Diagnostic utility of cyfra 21-1 for differentiating malignant versus benign cavitary and noncavitary Lung Lesions

This study was planned to assess the possible role a new tumor marker, cytokeratin fragment, Cyfra 21-1 in differentiating malignant and benign lung lesions in presence or absence of cavitation. This study included 30 patients with proved lung cancer [15 squamous cell carcinoma, 6 adenocarcinoma, 5 large cell carcinoma, and 4 small cell carcinoma] and 30 patients with proved benign lung disease [12 T.B., 10 pneumonia, and 8 lung abscess]. All patients were diagnosed as having cavitary or noncavitary lung lesions by chest X-ray and CT-scan. Lung cancer patients included [13 cavitary and 17 noncavitary disease], while benign lung disease included [14 cavitary and 16 noncavitary lesion]. Serum samples were obtained from a total of 60 patients and examined for Cyfra 21-1 by electro-chemiluminescence immunoassay. The results showed that serum cyfra 21-1 level was significantly higher in lung cancer patients [16.22 +/- 2.1 ng/ml] than in patients with benign lung disease [3.85 +/- 0.46 ng/ml]. Moreover, significant differences in the serum Cyfra 21-1 levels were observed between cavitary lung cancer [25.15 +/- 3.27 ng/ml] and benign cavitary lung disease [6.17 +/- 0.48ng/ml], and between noncavitary lung cancer [9.38 +/- 1.06 ng/ml] and benign noncavitary lung disease [1.83 +/- 0.12 ng/ml]. The results also showed a significant difference in the serum Cyfra 21-1 levels between noncavitary lung cancer [9.38 +/- 1.06 ng/ml] and benign cavitary lung disease [6.17 +/- 0.48 ng/ml]. Among lung cancer patients, the serum Cyfra 21-1 level was significantly higher in squamous cell carcinoma [24.13 +/- 2.89 ng/ml] than adenocarcinoma [10.70 +/- 1.43 ng/ml], large cell carcinoma [9.88 +/- 1.09 ng/ml] or small cell carcinoma [5.42 +/- 1.00 ng/ml]. The study showed that a cutoff value of serum Cyfra2l-l level>8 gives a sensitivity of 76% and a specificity of 93%. At a cutoff value of serum Cyfra21-1 of> 3 ng/ml, all patients with noncavitary cancerous lesions were differentiated from patients with noncavitary benign lesions. Also, at a cutoff value of serum Cyfra21-1 of>10 ng/ml, all patients with cavitary cancerous lesions were separated from patients with cavitary benign lesions. This study concluded that serum cyfra 21-1 is a useful marker for differentiating malignant versus benign cavitary and noncavitary lung lesions with greater sensitivity and specificity when different cutoff values are applied

Correlations between ventilatory function tests, arterid blood gases and blood levels of some radioactive isotopes in asymptomatic and symptomatic cigarette smokers

In this work, three groups of subjects were studied. The first was control group [8 cases], the second was asymptomatic cigarette smokers [30 cases] and the third was symptomatic cigarette smokers [36 cases] that was in turn divided into three equal subgroups: asthma, COPD and cancer lung. All groups were examined for ventilatory function tests [FVC, FEV1 -FEV1% and FEF 25-75%], arterial blood gases, [Pa O2 and PaCO2, pH] and blood levels of lead 212, lead214, and Cesium 137. There was a significant decrease in all ventilalory function tests, PaO 2and increase PaCO2 in symptomatic group in relation to control and asymptomatic groups. The pH of blood showed no change. The study showed a significant increase in the levels of lead 212, lead214 and cesium137 in both smokers groups in relation to control. FEV1 and FEF 25-75%, lead212, lead 214 and cesium 137 showed significant differences between the three studied groups. Also there was a significant negative correlation between the blood lead 212 and the FEV1% in the symptomatic cigarette smokers group. These changes were related to the toxic contents of cigarette leaves and wrappings including the high content of the previously estimated radioisotopes

Pulmonary function tests and pathological profile of the airways in Rheumatoid Arthritis and Systemic Lupus Erythematosus

This study was carried out on 16 patients [10 patients with RA and 6 patients with SLE] to evaluate the effects of RA and SLE on bronchial tree with special emphasis on physiological and pathological changes. All patients were subjected to routine laboratory investigations, complete pulmonary function tests using Morgan transfer apparatus with Della computer, BAL and bronchial biopsies were taken via FOB Olympus BF type B10. The results of this study revealed abnormal airway functions evidenced by reduction in FEV[1] FEF[25-75%] and PEER with consequent increase in RV and RV/TLC. BAL and bronchial biopsy showed the involvement of bronchial tree in these immune complex diseases as evidenced by different patterns of cellular infiltrations, epithelial changes and vasculitic processes