Gene Expression Profiles from Needle Biopsies Provide Useful Signatures of Non-Small Cell Lung Carcinomas

Gene expression profiles from DNA microarrays can provide molecular signatures that improve tumor classification, prognosis, and treatment options. While much of this work has focused on isolation of RNA from the resected tumor, fewer studies have utilized RNA from fine needle aspirates (FNA). In this pilot study we examined whether the gene signatures obtained from FNA samples would correlate with signatures taken from the resected tumor. Based on NSCLC gene expression profiles obtained from eleven sets of FNA and tumor samples we obtained a high concordance of FNA profiles matching their matched tumor sample. These results suggest that FNA samples may provide informative gene expression signatures regarding the potential aggressiveness of non-small-cell lung carcinomas

Stromal Eosinophilia in Colonic Epithelial Neoplasms

OBJECTIVE: The purpose of this retrospective study was to determine the frequency and intensity of eosinophilic infiltration (or tissue eosinophilia) in the stroma of colonic adenomas, hyperplastic polyps, and colorectal adenocarcinomas. Eosinophilic infiltration in various malignancies has been reported but has not been evaluated in benign colorectal adenomas and hyperplastic polyps. METHODS: We analyzed 488 colonic neoplasms: 176 tubular adenomas, 55 tubulovillous adenomas, 82 villous adenomas, 15 early carcinomas in polyps, 95 invasive adenocarcinomas, and 65 hyperplastic polyps for the presence of eosinophilic infiltration. The eosinophilic infiltration was graded as negative (\u3c or =5%), mild to moderate (\u3e5-40%), or marked (\u3e40%), depending on the percentage of eosinophils relative to total inflammatory cells in the stroma. RESULTS: Mild to moderate eosinophilia was noted in 75% of all adenomas. The transitional zone in all cases of invasive adenocarcinoma (zone between normal tissue and adenocarcinoma) revealed a high percentage of tissue eosinophilia. There was a striking absence of TE in the stroma of invasive adenocarcinomas. Only 5% of hyperplastic polyps had any eosinophilic infiltration. CONCLUSIONS: These data suggest that, in the spectrum of colonic neoplasms, stromal eosinophilia is most prominent in adenomas and seems to decrease with progression through the adenoma-carcinoma sequence. The ramifications of this study may alter management plans and provide some prognostic information for clinical evaluation

Stromal Eosinophilia in Colonic Epithelial Neoplasms

OBJECTIVE: The purpose of this retrospective study was to determine the frequency and intensity of eosinophilic infiltration (or tissue eosinophilia) in the stroma of colonic adenomas, hyperplastic polyps, and colorectal adenocarcinomas. Eosinophilic infiltration in various malignancies has been reported but has not been evaluated in benign colorectal adenomas and hyperplastic polyps. METHODS: We analyzed 488 colonic neoplasms: 176 tubular adenomas, 55 tubulovillous adenomas, 82 villous adenomas, 15 early carcinomas in polyps, 95 invasive adenocarcinomas, and 65 hyperplastic polyps for the presence of eosinophilic infiltration. The eosinophilic infiltration was graded as negative (\u3c or =5%), mild to moderate (\u3e5-40%), or marked (\u3e40%), depending on the percentage of eosinophils relative to total inflammatory cells in the stroma. RESULTS: Mild to moderate eosinophilia was noted in 75% of all adenomas. The transitional zone in all cases of invasive adenocarcinoma (zone between normal tissue and adenocarcinoma) revealed a high percentage of tissue eosinophilia. There was a striking absence of TE in the stroma of invasive adenocarcinomas. Only 5% of hyperplastic polyps had any eosinophilic infiltration. CONCLUSIONS: These data suggest that, in the spectrum of colonic neoplasms, stromal eosinophilia is most prominent in adenomas and seems to decrease with progression through the adenoma-carcinoma sequence. The ramifications of this study may alter management plans and provide some prognostic information for clinical evaluation

Choice of First Intervention is Related to Outcomes in the Management of Empyema

Background The study determined whether the first procedure; simple drainage (tube thoracostomy, pigtail catheter) or operation (video-assisted thoracic surgery [VATS], thoracotomy) was related to outcomes in the management of empyema. Methods Data were collected from 104 consecutive patients with empyema. Primary outcomes were additional procedures and death. Predictor variables included age, delay, Karnofsky performance status (KPS), Charlson comorbidity index (CCI), serum albumin, malignancy, Acute Physiology and Chronic Health Evaluation II score, loculations on computed tomography scan, empyema stage, and first procedure choice. Results Advanced empyema (≥ stage IIA) was present in 84% of patients. Overall treatment success rates (no death, no additional drainage procedures) among evaluable patients for pigtail drainage, tube thoracostomy, VATS, and thoracotomy were 40% (4 of 10), 38% (14 of 37), 81% (13 of 16), and 89% (32 of 36), respectively. Five patients underwent miscellaneous procedures. Univariate variables associated with hospital death included KPS, CCI, and drainage as the first procedure. In multivariate analyses, KPS (coefficient, –0.06, p = 0.002) and failure of the first procedure (odds ratio [OR], 6.76; 95% confidence interval [CI], 1.45 to 31.4, p = .01) were independent predictors of death. Simple drainage as the first procedure was a strong, independent predictor of failure of the first procedure (OR, 11.1; 95% CI, 3.51 to 34.9; p = .00004). Conclusions The choice of the first procedure is critical in the outcome for treatment of empyema, even with adjustment for confounding variables. VATS or thoracotomy as initial therapy for advanced empyema is associated with better outcome

Choice of First Intervention is Related to Outcomes in the Management of Empyema

Background The study determined whether the first procedure; simple drainage (tube thoracostomy, pigtail catheter) or operation (video-assisted thoracic surgery [VATS], thoracotomy) was related to outcomes in the management of empyema. Methods Data were collected from 104 consecutive patients with empyema. Primary outcomes were additional procedures and death. Predictor variables included age, delay, Karnofsky performance status (KPS), Charlson comorbidity index (CCI), serum albumin, malignancy, Acute Physiology and Chronic Health Evaluation II score, loculations on computed tomography scan, empyema stage, and first procedure choice. Results Advanced empyema (≥ stage IIA) was present in 84% of patients. Overall treatment success rates (no death, no additional drainage procedures) among evaluable patients for pigtail drainage, tube thoracostomy, VATS, and thoracotomy were 40% (4 of 10), 38% (14 of 37), 81% (13 of 16), and 89% (32 of 36), respectively. Five patients underwent miscellaneous procedures. Univariate variables associated with hospital death included KPS, CCI, and drainage as the first procedure. In multivariate analyses, KPS (coefficient, –0.06, p = 0.002) and failure of the first procedure (odds ratio [OR], 6.76; 95% confidence interval [CI], 1.45 to 31.4, p = .01) were independent predictors of death. Simple drainage as the first procedure was a strong, independent predictor of failure of the first procedure (OR, 11.1; 95% CI, 3.51 to 34.9; p = .00004). Conclusions The choice of the first procedure is critical in the outcome for treatment of empyema, even with adjustment for confounding variables. VATS or thoracotomy as initial therapy for advanced empyema is associated with better outcome