37 research outputs found

    Aptamers in Diagnostics and Treatment of Viral Infections

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    Aptamers are in vitro selected DNA or RNA molecules that are capable of binding a wide range of nucleic and non-nucleic acid molecules with high affinity and specificity. They have been conducted through the process known as SELEX (Systematic Evolution of Ligands by Exponential Enrichment). It serves to reach specificity and considerable affinity to target molecules, including those of viral origin, both proteins and nucleic acids. Properties of aptamers allow detecting virus infected cells or viruses themselves and make them competitive to monoclonal antibodies. Specific aptamers can be used to interfere in each stage of the viral replication cycle and also inhibit its penetration into cells. Many current studies have reported possible application of aptamers as a treatment or diagnostic tool in viral infections, e.g., HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C Virus), SARS (Severe Acute Respiratory Syndrome), H5N1 avian influenza and recently spread Ebola. This review presents current developments of using aptamers in the diagnostics and treatment of viral diseases

    Patofizjologiczne mechanizmy migotania przedsionk贸w (AF) jako podstawa skutecznego leczenia w d膮偶eniu do polepszenia jako艣ci 偶ycia chorych w 艣wietle aktualnych wytycznych ESC (European Society of Cardiology)

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    Migotanie przedsionk贸w (atrial fibrillation, AF) nale偶y do najcz臋stszych przyczyn nag艂ych zgon贸w, udar贸w m贸zgu i niewydolno艣ci serca, a zapadalno艣膰 na AF w najbli偶szych latach jeszcze wzro艣nie. Przyczynami choroby s膮: predyspozycje genetyczne, cukrzyca, niewydolno艣膰 serca, oty艂o艣膰, choroba wie艅cowa, nadci艣nienie t臋tnicze i starzenie si臋. Zmiany patofizjologiczne AF obejmuj膮 przebudow臋 przedsionk贸w i naczy艅 wie艅cowych, odczyn zapalny, niedokrwienie oraz zaburzenia gospodarki wapniowej kardiomiocyt贸w. Jako艣膰 偶ycia chorych z AF jest istotnie gorsza ni偶 u os贸b zdrowych. Dzieje si臋 tak wskutek os艂abienia, ko艂atania serca, duszno艣ci, ucisku w klatce piersiowej i zaburze艅 snu. Chorobie towarzyszy tak偶e stres psychospo艂eczny. Zintegrowane leczenie AF obejmuje 4 filary: zaanga偶owanych chorych, zespo艂y wielodyscyplinarne, narz臋dzia technologiczne i dost臋p do wszystkich mo偶liwych terapii. Rozpoznanie oraz kontrola chor贸b wsp贸艂istniej膮cych, leczenie przeciwzakrzepowe, kontrola rytmu serca i jego cz臋stotliwo艣ci, a tak偶e edukacja istotnie poprawiaj膮 rokowanie i jako艣膰 偶ycia chorych. Dora藕ne przywr贸cenie rytmu zatokowego i jego utrzymanie pozostaje integraln膮 cz臋艣ci膮 post臋powania. W celu zapobiegania nawrotowi AF, w razie wsp贸艂istniej膮cej niewydolno艣ci serca ze zmniejszon膮 frakcj膮 wyrzutow膮, stosuje si臋 leki nieantyarytmiczne (ACEI/ARB, LBA), podobnie jak ma to miejsce w kardiomiopatii nadci艣nieniowej (ACEI/ARB). Leczenie zabiegowe w AF ma na celu ca艂kowit膮 izolacj臋 偶y艂 p艂ucnych, co przynosi skuteczniejsz膮 kontrol臋 rytmu serca ni偶 farmakoterapia. Zabieg przezcewnikowy jest leczeniem z wyboru, a gdy jest on nieskuteczny lub przyjmowane leki nie pomagaj膮, przeprowadza si臋 zabieg chirurgiczny. Wiele wsp贸艂istniej膮cych chor贸b zwi臋ksza ryzyko wyst膮pienia, nawrot贸w i powik艂a艅 AF. Ich identyfikacja i leczenie odgrywaj膮 wa偶n膮 rol臋 w zapobieganiu AF oraz w optymalnym prowadzeniu chorych.Atrial fibrillation (AF) is one o f the most common causes o f sudden death, cerebral stroke and heart failure. AF morbidity will increase in the coming years. The disease is precipitated by gene predisposition, diabetes, heart failure, obesity, coronary disease, hypertension and aging. Pathophysiological changes include atrial and coronary arteries remodelling, inflammation, and cardiomyocyte calcium metabolism disorders. Life quality in AF patients is significantly impaired, as compared to healthy people, due to weakness, heart palpitation, dyspnea, chest discomfort and sleep disorders; psychosocial stress occurs as well. Integrated AF management requires 4 areas: patient involvement, multidisciplinary teams, technological tools and access to all currently possible therapies. Diagnosis and control of coexisting diseases, anticoagulant treatment, heart rhythm and heart rate control, as well as education, remarkably improve AF prognosis and life quality. Casual recovery and maintaining the sinus rhythm is important as a part of the integral approach. Prevention of AF recurrence include non-antiarrhythmic medicines (ACEI/ARB, LBA) in heart failure with decreased ejection fraction, as well as in hypertensive cardiomyopathy (ACEI/ ARB). Surgical treatment aims the total isolation of pulmonary veins with more efficient heart rhythm control, as compared to pharmacological management. In paroxysmal AF, percutaneous intervention is a treatment of choice. Surgery can be necessary, if percutaneous intervention either pharmacotherapy is unsuccessful. Coexisting diseases elevate the risk of AF, including AF recurrence and complications. They need to be properly identified and treated in order to optimize the patient management

    Apoptosis of alveolar lymphocytes. Part 1: pathways of lymphocyte apoptosis

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    Apoptoza jest postaci膮 zaprogramowanej 艣mierci, zasadnicz膮 w utrzymaniu homeostazy ustrojowej, w tym zapocz膮tkowania, rozwoju i zej艣cia reakcji odporno艣ciowych. Wyr贸偶niono dwa g艂贸wne szlaki apoptozy, zewn膮trzpochodny (z po艣rednictwem receptor贸w 艣mierci) i wewn膮trzpochodny (mitochondrialny). Dodatkowo limfocyty o czynno艣ci cytotoksycznej inicjuj膮 apoptoz臋 kom贸rek docelowych na szlaku granzym贸w/perforyny (pseudoreceptorowym). Swoiste procesy apoptotyczne, tj. 艣mier膰 kom贸rkowa wzbudzona aktywacj膮 (AICD) i 艣mier膰 z zaniechania (NID) s膮 odmianami odpowiednio: szlaku zewn膮trz- i wewn膮trzpochodnego. Obydwa wydaj膮 si臋 pe艂ni膰 kluczow膮 rol臋 w apoptozie uczulonych antygenowo kom贸rek T w fazie kontrakcji odczynu zapalnego. Limfocyty p臋cherzykowe (AL) s膮 prawie wy艂膮cznie efektorowymi kom贸rkami T, uczestnicz膮cymi w patofizjologii 艣r贸dmi膮偶szowych chor贸b p艂uc (ILD). Liczba AL w dolnych drogach oddechowych zale偶y od rekrutacji do p艂uc, proliferacji i miejscowej apoptozy. Zgodnie z pi艣miennictwem nale偶y zaznaczy膰, 偶e AL zwykle nie proliferuj膮 w p臋cherzykach p艂ucnych, cz臋sto艣膰 ich apoptozy wynosi oko艂o 1% kom贸rek u os贸b zdrowych i jest ono znamiennie obni偶one w chorobach z limfocytowym zapaleniem p臋cherzyk贸w, jak sarkoidoza i zewn膮trzpochodne alergiczne zapalenie p臋cherzyk贸w (EAA). Mechanizmy apoptozy AL nie zosta艂y ca艂kowicie wyja艣nione. Prawdopodobnie zasadnicze znaczenie w wygaszaniu odpowiedzi ze strony kom贸rek T, jak w remisji w EAA lub sarkoidozie, pe艂ni jednak proces NID, podczas gdy mechanizm AICD ma znaczenie pomocnicze i/lub moduluj膮ce. Wypada podkre艣li膰, 偶e wiele chor贸b grupy ILD ma charakter przewlek艂y bez remisji lub poprawy klinicznej i opisanie ich w kategoriach ekspansji/kontrakcji odpowiedzi immunologicznej napotyka na trudno艣ci.Apoptosis is a form of programmed cell death essential for maintaining homeostasis, including onset, progress and resolution of immune reactions. Two major apoptosis pathways: extrinsic (mediated by death receptors) and intrinsic (mitochondrial), were distinguished. Lymphocytes with cytotoxic activity may also initiate apoptosis of target cells by granzyme/perforin (pseudoreceptor) pathway. The specific apoptotic processes, i.e. activation induced cell death (AICD) and neglect induced death (NID), are types of extrinsic and intrinsic pathways, respectively. They both seem to be crucial in apoptosis of antigen-primed T cells during the contraction phase of inflammation. Alveolar lymphocytes (AL) are almost exclusively T effector cells, engaged in interstitial lung disease (ILD) pathophysiologies. The AL numbers in lower airways depends on recruitment to the lung, proliferation and local apoptosis. According to the references, it should be noted that AL usually do not proliferate in alveoli; their apoptosis rate accounts, on average, for 1% of cells in healthy subjects, and this is significantly decreased in disorders with lymphocytic alveolitis such as sarcoidosis and extrinsic allergic alveolitis (EAA). The mechanisms of AL apoptosis have not been completely explained. However, it is the NID process that is probably critical for the culling of T-cell response, as in EAA or sarcoidosis remission, with AICD as an auxiliary and/or modulating mechanism only. It should be emphasised that many ILDs are chronic disorders with no remission or improvement, and it is difficult to describe the AL response in terms of immune expansion/contraction

    Expression of insulin-like growth factor-I (IGF-I) in alveolar macrophages and lymphocytes obtained by bronchoalveolar lavage (BAL) in interstitial lung diseases (ILD). Assessment of IGF-I as a potential local mitogen and antiapoptotic cytokine.

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    Little is known about IGF-I expression in the alveolar lymphocytes (AL), and about local role of IGF-I in physiological conditions and in interstitial lung diseases. Bronchoalveolar lavage was carried out in patients with silicosis, asbestosis, idiopathic pulmonary fibrosis (IPF) and sarcoidosis, as well as in control subjects (n = 13, 9, 12, 56, 15, resp). Alveolar macrophages (AM) and lymphocytes (AL) were studied for (1) IGF-I, BCL-2, Fas and Fas Ligand expression and (2) cell cycle (incl. sub-G1 peak of late apoptosis) with propidium iodide (PI). Flow cytometry (FC) and immunocytochemistry were used. AL early apoptosis was detected by Annexin V FITC/PI staining. IGF-I was present in AL of all tested groups. The number of IGF-I positive AL was significantly higher in IPF (52 +/- 6.7%) and in later (II and III) stages of sarcoidosis (39 +/- 7.8 vs 16 +/- 4.0% in controls, p < 0.05). Increased BCL-2 expression in AL was detected in IPF and sarcoidosis. In all tested groups, AL were almost exclusively Fas+ T cells. Generally, a low number of AL entered apoptosis; no significant differences were found between patient groups, except decreased apoptosis rate in sarcoidosis (0.60 +/- 0.17 vs 1.15 +/- 0.33% in controls, p < 0.05). Proportion of AL positive for IGF-I was significantly correlated with parameters reflecting AL and AM cell proliferation and BCL-2 expression (e.g. AL IGF-I+ vs AM in S phase of cell cycle: r(S) = +0.50, p = 0.001), but not with apoptosis. The results show that human alveolar lymphocytes express IGF-I in normal conditions, as well as in ILD. The proportion of IGF-I+ lymphocytes was significantly increased in IPF and at later stages of sarcoidosis. In our material there was no evidence for profibrogenic or antiapoptotic activity of IGF-I. We suggest that IGF-I originating from AL may be locally active as a mitogen for alveolar macrophages and lymphocytes in ILD

    Expression of insulin-like growth factor-I (IGF-I) in alveolar macrophages and lymphocytes obtained by bronchoalveolar lavage (BAL) in interstitial lung diseases (ILD) : assessment of IGF-I as a potential local mitogen and antiapoptotic cytokine

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    Little is known about IGF-I expression in the alveolar lymphocytes (AL), and about local role of IGF-I in physiological conditions and in interstitial lung diseases. Bronchoalveolar lavage was carried out in patients with silicosis, asbestosis, idiopathic pulmonary fibrosis (IPF) and sarcoidosis, as well as in control subjects (n = 13, 9, 12, 56, 15, resp). Alveolar macrophages (AM) and lymphocytes (AL) were studied for (1) IGF-I, BCL-2, Fas and Fas Ligand expression and (2) cell cycle (incl. sub-G1 peak of late apoptosis) with propidium iodide (PI). Flow cytometry (FC) and immunocytochemistry were used. AL early apoptosis was detected by Annexin V FITC/PI staining. IGF-I was present in AL of all tested groups. The number of IGF-I positive AL was significantly higher in IPF (52 +/- 6.7%) and in later (II and III) stages of sarcoidosis (39 +/- 7.8 vs 16 +/- 4.0% in controls, p &lt; 0.05). Increased BCL-2 expression in AL was detected in IPF and sarcoidosis. In all tested groups, AL were almost exclusively Fas+ T cells. Generally, a low number of AL entered apoptosis; no significant differences were found between patient groups, except decreased apoptosis rate in sarcoidosis (0.60 +/- 0.17 vs 1.15 +/- 0.33% in controls, p &lt; 0.05). Proportion of AL positive for IGF-I was significantly correlated with parameters reflecting AL and AM cell proliferation and BCL-2 expression (e.g. AL IGF-I+ vs AM in S phase of cell cycle: r(S) = +0.50, p = 0.001), but not with apoptosis. The results show that human alveolar lymphocytes express IGF-I in normal conditions, as well as in ILD. The proportion of IGF-I+ lymphocytes was significantly increased in IPF and at later stages of sarcoidosis. In our material there was no evidence for profibrogenic or antiapoptotic activity of IGF-I. We suggest that IGF-I originating from AL may be locally active as a mitogen for alveolar macrophages and lymphocytes in ILD

    Role of endoplasmic-reticulum-associated protein degradation pathway in the virus infection cycle

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    Wandtke Tomasz, W臋drowska Ewelina, Goede Arkadiusz, Owczarska Paulina, Piskorska El偶bieta, Kopi艅ski Piotr. Role of endoplasmic-reticulum-associated protein degradation pathway in the virus infection cycle. Journal of Education, Health and Sport. 2017;7(8):607-635. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.890229 http://ojs.ukw.edu.pl/index.php/johs/article/view/4801 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 漏 The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2017. Revised: 10.08.2017. Accepted: 31.08.2017. Znaczenie zale偶nego od retikulum endoplazmatyznego szlaku degradacji bia艂ek wewn膮trzkom贸rkowych w cyklu infekcyjnym wirus贸w Role of endoplasmic-reticulum-associated protein degradation pathway in the virus infection cycle Tomasz Wandtke1, Ewelina W臋drowska1, Arkadiusz Goede1, Paulina Owczarska1, El偶bieta Piskorska2, Piotr Kopi艅ski1 1Zak艂ad Genoterapii, Uniwersytet Miko艂aja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy 2Katedra Patobiochemii i Chemii Klinicznej, Uniwersytet Miko艂aja Kopernika w Toruniu, Collegium Medicum im. L. Rydygiera w Bydgoszczy 1Department of Gene Therapy, Faculty of Medicine, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland 2Department of Pathobiochemistry and Clinical Chemistry, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland Streszczenie Wprowadzenie: Proces degradacji bia艂ek zale偶ny od retikulum endoplazmatycznego (ang. endoplasmic-reticulum-associated protein degradation - ERAD) odgrywa istotn膮 rol臋 w utrzymaniu stanu homeostazy wewn膮trzkom贸rkowej i dotyczy przede wszystkim bia艂ek, kt贸re nie uzyska艂y posttranslacyjnie prawid艂owej konformacji. Mechanizm ten mo偶e zosta膰 wykorzystany przez wirusy, zwykle celem unikni臋cia detekcji przez uk艂ad odporno艣ciowy gospodarza. Zale偶nie od typu wirusa, rodzaj i spos贸b degradacji bia艂ek bywa odmienny. Cel pracy: Celem pracy jest przedstawienie mechanizmu ERAD oraz jego znaczenia dla cyklu infekcyjnego wybranych cz膮steczek wirusowych. Dok艂adne poznanie tego procesu mo偶e istotnie przyczyni膰 si臋 do wskazania potencjalnie skutecznych, nowych przeciwwirusowych rozwi膮za艅 terapeutycznych. Skr贸cony opis stanu wiedzy: W pracy om贸wiono mechanizm ERAD i jego wykorzystanie przez: Poliomawirusy (BK i SV-40), Herpeswirusy (Cytomegalowirus), Retrowirusy (HIV-I) oraz Hepadnawirusy (HBV). Podsumowanie: Znaczenie ERAD w cyklu infekcyjnym wirus贸w jest niezwykle istotne w przebiegu zaka偶enia. Nale偶y dalej bada膰 mo偶liwo艣膰 wykorzystywania ERAD przez inne rodzaje wirus贸w. Warto r贸wnie偶 monitorowa膰 skuteczno艣膰 inhibitor贸w proteasomu jako potencjalnych lek贸w w walce z chorobami wirusowymi. S艂owa kluczowe: ERAD, Herpeswirusy, HBV, HIV-I, Poliomawirusy, retikulum endoplazmatyczne Summary Introduction: The endoplasmic-reticulum-associated protein degradation (ERAD) pathway plays an important role in maintaining intracellular homeostasis and primarily affects proteins that have not achieved correct post-translational conformation. ERAD can be also exploited by viruses, usually in order to avoid detection by the host's immune system. Depending on the type of virus, the character and manner of protein degradation may be different. Aim of the study: The aim of this paper is to present the ERAD mechanism and its importance for the infection cycle of select viral particles. Gaining knowledge about this process can help to identify potentially effective new antiviral therapies. Short description of state of knowledge: The ERAD mechanism and its utilization by: Poliomaviruses (BK and SV-40), Herpesviruses (Cytomegalovirus), Retroviruses (HIV-I) and Hepadnaviruses (HBV) are discussed in the paper. Summation: The ERAD process in the viral infection cycle is extremely important. The possibility of using ERAD by differnet viruses should be further investigated. It could be also useful to exploit proteasome inhibitors as potential drugs in the fight against viral diseases. Key words: ERAD, Herpesviruses, HBV, HIV-I, Poliomaviruses, endoplasmic reticulu

    Enhanced expression of Fas Ligand (FasL) in the lower airways of patients with fibrotic interstitial lung diseases (ILDs)

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    The exact role of FasL, and particularly its soluble and membrane-bound forms, in the development of chronic ILDs and lung fibrosis has not been extensively explored. We aimed at analyzing membrane-bound FasL expression on alveolar macrophages (AM) and lymphocytes (AL) as well as soluble FasL (sFasL) levels in bronchoalveolar lavage (BAL) from ILDs patients, incl. pulmonary sarcoidosis (PS), hypersensitivity pneumonitis (HP), silicosis, asbestosis, idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), and healthy subjects (n = 89, 12, 7, 8, 23, 6, 17, respectively). In IPF, significantly increased percentage of AM FasL+ and CD8+FasL+ cells as well as sFasL levels in BAL were found. Increased sFasL levels were also observed in HP. NSIP and asbestosis were characterized by higher AM FasL+ relative number; CD8+FasL+ population was expanded in asbestosis only. There was a significant decline in AL FasL+ percentage in PS and HP. Vital capacity was negatively correlated with sFasL levels, AM FasL+ and CD8+FasL+ cell relative count. CD4+FasL+ and CD8+FasL+ percentage strongly correlated with BAL neutrophilia, an unfavorable prognostic factor in lung fibrosis. The concurrent comparative BAL analysis of FasL expression indicates that FasL+ AM and AL (mainly Tc cells) comprise an important element of the fibrotic process, mostly in IPF. FasL might play a crucial role in other fibrosis-complicated ILDs, like NSIP and asbestosis. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 4, pp. 636&#8211;645

    Transbronchial needle aspiration as a diagnostic method in lung cancer and non-malignant mediastinal adenopathy

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    Introduction: The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: lung cancer, staging of NSCLC, sarcoidosis and other non-malignant diseases. Material and methods: Transbronchial needle aspiration was performed in 347 consecutive patients - 402 biopsies in groups of lymph nodes: subcarinal (7) - 179, all paratracheal (2R, 2L, 4R, 4L) - 168 and hilar (10R, 10L) - 55, with no real-time imaging guidance, preceded by computed tomography (CT), using 22-gauge needles. All negative results in NSCLC patients were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA) and the remaining patients underwent mediastinoscopy or thoracotomy. Results: TBNA technique was diagnostic in 67.1% of lung cancer patients and in 59.0% of patients with sarcoidosis. In the group of all lung cancer patients specificity was 100%, sensitivity 88.5%, accuracy 91.8% and negative predictive value 77.9% and in diagnosing of lymph nodes involvement in NSCLC was respectively 100%, 86.6%, 90.7% and 76.6%. The high diagnostic yield was comparable for all mediastinal groups. In 80% of NSCLC patients with false negative results of TBNA there was observed partial involvement of metastatic lymph nodes, confirmed by TEMLA. Conclusions: The diagnostic value of TBNA is very high in diagnostics of lung cancer, NSCLC staging and sarcoidosis but much lower in lymphomas, tuberculosis and other non-malignant diseases.Wst臋p: Celem pracy by艂a ocena skuteczno艣ci diagnostycznej przezoskrzelowej aspiracyjnej biopsji ig艂owej (TBNA) w chorobach przebiegaj膮cych z powi臋kszeniem w臋z艂贸w ch艂onnych 艣r贸dpiersia i wn臋k p艂uca w: raku p艂uca, ocenie stopnia zaawansowania niedrobnokom贸rkowego raka p艂uca (NSCLC), sarkoidozie i innych chorobach. Materia艂 i metody: U kolejnych 347 chorych wykonano 402 TBNA, poprzedzone tomografi膮 komputerow膮 klatki piersiowej, bez u偶ycia dodatkowych technik obrazowania w czasie rzeczywistym, z zastosowaniem igie艂 22-gauge nast臋puj膮cych grup w臋z艂贸w ch艂onnych: rozwidlenia tchawicy (7) - 179, przytchawiczych (2R, 2L, 4R, 4L) - 168 i wn臋kowych - 55. U chorych na NSCLC i z ujemnym wynikiem TBNA wykonywano weryfikuj膮c膮 operacyjn膮 obustronn膮 rozszerzon膮 limfadenektomi臋 艣r贸dpiersiow膮 (TEMLA), a w przypadku podejrzenia chor贸b nienowotworowych - mediastinoskopi臋 b膮d藕 limfadenektomi臋 艣r贸doperacyjn膮. Wyniki: Skuteczno艣膰 diagnostyczna TBNA w grupie chorych na raka p艂uca wynios艂a 67,1%, a na sarkoidoz臋 - 59%. Czu艂o艣膰 metody TBNA w rozpoznawaniu raka p艂uca wynios艂a 88,5%, swoisto艣膰 100%, dok艂adno艣膰 91,8%, a warto艣膰 predykcyjna wyniku ujemnego - 77,9%, a w ustalaniu stopnia zaawansowania NSCLC (cecha N) wynios艂a odpowiednio 86,6%, 100%, 90,7% i 76,6%. Du偶a skuteczno艣膰 diagnostyczna TBNA by艂a podobna we wszystkich bioptowanych grupach w臋z艂贸w ch艂onnych 艣r贸dpiersia. U 80% chorych na NSCLC, u kt贸rych uzyskano wyniki fa艂szywie ujemne TBNA przerzuty raka by艂y obecne tylko w cz臋艣ci w臋z艂贸w ch艂onnych, co potwierdzono operacyjnie metod膮 TEMLA. Wnioski: Przezoskrzelowa biopsja w臋z艂贸w ch艂onnych 艣r贸dpiersia i wn臋k jest bardzo skuteczn膮 metod膮 w diagnostyce raka p艂uca i sarkoidozy oraz ocenie stopnia zaawansowania NSCLC, a w mniejszym stopniu w diagnostyce ch艂oniak贸w i gru藕licy

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