Evaluation of CYFRA 21-1 as a new marker for non-small cell lung cancer

The levels of the new tumour marker CYFRA 21-1 were assessed in 115 patients with non-small cell lung cancer (NSCLC) and in 45 patients with non-malignant lung disease. Increased levels of CYFRA 21-1 were observed in 47.8%, mostly in patients with squamous cell carcinoma (SCC; 69.1%). Serum CYFRA 21-1 levels were correlated with the stage of SCC type. Positive CYFRA 21-1 levels in patients with SCC were present in 40% of stage I, 61.1% of stage II, and 85.2% of stage III. In addition, SCC patients who presented mediastinal lymph nodes (N2) demonstrated higher serum CYFRA 21-1 levels, compared with patients without mediastinal lymph nodes metastases (N0 or N1). With regard to tumour size, significant difference was observed between T1, T2 and T3. The study also showed that the percentage of patients who survived 18 months with normal preoperative level of CYFRA 21-1 was higher compared with those patients with elevated preoperative levels of this marker, but the differences were not statistically significant.

[SCC-Ag antigen in serum of patients with primary non-small cell lung carcinoma]

The study aimed at evaluating SCC-Ag in patients with NSCLC, especially its predictive value following radical lung surgery. The study involved 70 patients with NSCLC and 48 patients with non-cancerous lesions to the lungs. SCC-Ag was assayed with Imx technique supplied by Abbott. Serum was tested before and 3 years after surgery. The results were analysed statistically with Wilcoxon-Fisher test. Elevated SCC-Ag levels were found in 45.7% of patients with NSCLC and in 4.1% pf patients with non-cancerous lesions. An increase in this antigen level was most frequent in patients with squamous-cell lung carcinoma (65.7%) and percentage of increased values was higher in more advanced stages of the disease (40% in I stage, 66.7% in II, and 78.9% in the III stage). During a 3-year follow-up, a relationship of recurrences or metastases and SCC-Ag levels was noted. Recurrence or metastases were more frequent when antigen levels were increased both before surgery and in postoperative period. The same relationship was seen when normal values before surgery increased after surgical treatment.

Prognostic value of pretreatment CEA, SCC-Ag and CA 19-9 levels in sera of patients with non-small cell lung cancer

The levels of carcinoembryonic antigen (CEA), squamous cell associated antigen (SCC-Ag) and carbohydrate antigenic determinant 19-9 (CA 19-9) were assessed in 70 patients with non-small cell lung cancer (NSCLC) and in 20 patients with non-malignant lung diseases. Increased levels of CEA and CA 19-9 were observed in 55.7 and 44.2%, respectively, mostly in patients with adenocarcinoma (adeno C; 69.5 and 56.5%). Increased levels of SCC-Ag were observed in 45.7%, first in patients with squamous cell carcinoma (68.6%). Serum CEA, CA 19-9 and SCC-Ag levels were correlated with the postoperative, pathological stage of disease. Positive CEA levels in patients with adeno C were present in 50% of stage 1, 66.6% of stage 2 and 88.8% of stage 3; positive CA 19-9 levels in patients with adeno C were present in 30% of stage 1, 66.6% of stage 2 and 80% of stage 3; positive SCC-Ag levels were present in patients with squamous LC in 50% of stage 1, 83.3% of stage 2 and 73.7% of stage 3. The study proved that preoperative CEA, SCC-Ag and CA 19-9 determination have been shown to be of prognostic value in patients with NSCLC. A high preoperative antigen value suggests a worse prognosis than a lower value.

Percutaneous transluminal coronary angioplasty of chronic total occlusions. Primary success, restenosis, and long-term clinical follow-up

BACKGROUND

Angioplasty of chronically totally occluded vessels has been associated with a success rate well below and restenosis rate well above that for angioplasty of stenosed segments. However, long-term clinical outcome after successful revascularization of a chronically totally occluded vessel has not been reported in detail.

METHODS AND RESULTS

Accordingly, data for 480 patients undergoing angioplasty for chronic total occlusion at Emory University Hospital, Atlanta, Ga., from 1980 to 1988 were analyzed for predictors of in-hospital procedural and clinical (procedural success and absence of in-hospital complications) success, restenosis, and 4-year clinical follow-up. The study population was grouped by procedural and clinical success and failure. The groups were then compared for outcome, both in hospital and long term. The initial clinical success rate was 66% (317 of 480 patients). Independent correlates of failure were the number of vessels diseased (p less than 0.001), vessel location of the lesion (p = 0.016), and absence of any distal antegrade filling (p = 0.002). Follow-up data revealed 98% cardiac survival and 96% overall survival at 4 years for the group as a whole. Freedom from myocardial infarction or cardiac death was significantly greater in patients with clinical success (93%) than with clinical failure (89%, p = 0.0044). In the successful group, 87% were free from coronary surgery after 4 years compared with 64% in the failure group (p less than 0.0001). Two thirds of the patients were free of angina at last follow-up. The presence of angina at follow-up was the same for patients successfully treated and for those with failed angioplasty, which may be related to the frequent use of coronary surgery in the failure group.

CONCLUSIONS

In well-selected cases, the success rate for angioplasty of chronic total occlusion is acceptable. Furthermore, long-term clinical benefit is suggested by the high freedom from coronary surgery, myocardial infarction, and death in the patients who underwent successful revascularization.

Resistance of rabbits and guinea pigs to the diabetogenic effect of streptozotocin

Streptozotocin is an antibiotic with antitumor properties. It has been reported to be diabetogenic in dogs, monkeys, hamsters, rats, and mice. Rabbits and guinea pigs were found to be resistant to the diabetogenic action of streptozotocin. Resistance in these species was not related to impaired ability to maintain adequate serum concentrations of the drug. Streptozotocin incubated with rabbit serum and liver homogenate maintained its diabelogenic properties when injected in the rat. Liver and pancreas homogenates of the resistant species did not metabolize the drug in vitro as determined spectrophotometrically. It is postulated that the diabetogenic action of streptozotocin may be related to its ability to impair NAD synthesis. It is postulated that the drug apparently blocks the synthesis of NAD from nicotinamide but has no effect on the synthesis of NAD from nicotinic acid, the pathway which may be preferentially employed by rabbits and guinea pigs.