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Bonella F, Wessendorf T, Börner E, Theegarten D, Costabel U. Die Abnahme von Serum KL-6 korreliert mit dem Ansprechen auf die Ganzlungenlavage bei der Alveolarproteinose. Pneumologie 2014. [DOI: 10.1055/s-0034-1367789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hager T, Reis H, Trübner K, Theegarten D. Pathologie und Klinik der letal verlaufenden Influenza. Pneumologie 2014. [DOI: 10.1055/s-0034-1367850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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53
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Darwiche K, Zarogoulidis P, Baehner K, Welter S, Tetzner R, Wohlschlaeger J, Theegarten D, Nakajima T, Freitag L. Assessment of SHOX2 methylation in EBUS-TBNA specimen improves accuracy in lung cancer staging. Ann Oncol 2013; 24:2866-70. [PMID: 24026539 DOI: 10.1093/annonc/mdt365] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) is a well-established method to assess mediastinal lymph nodes for lung cancer. However, a proportion of patients require further investigation, due to the low negative predictive value (NPV). The objective of this study was to determine whether the assessment of short stature homeobox 2 (SHOX2) DNA methylation level in lymph node tissue obtained by EBUS-TBNA improves the accuracy of mediastinal staging. PATIENTS AND METHODS EBUS-TBNA was carried out for suspicious lymph nodes of 154 patients. Negative or ambiguous histological results were confirmed by surgical means and clinical follow-up over 6 months. EBUS-TBNA was assessed on 80 positive and 85 negative classified lymph nodes and compared with the result of the SHOX2 DNA methylation real-time PCR analysis. Relative methylation measured by delta-delta cycle threshold (ΔΔCt) was used to classify the samples. Clinical performance of the EBUS-TBNA procedure with and without the additional SHOX2 assessment was calculated against the final classification according to the gold standard. RESULTS Based on data from 105 patients, an average 80-fold increase in the SHOX2 methylation level was measured for positive compared with negative lymph nodes. SHOX2 results with a ΔΔCt value of <6.5 indicate positive lymph nodes. Applying this molecular analysis to EBUS-TBNA cases, not diagnosed by pathologic assessment, the sensitivity of staging was improved by 17%-99%. The NPV increased from 80% to 99%. CONCLUSIONS The combination of EBUS-TBNA and SHOX2 methylation level strongly improves the assessment of the nodal status by identifying additional malignant lesions and confirming benign nodes and therefore avoiding invasive follow-up procedures.
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Kühl H, Theegarten D, Souri K, Lütkes P, Herbrick M, Darwiche K, Freitag L. Diagnostische Sicherheit und Kosteneffizienz einer Kombination von CT-gesteuerter Stanzbiopsie und zytologischer Sofortbefundung bei Patienten mit peripheren Lungentumoren. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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55
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Bonella F, Theegarten D, Worm K, Wessendorf T, Guzman J, Costabel U. Beeinflussung der Serum YKL-40 Konzentration bei Patienten mit Alveolarproteinose durch Chitinase 3-like 1 Genpolymorphismen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Theegarten D, Wohlschläger J, Tintelnot K, Stamatis G. Histoplasmom als seltene Ursache eines pulmonalen Rundherdes. Pneumologie 2013. [DOI: 10.1055/s-0033-1334755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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57
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Darwiche K, Bähner K, Theegarten D, Wohlschläger J, Welter S, Walter R, Hang H, Karpf-Wissel R, Freitag L. SHOX2 Methylierung - ein Biomarker zur Optimierung der EBUS-TBNA Lymphknotenstadiierung. Pneumologie 2013. [DOI: 10.1055/s-0033-1334494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Funke F, Bonella F, Ting S, Wohlschläger J, Costabel U, Theegarten D. Todesursachen bei interstitiellen Lungenerkrankungen: Ergebnisse von 22 Obduktionen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fleimisch P, Theegarten D, Weinreich G, Kamler M, Rath PM, Teschler H, Sommerwerck U. Nach Lungentransplantation Infektion der Lunge durch Trichosporon asahii. Pneumologie 2013. [DOI: 10.1055/s-0033-1334632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wälscher J, Weinreich G, Theegarten D, Ting S, Tannapfel A, Stamatis G. Langzeitergebnisse und Prognosefaktoren von neuroendokrinen Tumoren der Lunge G1 und G2. Pneumologie 2013. [DOI: 10.1055/s-0033-1334679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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61
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Hagmeyer L, Wohlschläger J, Priegnitz C, Randerath WJ, Theegarten D. Transbronchiale Kryobiopsien (TKB) und offene Lungenbiopsien (OLB) zur Diagnostik interstitieller Lungenerkrankungen: 5 Fälle im Vergleich. Pneumologie 2013. [DOI: 10.1055/s-0033-1334510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Behr J, Günther A, Ammenwerth W, Bittmann I, Bonnet R, Buhl R, Eickelberg O, Ewert R, Gläser S, Gottlieb J, Grohé C, Kreuter M, Kroegel C, Markart P, Neurohr C, Pfeifer M, Prasse A, Schönfeld N, Schreiber J, Sitter H, Theegarten D, Theile A, Wilke A, Wirtz H, Witt C, Worth H, Zabel P, Müller-Quernheim J, Costabel U. [German guideline for diagnosis and management of idiopathic pulmonary fibrosis]. Pneumologie 2013; 67:81-111. [PMID: 23325398 DOI: 10.1055/s-0032-1326009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Idiopathic pulmonary fibrosis is a fatal lung disease with a variable and unpredictable natural history and limited treatment options. Since publication of the ATS-ERS statement on IPF in the year 2000 diagnostic standards have improved and a considerable number of randomized controlled treatment trials have been published necessitating a revision. In the years 2006 - 2010 an international panel of IPF experts produced an evidence-based guideline on diagnosis and treatment of IPF, which was published in 2011. In order to implement this evidence-based guideline into the German Health System a group of German IPF experts translated and commented the international guideline, also including new publications in the field. A consensus conference was held in Bochum on December 3rd 2011 under the protectorate of the "Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)" and supervised by the "Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften" (AWMF). Most recommendations of the international guideline were found to be appropriate for the german situation. Based on recent clinical studies "weak negative" treatment recommendations for pirfenidone and anticoagulation were changed into "weak positive" for pirfenidone and "strong negative" for anticoagulation. Based on negative results from the PANTHER-trial the recommendation for the combination therapy of prednisone plus azathiorpine plus N-acetlycsteine was also changed into strong negative für patients with definite IPF. This document summarizes essential parts of the international IPF guideline and the comments and recommendations of the German IPF consensus conference.
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Rossler L, Utz N, Garel C, Theegarten D, Müntefering H, Leuschner I, Sander V, Heyer CM. Gutartige Neubildungen der Thoraxwand: Klinik – Bildgebung – Histopathologie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Christoph DC, Kasper S, Gauler TC, Loesch C, Engelhard M, Theegarten D, Poettgen C, Hepp R, Peglow A, Loewendick H, Welter S, Stamatis G, Hirsch FR, Schuler M, Eberhardt WEE, Wohlschlaeger J. βV-tubulin expression is associated with outcome following taxane-based chemotherapy in non-small cell lung cancer. Br J Cancer 2012; 107:823-30. [PMID: 22836512 PMCID: PMC3425975 DOI: 10.1038/bjc.2012.324] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Tubulin-binding agents (TBAs) are effective in non-small cell lung cancer (NSCLC) treatment. Both βIII- and βV-tubulins are expressed by cancer cells and may lead to resistance against TBAs. Methods: Pre-treatment samples from 65 locally advanced or oligometastatic NSCLC patients, who underwent uniform induction chemotherapy with paclitaxel and platinum followed by radiochemotherapy with vinorelbine and platinum were retrospectively analysed by immunohistochemistry. Protein expression of βIII- and βV-tubulin was morphometrically quantified. Results: Median pre-treatment H-score for βIII-tubulin was 110 (range: 0–290), and 160 for βV-tubulin (range: 0–290). Low βIII-tubulin expression was associated with improved overall survival (OS) (P=0.0127, hazard ratio (HR): 0.328). An association between high βV-tubulin expression and prolonged progression-free survival (PFS, median 19.2 vs 9.4 months in high vs low expressors; P=0.0315, HR: 1.899) was found. Further, high βV-tubulin expression was associated with objective response (median H-score 172.5 for CR+PR vs 120 for SD+PD patients, P=0.0104) or disease control following induction chemotherapy (170 for CR+PR+SD vs 100 for PD patients, P=0.0081), but not radiochemotherapy. Conclusion: Expression of βV-tubulin was associated with treatment response and PFS following paclitaxel-based chemotherapy of locally advanced and oligometastatic NSCLC patients. Prolonged OS was associated with low levels of βIII-tubulin. Prospective evaluation of βIII/βV-tubulin expression in NSCLC is warranted.
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Wohlschläger J, Darwiche K, Ting S, Hager T, Freitag L, Schmid K, Kühl H, Theegarten D. „Rapid on-site evaluation“ (ROSE) in der zytologischen Diagnostik von Lungen- und Mediastinalerkrankungen. DER PATHOLOGE 2012; 33:308-15. [DOI: 10.1007/s00292-012-1578-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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66
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Theegarten D, Funke F, Welter S, Eberhardt W, Wohlschläger J. Obduktionen als notwendiges Instrument der Qualitätssicherung in einem Lungenkrebszentrum. Pneumologie 2012. [DOI: 10.1055/s-0032-1302865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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67
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Anhenn O, Rabis T, Sommerwerck U, Baumbach JI, Theegarten D, Darwiche K, Freitag L, Teschler H, Costabel U. Detektion volatiler organischer Komponenten in der Ausatemluft von Patienten mit Aspergillus-Besiedlung oder -Infektion und Exogen Allergischer Alveolitis. Pneumologie 2012. [DOI: 10.1055/s-0032-1302632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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68
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Besa V, Theegarten D, Anhenn O, Kamler M, Teschler H, Sommerwerck U. Pulmonale kapilläre Hämangiomatose – Case report. Pneumologie 2012. [DOI: 10.1055/s-0032-1302750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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69
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Funke F, Anhenn O, Freitag L, Theegarten D. Idiopathische pulmonale Vaskulitis Syndrome: Die Bedeutung der Frühdiagnose. Pneumologie 2012. [DOI: 10.1055/s-0032-1302705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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70
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Kurth I, Darwiche K, Rabis T, Besa V, Theegarten D, Schmid KW, Baumbach JI, Purkhart R, Freitag L. Volatile Biomarker in der Ausatemluft – nicht-invasives Therapie Monitoring mittels Ionenmobilitätsspektrometrie (IMS) bei Patienten mit einem Bronchialkarzinom. Pneumologie 2012. [DOI: 10.1055/s-0032-1302597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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71
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Neumann C, Teschler H, Freitag L, Darwiche K, Karpf-Wissel R, Theegarten D, Schmid KD. Klinische Evaluation der EBUS gesteuerten Punktion mediastinal und hilär vergrößerter Lymphknoten mittels der Lymphknotenbiopsiezange. Pneumologie 2012. [DOI: 10.1055/s-0032-1302805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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72
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Theegarten D, Kikhney J, Petrich A, Anhenn O, Sommerwerck U, Welter S, Moter A. Bakterielle Biofilme in Bronchiektasen bei der primären ziliären Dyskinesie (PCD) im Vergleich zur cystischen Fibrose (CF). Pneumologie 2012. [DOI: 10.1055/s-0032-1302528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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73
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Christoph D, Gauler T, Engelhard M, Theegarten D, Poettgen C, Hepp R, Schuler M, Hirsch F, Eberhardt W, Wohlschlaeger J. PP 35 Evaluation of betaV-tubulin expression as novel predictive biomarker for clinical benefit from treatment with taxanes in non-small cell lung cancer (NSCLC). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Darwiche K, Wagner M, Theegarten D. Aktueller Stellenwert des endobronchialen Ultraschalls (EBUS). Pneumologie 2011; 65:537-48. [DOI: 10.1055/s-0030-1256666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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75
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Abstract
Infections play a crucial role in organ transplantations as possible complications. Viruses, bacteria, fungi and parasites are potential agents. The relevance of individual diseases depends on the organ transplanted. Morphology of the inflammatory reaction is given by the agent involved, but often several reactions can be caused by the same agent and different agents can also lead to the same reaction. Histology therefore provides concrete identification of the causal agent only in some cases, such that additional microbiological diagnostics are necessary. Results from these investigations should be transferred to the pathologist to distinguish between infection-associated changes and transplant rejection.
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