieku przeprowadzono kilka randomizowanych badań klinicznych wykorzystujących w tym celu rentgenogramy klatki piersiowej i badanie cytologiczne plwociny, jednak nie wykazano w nich redukcji umieralności spowodowanej tym nowotworem. Prowadzono liczne badania z zastosowaniem niskodawkowej tomografii komputerowej. Wiele z tych projektów było badaniami obserwacyjnymi, bez grupy kontrolnej. Wykazano dużą czułość tomografii komputerowej w zakresie wykrywania wczesnych postaci raka, jednak określenie stopnia redukcji umieralności, głównego kryterium przydatności danego testu przesiewowego, jest możliwe jedynie w badaniach z grupą kontrolną. Przełomowym okazało się badanie przeprowadzone w Stanach Zjednoczonych — National Lung Screening Trial (NLST), w którym wykazano 20-procentową redukcję umieralności w grupie uczestników badanych za pomocą niskodawkowej tomografii komputerowej w porównaniu z grupą, w której wykonywano RTG klatki piersiowej. Oczekuje się na publikację wyników randomizowanych badań prowadzonych w Europie. Wielu badaczy poszukuje nowych metod diagnostycznych, które mogłyby pomóc we wczesnym wykrywaniu raka płuca. Należą do nich nowoczesne badania cytometryczne plwociny, badania molekularne czy bronchoskopia fluorescencyjna. Pneumonol. Alergol. Pol. 2011; 79, 6: 419–427Lung cancer is the most common cancer in Poland and in the world and the leading cause of cancer-related deaths. In the past 30 years lung cancer survival has not been improved. In the same period of time significant progress has been made in the results of treatment of many other cancers for example: breast, colorectal and prostate cancer. It may be connected with introduction of efficient screening tests. Lung cancer seems to be a disease for which screening could have great impact. In the 1970s trials evaluating chest roentgenograms and sputum cytology as screening modalities were conducted, but did not show reduction in lung cancer mortality. There have been several projects in which low-dose helical computed tomography was used. Many of them were non-randomized cohort studies and showed promising results with respect to sensitivity of computed tomography, but the real benefit, which is mortality reduction, must originate from randomized trials. The major breakthrough is the National Lung Screening Trial (NLST), randomized trial conducted in USA, that demonstrated 20% mortality reduction in low-dose computed tomography group comparing to radiography group. Several randomized trials are ongoing in Europe. Researchers continue to seek new methods of screening such as autofluorescence bronchoscopy, advanced techniques of sputum analysis and techniques of molecular biology. Pneumonol. Alergol. Pol. 2011; 79, 6: 419–42