Emphysema scores predict death from COPD and lung cancer

OBJECTIVE: Our objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer. METHODS: Emphysema was assessed with low-dose CT scans performed on 9,047 men and women for whom age and smoking history were documented. Each scan was scored according to the presence of emphysema as follows: none, mild, moderate, or marked. Follow-up time was calculated from time of CT scan to time of death or December 31, 2007, whichever came first. Cox regression analysis was used to calculate the hazard ratio (HR) of emphysema as a predictor of death. RESULTS: Median age was 65 years, 4,433 (49%) were men, and 4,133 (46%) were currently smoking or had quit within 5 years. Emphysema was identified in 2,637 (29%) and was a significant predictor of death from COPD (HR, 9.3; 95% CI, 4.3-20.2; P < .0001) and from lung cancer (HR, 1.7; 95% CI, 1.1-2.5; P = .013), even when adjusted for age and smoking history. CONCLUSIONS: Visual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer

Early Detection and Monitoring of Cancer with the Anti-Malignin Antibody Test &quot;

ABSTRACT: The serum anti-malignin antibody (AMA) test determines the antibody to malignin. a IO,OOO-Da peptide present in patients with a wide variety of cancers.l~ A total of 3315 double-blind tests demonstrated that AMA is a general transformation antibody, elevated in active no.nterminal cancer, regardless of the site or tissue type, with sensitivity and specificity of95% on the flTst determination and &gt;99% on repeat determinations. - 9 Data have not however been published yet that indicate whether, in daily clinical practice, the AMA test provides accurate prospective and predictive information. Fony-two physicians from II states, who ordered the AMA test, performed blind, report here on their results on 208 determinations in the first consecutive 181 patients and controls. Used in monitoring treatment in 56 patients, the test predicted or agreed 94.1 % overall with the clinical status. Used in early detection in 125 patients and controls, of which 118 now have confirmed diagnoses. AMA was elevated in 21, all of whom were proven to have cancer; AMA was normal in 97, none of whom had cancer. Transient elevated AMA occurred in 3%, followed by normal values. Seven patients with still uncertain diagnosis who have had elevated AMA on repeated tests for I year or longer include six who are symptomatic, and three whose families have a high frequency of cancer. The conditions of these 7 may include undetected cancer because of the 118 with now certain diagnosis the AMA test predicted all correctly. From our experience, the AMA test should be used together with other routine procedures whenever signs and symptoms suggest cancer to facilitate early detection

Emphysema scores predict death from COPD and lung cancer

OBJECTIVE: Our objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer. METHODS: Emphysema was assessed with low-dose CT scans performed on 9,047 men and women for whom age and smoking history were documented. Each scan was scored according to the presence of emphysema as follows: none, mild, moderate, or marked. Follow-up time was calculated from time of CT scan to time of death or December 31, 2007, whichever came first. Cox regression analysis was used to calculate the hazard ratio (HR) of emphysema as a predictor of death. RESULTS: Median age was 65 years, 4,433 (49%) were men, and 4,133 (46%) were currently smoking or had quit within 5 years. Emphysema was identified in 2,637 (29%) and was a significant predictor of death from COPD (HR, 9.3; 95% CI, 4.3-20.2; P < .0001) and from lung cancer (HR, 1.7; 95% CI, 1.1-2.5; P = .013), even when adjusted for age and smoking history. CONCLUSIONS: Visual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer