Clinico-pathological profile of bronchogenic carcinoma cases presented to Chest Department, Cairo University in the last 10 years

Introduction: Lung cancer was the most commonly diagnosed cancer as well as the leading cause of cancer death in males in 2008 globally

Aim of the work: To evaluate the clinico-pathological profile of the bronchogenic carcinoma cases in the Chest Department, Cairo University

Patients and methods: Retrospective study was carried out in the Chest Department, Cairo University, in which four hundred and four confirmed cases of bronchogenic carcinoma were admitted during July 2002 till July 2012. Data regarding demographics, smoking, histology, clinical presentation, radiographic findings are reported

Results: Our study included 404 confirmed cases of bronchogenic carcinoma. Male to female ratio was 4.6:1. The highest incidence was in the sixth and seventh decades of life [63.6%]. Smoking was found to be the main risk factor in 75.7% of patients. Cough was the most common symptom found in 347 patients [85.9%], followed by dyspnea in 276 patients [68.3%]. Most common radiological finding was mass lesion [49.8%]. Majority of cases were diagnosed by bronchoscopy [68.1%]. Four types of bronchogenic carcinoma were found: squamous cell carcinoma 37.4% adenocarcinoma 29.5%, small cell carcinoma 14.9%, large cell carcinoma 7.2% and undifferentiated carcinoma 11.1%. In females, adenocarcinoma was the predominant cell type [54.2%] while in males, squamous cell carcinoma was the predominant cell type [42.5%]

Conclusion: Bronchogenic carcinoma is more frequent beyond the middle age. Smoking is still the major risk factor. Adenocarcinoma is more common in females and was the most frequent tumor in non-smokers, while in males, squamous cell carcinoma is still the predominant cell type

Association of chlamydia pneumoniae infection with coronary heart disease

C. pneumoniae is an obligatory intracellular bacterium responsible for upper and lower respiratory tract infections. This work was carried out to study the association between C. pneumoniae infection and coronary heart disease [CHD]. This study included 70 patients, divided into two groups[Group I ,included 55 patients with acute coronary syndromes: 32 patients with acute myocardial infarction and 23 patients with unstable angina Group II, It included 15 patients with previously diagnosed chronic coronary heart disease]and healthy Control Group [Group III],It included 22 healthy subjects as control. Venous blood samples were collected from all patients and controls for: determination of total blood cholesterol level, detection of C. pneumoniae-specific IgG by ELISA and detection of C. pneumoniae DNA in the peripheral blood mononuclear cells by PCR The results of this study showed that: C. pneumoniae-specific IgG was detected by ELISA in 83.6% of the acute patients, 73.3% of the chronic patients, and 68.2% of the healthy control subjects.There was no statistically significant difference among the different studied groups as regarding the prevalence of C. pneumoniae-specific IgG antibodies.C. pneumoniae IgG seropositivity among the CHD patients was correlated with smoking but not with age, male sex, hypertension, diabetes mellitus or hypercholesterolemia. C. pneumoniae-specific DNA was detected by PCR in the PBMCs of 61.8% of the acute patients, 26.7% of the chronic patients, and 18.2% of the healthy control subjects. Positive PCR results were significantly higher among the whole studied CHD patients [acute plus chronic] compared to the control subjects. Also, positive PCR results were significantly higher among the acute patients than both the chronic patients and the healthy controls. In contrast, the difference between the chronic patients and healthy controls as regarding the prevalence of C. pneumoniae DNA in the PBMCs was not statistically significant. C. pneumoniae DNA positivity among the patients [either the whole patients or acute patients only] was not significantly correlated with age, sex or any of the studied classic coronary risk factors [smoking, hypertension, diabetes mellitus and hypercholesterolemia]. After adjustment for the classic coronary risk factors and demographic characteristics in the multiple logistic regression analysis, C. pneumoniae infection [as indicated by PCR positivity] was associated with the CHD.No statistically significant difference was found between C. pneumonia DNA positive and C. pneumoniae DNA negative patients [either the whole patients or acute patients only] as regarding the prevalence of C. pneumoniae-specific IgG. This study concluded that: C. pneumoniae DNA detection in the PBMCs was found to be an independent predictor for CHD, particularly acute coronary events.The prevalence of C. pneumoniae DNA in the peripheral blood was found to be higher among the acute CHD patients with recurrent attacks than those with first attacks.C. pneumoniae IgG seropositivity was unreliable predictor for the presence of C. pneumoniae DNA in the CHD patients