A simple numerical discriminant in the follow-up of lung cancer

Statistical analysis of laboratory data obtained during a study on a group of patients with lung cancer suggests that a simple numerical discriminant may have value in the follow-up of such patients. The discriminant is based on six common laboratory tests and is rapidly derived in the consulting room using a simple pocket calculator.

Application of reflectance spectroscopy to the estimation of uric acid, urea and glucose: an evaluation of the Ames Seralyzer

An original approach to the measurement of analytes in clinical chemistry has now become available, in which dry reagent strip technology is linked to measurement by reflectance spectroscopy. The present studies have evaluated the performance of the first of these test systems-for uric acid, urea and glucose, in serum-by comparison with conventional liquid chemistry methods. Satisfactory performance in terms of both precision and accuracy was obtained for all three test systems, the current "state-of-the-art" performance criteria being met; the Seralyzer system proved reliable and easy to use in the hands of trained operators. It should find a place as a "Stat" analyser in the laboratory, in specified wards and in Health Centres.

Preoperative carcinoembryonic antigen and survival after resection of lung cancer

Carcinoembryonic antigen (CEA) was measured preoperatively in 43 patients who underwent complete resection of primary lung cancer. 7 of 43 patients (17%) had CEA levels in the cancer diagnostic range (greater than 40.9 microgram/litre), non of whom survived longer than 10 months. At two years, it was apparent that those patients with a preoperative CEA less than 21 microgram had a better survival rate than those with a CEA21-40.9 microgram/litre (P less than 0.005).

Carcinoembryonic antigen in the assessment of lung cancer

Carcinoembryonic antigen (CEA) was measured in the plasma by radioimmunoassay in 80 patients who were referred because of an apparently resectable lung cancer. There was no correlation between the initial CEA level and survival in patient whose tumours were found to be inoperable or had metastasized, with only 2 of 37 patients surviving longer than 2 years. Following a curative resection, the median survival for patients with initial CEA greater than 40 micrograms l-1 was 6 months compared to 14 months for those with CEA in the range 20-40 micrograms l-1, while 56 per cent of those with CEA less than 20 micrograms l-1 are still alive at 2 years. This trend was found to be highly significant (P < 0.005). Twenty-five per cent of all patients had an initial CEA greater than 40 micrograms l-1 and this was associated with a poor prognosis, despite complete surgical removal of the primary tumour. Such elevations, if discovered in the preoperative assessment, indicate a need for a thorough search for metastases.

Accuracy and linearity of spectrophotometers in clinical chemistry laboratories

Solutions of cobalt nitrate sealed in vials were circulated to all clinical chemistry laboratories in the United Kingdom. Participants reported wavelengths of maximum absorbance together with the actual absorbances obtained. The results were compared with values obtained from the National Physical Laboratory. The results show a wide scatter, and several instruments were extensively repaired or replaced as a result of the survey. The most recently marketed machines had the best performance, and it is suggested that regular quality control and maintenance of the machines is vital. It is intended to set up a scheme for regular monitoring of spectrophotometer performance.

Introduction of a Vickers M300 analyser into the routine service of a hospital laboratory. 1. Installation, staffing, logistics

A Vickers M300 analyser has been successfully installed in a busy hospital laboratory. A permanent team of operators is used, but this introduces problems for staff rotation, particularly for educational purposes. The vials used for the collection of samples are an essential feature of the system, but they present many difficulties and are no longer used for collecting samples from outpatients, or at remote sites. Direct costs during 1974, excluding staff and depreciation, amounted to approximately pounds 0-45 per patient sample: this is assessed on the rising workload during implementation. An increased workload could still be handled with existing staff. The siting of such high-capacity analysers constitutes an important policy decision.

Introduction of a Vickers M300 analyser into the routine service of a hospital laboratory. 2. Tests, methods, evaluation

A Vickers M300 analyser has been introduced into a busy hospital laboratory; a profile of 13 biochemical tests is currently provided. Analytical performance has been assessed over one year of routine service operation, and mechanical performance has been assessed over two separate three-month periods. At its best, the M300 achieves high standards of precision and accuracy and has the advantage of unrivalled speed. Enzyme assay methods are less satisfactory than the kinetic assays in current use. Random analytical errors occur and are difficult to detect. The restricted facilities of the integral process-control computer are inadequate for effective quality control.

Plasma calcium and magnesium in newborn babies

Normal values for plasma calcium and magnesium levels during the first week of life, in breast- and bottle-fed babies, have been determined. It has been shown on the sixth day that plasma levels of calcium, magnesium, and protein are all significantly lower in bottle-fed babies than in breast-fed babies, while the reverse is true of the plasma inorganic phosphorus. The normal babies have been compared with 30 babies who had convulsions, beginning towards the end of the first week of life. In only six of the babies was the plasma calcium outside our normal range and only four had abnormally low magnesium levels. As so many of these babies had calcium and magnesium levels within the normal range it must seriously be questioned whether hypocalcaemia or hypomagnesaemia could have been the sole cause of the convulsions.