Proteomic patterns analysis with multivariate calculations as a promising tool for prompt differentiation of early stage lung tissue with cancer and unchanged tissue material

<p>Abstract</p> <p>Background</p> <p>Lung cancer diagnosis in tissue material with commonly used histological techniques is sometimes inconvenient and in a number of cases leads to ambiguous conclusions. Frequently advanced immunostaining techniques have to be employed, yet they are both time consuming and limited. In this study a proteomic approach is presented which may help provide unambiguous pathologic diagnosis of tissue material.</p> <p>Methods</p> <p>Lung tissue material found to be pathologically changed was prepared to isolate proteome with fast and non selective procedure. Isolated peptides and proteins in ranging from 3.5 to 20 kDa were analysed directly using high resolution mass spectrometer (MALDI-TOF/TOF) with sinapic acid as a matrix. Recorded complex spectra of a single run were then analyzed with multivariate statistical analysis algorithms (principle component analysis, classification methods). In the applied protocol we focused on obtaining the spectra richest in protein signals constituting a pattern of change within the sample containing detailed information about its protein composition. Advanced statistical methods were to indicate differences between examined groups.</p> <p>Results</p> <p>Obtained results indicate changes in proteome profiles of changed tissues in comparison to physiologically unchanged material (control group) which were reflected in the result of principle component analysis (PCA). Points representing spectra of control group were located in different areas of multidimensional space and were less diffused in comparison to cancer tissues. Three different classification algorithms showed recognition capability of 100% regarding classification of examined material into an appropriate group.</p> <p>Conclusion</p> <p>The application of the presented protocol and method enabled finding pathological changes in tissue material regardless of localization and size of abnormalities in the sample volume. Proteomic profile as a complex, rich in signals spectrum of proteins can be expressed as a single point in multidimensional space and than analysed using advanced statistical methods. This approach seems to provide more precise information about a pathology and may be considered in futer evaluation of biomarkers for clinical applications in different pathology. Multiparameter statistical methods may be helpful in elucidation of newly expressed sensitive biomarkers defined as many factors "in one point".</p

Diagnostic and therapeutic difficulties in mediastinal fibromatosis. Case report

Włókniakowatość (fibromatosis) śródpiersia to bardzo rzadki mezenchymalny guz wywodzący się z tkanki włóknistej. W pracy przedstawiono przypadek 26-letniego mężczyzny z guzem śródpiersia wywołującym niewydolność oddechową oraz dysfagię. Objawy te spowodowane były uciskiem przełyku oraz naciekaniem i zamknięciem oskrzela głównego lewego przez masę guzowatą śródpiersia. Etiologia guza została ostatecznie ustalona na podstawie badania histopatologicznego wycinków pobranych podczas torakotomii próbnej dopiero po 3 latach i przeprowadzeniu wielu badań diagnostycznych. Autorzy opisują trudności w diagnostyce guzów śródpiersia, szczególnie tych rzadko występujących.Mediastinal fibromatosis is a very rare mesenchymal tumor originated from fibrous tissue. A case of 26-year old men with mediastinal tumor causes respiratory insufficiency and dysphagia is described. This sympthoms occured due to esophageal impression and infiltration with occlusion of main left bronchus by mediastinal tumor. Ethiology of the tumor was established based on histopathology assesment of the tissue samples taken during explorative thoracotomy after 3 years and many other diagnostic procedures undertaken. The authors describe difficulties in diagnosis of mediastinal tumors, especially those rare observed

Non-small cell lung cancer in patient with visceral total inversion

W artykule przedstawiono opis przypadku współwystępowania wrodzonego stanu anatomicznego pod postacią zespołu całkowitego odwrócenia trzewi oraz niedrobnokomórkowego raka płuca lewego u 74-letniego chorego. Omówiono epidemiologię i główne odrębności anatomiczne występujące w tym rzadkim zespole. Przedstawiono proces diagnostyczny, wyniki poszczególnych badań mających kluczowe znaczenie dla procesu leczniczego oraz zastosowaną technikę leczenia operacyjnego. Przeanalizowano wyniki histopatologiczne oraz przebieg okołooperacyjny. Odniesiono się do opisów podobnych przypadków dostępnych w literaturze światowej.This article reports a case of non-small cell lung cancer in a 74-year-old man with visceral total inversion. The epidemiology and main anatomical differences present in this rare syndrome, as well as basic information on lung cancer, are explored. We present diagnostic procedures and their results and describe the surgical technique of lung cancer treatment performed in this rare case. The perioperative period and the histopathological findings are analysed. Finally, references to similar cases found in worldwide literature are discussed

Program of early detection of pulmonary neoplasms by the computed tomography - preliminary Szczecin experience

Wstęp: Rak płuca (RP) stanowi jeden z najpoważniejszych problemów epidemiologicznych i klinicznych w Polsce i na świecie. Wyniki leczenia RP są niezadowalające. Jedną z przyczyn wysokiej umieralności z powodu RP jest niski odsetek pacjentów identyfikowanych we wczesnym stadium choroby. Obecnie na świecie prowadzi się kilka programów przesiewowych RP opartych na tomografii komputerowej (TK). W Polsce dotychczas nie przeprowadzono tego typu badań. Materiał i metody: Badaniami przesiewowymi objęto mieszkańców Szczecina znajdujących się w grupie podwyższonego ryzyka zachorowania na raka płuca: wiek 55-65 lat, obie płcie, osoby palące tytoń lub mające w wywiadzie przynajmniej 20 paczkolat palenia. Program zaplanowano na minimum 3 kolejne lata i rozpoczęto 1 maja 2008 roku. Do 31 grudnia 2008 roku przebadano 3647 osób. Algorytm dalszego postępowania z pacjentami w zależności od rodzaju wykrytych zmian oparto na protokole International Early Lung Cancer Action Program (IELCAP) oraz na programie NELSON. Wyniki: Wykryto 25 nowotworów złośliwych, w tym 21 niedrobnokomórkowych RP (17 kobiet, 4 mężczyzn), z tego 70% w stadium I. W porównywalnej grupie wiekowej diagnozowanej na podstawie objawów odsetek RP w stadium IA wynosił jedynie 16,8%. Pięćdziesięciu siedmiu chorych operowano, wykonując radykalne wycięcie płata lub płuca z limfadenektomią śródpiersia w 16 przypadkach. U 3 osób przeprowadzono resekcję brzeżną, u 2 kolejnych segmentektomię. Śmiertelność okołooperacyjna wyniosła 0%. Usunięto również 3 przerzuty do płuc oraz pobrano wycinki międzybłoniaka złośliwego. W 32 przypadkach usunięto zmiany łagodne (gruźliczaki, odpryskowiaki, zmiany zapalne, grzybicze, sarkoidalne i inne) o różnym znaczeniu klinicznym. U 996 osób stwierdzono ogółem 1365 zmian w obrębie klatki piersiowej, które były diagnozowane zgodnie z przyjętym algorytmem. Wnioski: Program wczesnego wykrywania nowotworów płuc zainicjowany w Szczecinie pozwolił istotnie zwiększyć liczbę pacjentów zidentyfikowanych we wczesnym stadium choroby, a następnie leczonych radykalnie. Wykryto znaczną liczbę zmian o zróżnicowanym znaczeniu klinicznym, podlegających dalszej ocenie.Introduction: Lung cancer (LC) remains one of the most serious epidemiological and clinical challenges both in the world and Poland. Results of LC therapy are far from satisfaction. One of the reasons of high LC mortality is its late detection. Currently, few centers in the world conduct LC screening programs based on low-dose spiral computed tomography (CT) of the chest. There have been no such programs in Poland up to date. Material and methods: The program of LC early detection based on CT for citizens of Szczecin aged 55-65, who smoked at least 20 pack/years, was introduced on May 1st 2008 and was planned for 3 years. There were 3647 subjects examined till December 31st 2008. Algorithm of further action for detected lesions was based on the IELCAP and NELSON trial protocols. Results: There were 25 malignancies detected, including 21 LC (17 females and 4 males) up to date (70% were in stage I TNM). In contrast - there was only 16.8% stage IA LC detected in the comparable group diagnosed on the symptoms basis. Fifty seven patients were treated surgically, of whom 16 underwent lobectomy or pneumonectomy coupled with radical mediastinal lymphadenectomy. There were 3 wedge resections and 2 segmentectomies performed, too. Perioperative mortality was 0%. There were 32 benign lesions of different clinical importance resected as well (tuberculoma, hamartoma, inflammatory, mycotic and sarcoidal lesions). In our group 1365 lesions were detected in 996 persons &#8212; they are followed up in accordance with the IELCAP algorithm. Conclusions: Early LC detection program initiated in Szczecin resulted in significant increase of stage IA TNM detected patients subsequently treated radically. There was also a large number of small non malignant lesions detected

The assessment of the role of baseline low-dose CT scan in patients at high risk of lung cancer

Background: Despite the progress in contemporary medicine comprising diagnostic and therapeutic methods, lung cancer is still one of the biggest health concerns in many countries of the world. The main purpose of the study was to evaluate the detection rate of pulmonary nodules and lung cancer in the initial, helical low-dose CT of the chest as well as the analysis of the relationship between the size and the histopathological character of the detected nodules. Material and Methods: We retrospectively evaluated 1999 initial, consecutive results of the CT examinations performed within the framework of early lung cancer detection program initiated in Szczecin. The project enrolled persons of both sexes, aged 55-65 years, with at least 20 pack-years of cigarette smoking or current smokers. The analysis included assessment of the number of positive results and the evaluation of the detected nodules in relationship to their size. All of the nodules were classified into I of VI groups and subsequently compared with histopathological type of the neoplastic and nonneoplastic pulmonary lesions. Results: Pulmonary nodules were detected in 921 (46%) subjects. What is more, malignant lesions as well as lung cancer were significantly, more frequently discovered in the group of asymptomatic nodules of the largest dimension exceeding 15 mm. Conclusions: The initial, low-dose helical CT of the lungs performed in high risk individuals enables detection of appreciable number of indeterminate pulmonary nodules. In most of the asymptomatic patients with histopathologically proven pulmonary nodules greater than 15 mm, the mentioned lesions are malignant, what warrants further, intensified diagnostics

Non-small Cell Lung Cancer in Patient with Visceral Total Inversion

This article reports a case of non-small cell lung cancer in a 74-year-old man with visceral total inversion. The epidemiology and main anatomical differences present in this rare syndrome, as well as basic information on lung cancer, are explored. We present diagnostic procedures and their results and describe the surgical technique of lung cancer treatment performed in this rare case. The perioperative period and the histopathological findings are analysed. Finally, references to similar cases found in worldwide literature are discussed

Influence of the Levels of Arsenic, Cadmium, Mercury and Lead on Overall Survival in Lung Cancer

The effects of heavy metals on cancer risk have been widely studied in recent decades, but there is limited data on the effects of these elements on cancer survival. In this research, we examined whether blood concentrations of the heavy metals arsenic, cadmium, mercury and lead were associated with the overall survival of lung cancer patients. The study group consisted of 336 patients with lung cancer who were prospectively observed. Blood concentrations of heavy metals were measured to study the relationship between their levels and overall survival using Cox proportional hazards analysis. The hazard ratio of death from all causes was 0.99 (p = 0.94) for arsenic, 1.37 (p = 0.15) for cadmium, 1.55 (p = 0.04) for mercury, and 1.18 (p = 0.47) for lead in patients from the lowest concentration quartile, compared with those in the highest quartile. Among the patients with stage IA disease, this relationship was statistically significant (HR = 7.36; p &lt; 0.01) for cadmium levels in the highest quartile (&gt;1.97–7.77 µg/L) compared to quartile I (0.23–0.57 µg/L, reference). This study revealed that low blood cadmium levels &lt;1.47 µg/L are probably associated with improved overall survival in treated patients with stage IA disease