Equol and its enantiomers inhibited urethane-induced lung cancer in mice / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects and mechanisms of equol and its enantiomers on urethane-induced lung cancer in mice.@*METHODS@#A total of 120 5-week-old male C57BL/6 mice were randomly divided into 8 groups: lung cancer tumor control group (CG), genistein control group (GCG), low dose racemic equol group (LEG), high dose racemic equol group (HEG), low dose R-equol group (LRE), high dose R-equol group (HRE), low dose S-equol group (LSE) and high dose S-equol group (HSE). Urethane was injected subcutaneously twice a week for 4 weeks to induce lung cancer and then the mice were fed for 4 months. The body weight and food intake of each group were measured and recorded weekly. After the mice were sacrificed, the blood, livers and lungs of the mice were collected. The incidence of lung cancer in each group was recorded. The concentration of serum superoxide dismutase (SOD), malondialdehyde (MDA) and 8-hydroxydeoxygunosine (8-OHdG) were detected by the corresponding kits. Western blotting was used to detect the expression of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in the livers. Between-group differences in body weight and food intake of the mice were compared using repeated measures ANOVA, and ANOVA for the differences between non-repeated measurements, with post hoc analysis using Tukey's method if there were between-group differences. Comparisons of categorical data were performed by chi-square test, and if there were differences between the groups, the Bonferroni method was used for pairwise comparison.@*RESULTS@#A total of 49 in the 120 mice developed lung cancer. The overall incidence of lung cancer was 40.8%. Compared with the control group, the incidence of lung cancers in each experimental group was lower, and the difference was statistically significant. The incidence of lung cancer in the high-dose experimental group was significantly lower than that in the low-dose experimental group. However, the incidence of lung cancer was similar in the three equol groups and the genistein group at the same dose. Compared with the control group, the high-dose experimental group had higher serum SOD concentration, lower MDA and 8-OHdG concentrations, and the differences were statistically significant. Western blotting analysis showed that the expression levels of Nrf2 protein in the experimental groups were higher than those in the control group except the low-dose racemic equol group, and the Nrf2 protein expression level in the high-dose equol groups was higher than that in the low-dose equol groups.@*CONCLUSION@#Racemic equol and its enantiomers mayinhibit lung carcinogenesis through antioxidant effects.

Current Status and Progress of Early Lung Cancer Screening under the Normal State of COVID-19 Epidemic Prevention and Control / 中国肺癌杂志

Lung cancer is the malignant tumor with the highest incidence in China. Early detection and identification of symptomatic lung cancer patients and timely screen out asymptomatic patients from high-risk groups require multiple cooperation. At present, although combined imaging, serology, genomics, proteomics and other methods have been combined to screen for suspected lung cancer, there are still problems such as missed diagnosis and misdiagnosis. Meanwhile, the spread of the corona virus disease 2019 (COVID-19) epidemic has brought new challenges to early lung cancer screening. Under the normalization of epidemic prevention and control, the work of early lung cancer screening should be changed accordingly: improve the population's awareness of cancer prevention and control, strengthen the management of medical procedures, improve the efficiency of tumor detection, optimize detection technology, and utilize internet and big data platforms rationally. We should establish an ideal model, combining multiple screening methods, which is streamlined and efficient for early lung cancer screening under normal epidemic prevention and control.
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Tratamento Quimioterápico do Mesotelioma Pleural Maligno: Revisão Sistemática / Malignant Pleural Mesothelioma Chemotherapy Treatment: Systematic Review / Tratamiento Quimioterápico del Mesotelioma Pleural Maligno: Revisión Sistemática

Introdução: O mesotelioma pleural maligno é um câncer raro, agressivo e que apresenta expectativa de aumento na incidência até 2030. As melhores formas de tratar essa neoplasia continuam em debate. Objetivo: Sintetizar as evidências de eficácia e segurança dos esquemas quimioterápicos de primeira linha disponíveis para o tratamento do mesotelioma pleural maligno. Método: Foram utilizadas as bases bibliográficas LILACS, MEDLINE, Scopus, Cochrane Controlled Trials Register e Web of Science. Buscaram-se estudos na literatura cinzenta. Os critérios de elegibilidade incluíram ensaios randomizados de fases II ou III, de pacientes com mesotelioma pleural virgem de tratamento quimioterápico, submetidos a qualquer regime terapêutico, tendo como controle outros esquemas quimioterápicos ou controle ativo de sintomas, e apresentando tempo de sobrevida global, tempo livre de progressão, resposta tumoral e toxicidade como desfechos. Todas as etapas foram realizadas por dois revisores, de forma independente. O protocolo da revisão foi registrado no International Prospective Register of Systematic Reviews (PROSPERO 2014: CRD42014014388). Resultados: Treze estudos envolvendo 14 esquemas terapêuticos foram incluídos. O único esquema quimioterápico que se apresentou superior ao comparado com significância estatística nos três desfechos de eficácia foi cisplatina + pemetrexede. Cisplatina + pemetrexede e cisplatina + gemcitabina apresentaram mais casos de toxicidade graus 3 e 4. Conclusão: Existem boas evidências para recomendar combinações de derivado de platina e antifolato como opção de primeira escolha no tratamento quimioterápico do mesotelioma pleural. Mais estudos clínicos são necessários para embasar decisões de incorporação dos antifolatos no tratamento rotineiro dessa neoplasia no Brasil.

Introduction: Malignant pleural mesothelioma is a rare, aggressive cancer that is expected to increase in incidence by 2030. The best ways to treat this neoplasm are still under discussion. Objective: To synthesize the evidence of efficacy and safety of the different first-line chemotherapy regimens available for the treatment of malignant pleural mesothelioma. Method:The LILACS, MEDLINE, Scopus, Cochrane Controlled Trials Register and Web of Science bibliographic databases were used. Studies were sought in the grey literature. Eligibility criteria included randomized phase II or III trials of chemotherapy-naive patients with pleural mesothelioma who underwent any therapeutic regimen, compared to other chemotherapeutic regimens or active symptom control, and presenting overall survival, progression free survival, tumor response and toxicity as outcomes. All steps were performed independently by two reviewers. The review protocol was recorded in the International Prospective Register of Systematic Reviews (PROSPERO 2014: CRD42014014388). Results: Thirteen studies involving fourteen therapeutic regimens were included. The only chemotherapy regimen that presented superior to the comparator with statistical significance in the three efficacy outcomes was cisplatin + pemetrexed. Cisplatin + pemetrexed and cisplatin + gemcitabine presented more grades 3 and 4 toxicity cases. Conclusion: There is good evidence to recommend combinations of platinum and antifolate derivatives as a first-choice option in the chemotherapeutic treatment of pleural mesothelioma. Further clinical studies are needed to support decisions to incorporate antifolates in the routine treatment of this neoplasm in Brazil.

Introducción: El mesotelioma pleural maligno es un cáncer raro, agresivo y que presenta expectativa de aumento en la incidencia hasta 2030. Objetivo: Sintetizar las evidencias de eficacia y seguridad de los diferentes esquemas quimioterápicos de primera línea disponibles para el tratamiento del mesotelioma pleural maligno. Método: Se utilizaron las bases bibliográficas LILACS, MEDLINE, Scopus, Cochrane Controlled Trials Register y Web of Science. Se buscó estudios en la literatura gris. Los criterios de elegibilidad incluyeron ensayos aleatorizados de fase II o III, de pacientes con mesotelioma pleural vírgenes de tratamiento quimioterápico, sometidos a cualquier régimen terapéutico, teniendo como control otros esquemas quimioterápicos o control activo de síntomas, y presentando tiempo de supervivencia global, tiempo libre de progresión, respuesta tumoral y toxicidad como resultados. Todas las etapas fueron realizadas por dos revisores, de forma independiente. El protocolo de la revisión se registró en el International Prospective Register of Systematic Reviews (PROSPERO 2014: CRD42014014388). Resultados: Se incluyeron trece estudios de catorce esquemas terapéuticos. El único esquema uimioterápico que se presentó superior al comparador con significancia estadística en los tres resultados de eficacia fue cisplatino + pemetrexede. Cisplatino + pemetrexed y cisplatino + gemcitabina presentaron más casos de toxicidad grados 3 y 4. Conclusion: Existen buenas evidencias para recomendar combinaciones de derivado de platino y antifolato como opción de primera elección en el tratamiento quimioterápico del mesotelioma pleural. Más estudios clínicos son necesarios para basar decisiones de incorporación de los antifolatos en el tratamiento rutinario de esa neoplasia en Brasil.

Protocolo del Sistema Nacional de Vigilancia Epidemiológica: enfermedades no transmitibles (ENT) diabetes, cardiovasculares y cáncer. No. 11 / Protocolo del Sistema Nacional de Vigilancia Epidemiológica: enfermedades no transmitibles (ENT) diabetes, cardiovasculares y cáncer. No. 11

Estos protocolos están dirigido a personal médico, paramédico y otros profesionales que realizan acciones gerenciales y operativas de vigilancia epidemiológica en los servicios de salud del país, y están divididos en varios tomos para dar a conocer y actualizar la identificación y medidas de control para diversos padecimientos a fin de continuar con el mejoramiento de las capacidades técnicas de los trabajadores de salud, que permita planificar la prestación de servicios con decisiones partiendo de un enfoque epidemiológico comprobado, para responder a los cambios de tendencias epidemiológicas y con ello contribuir al fortalecimiento de prácticas asertivas de la salud pública de nuestro país.

Malformación adenomatoidea quística y riesgo de tumores malignos pulmonares / Adenomatoid lung malformation and malignant tumors

Cystic adenomatoid malformation is the most frequent congenital pulmonary malformation. The usual treatment is surgical resection. However there is controversy over management in asymptomatic patients. The possible malignization would justify surgery of cystic lesions. Relation with pleuropulmonary blastoma has been described, however it is not clear whether this is a primary tumor or cyst malignization. Cystic adenomatoid malformation also has association with adenocarcinoma and rhabdomyosarcoma. Currently available evidence suggests surgical resection, despite the natural course of congenital lung cystic lesions is uncertain

La malformación adenomatoidea quística (MAQ) es la anomalía del desarrollo pulmonar más frecuente. El tratamiento habitual es la resección quirúrgica, no obstante existe controversia sobre el manejo en pacientes asintomáticos. La posible malignización de las lesiones quísticas es uno de los argumentos que justifican la cirugía en estos pacientes. Se ha descrito relación con blastoma pleuropulmonar, sin embargo no está claro si se trataría de una lesión quística que se maligniza o es una entidad diferente. También hay asociación con adenocarcinoma y rabdomiosarcoma . Actualmente se sugiere la resección quirúrgica como el tratamiento más adecuado, sin embargo la evolución natural de las lesiones quísticas pulmonares congénitas es incierta

Antioxidant and cytotoxic activity of Tecoma stans against lung cancer cell line (A549)

ABSTRACT Human have been constantly using plants and plant products to overcome many diseases. The antioxidant property of the plant sources is studied to obtain an efficacious drug against cancer. The objectives of the present study is to evaluate the antioxidant and cytotoxic activity of the Tecoma stans extracts against lung cancer cell line in comparison with vincristine drug. The antioxidant activity was studied using the standard DPPH assay and the cytotoxic activity using MTT assay. DPPH assay results show that methanolic extract of T. stans in higher concentration show better antioxidant potential than the standard L-ascorbic acid. They exhibited strong antioxidant potential at 20 µg/mL concentration. The absorbance at 517 nm showed that in the range of 0.201-0.0203 compared to that of absorbance of ascorbic acid at 0.023.Cytotoxic activity was studied using MTT assay which showed that the increase in concentration of extract increases the cell death. At 100µg/mL concentration there is an increased cytotoxic activity, i.e., 99% of cell inhibition. The results of antioxidant and anticancerous activity may be positively correlated.

Factors associated with disease-specific survival of patients with non-small cell lung cancer / Fatores associados à sobrevida doença-específica em pacientes com câncer de pulmão de células não pequenas

ABSTRACT Objective: Lung cancer is a global public health problem and is associated with high mortality. Lung cancer could be largely avoided by reducing the prevalence of smoking. The objective of this study was to analyze the effects of social, behavioral, and clinical factors on the survival time of patients with non-small cell lung cancer treated at Cancer Hospital I of the José Alencar Gomes da Silva National Cancer Institute, located in the city of Rio de Janeiro, Brazil, between 2000 and 2003. Methods: This was a retrospective hospital cohort study involving 1,194 patients. The 60-month disease-specific survival probabilities were calculated with the Kaplan-Meier method for three stage groups. The importance of the studied factors was assessed with a hierarchical theoretical model after adjustment by Cox multiple regression. Results: The estimated 60-month specific-disease lethality rate was 86.0%. The 60-month disease-specific survival probability ranged from 25.0% (stages I/II) to 2.5% (stage IV). The performance status, the intention to treat, and the initial treatment modality were the major prognostic factors identified in the study population. Conclusions: In this cohort of patients, the disease-specific survival probabilities were extremely low. We identified no factors that could be modified after the diagnosis in order to improve survival. Primary prevention, such as reducing the prevalence of smoking, is still the best method to reduce the number of people who will suffer the consequences of lung cancer.

RESUMO Objetivo: O câncer de pulmão é um problema de saúde pública global e é associado a elevada mortalidade. Ele poderia ser evitado em grande parte com a redução da prevalência do tabagismo. O objetivo deste estudo foi analisar os efeitos de fatores sociais, comportamentais e clínicos sobre o tempo de sobrevida de pacientes com câncer de pulmão de células não pequenas atendidos, entre 2000 e 2003, no Hospital do Câncer I do Instituto Nacional de Câncer José Alencar Gomes da Silva, localizado na cidade do Rio de Janeiro. Métodos: Estudo retrospectivo de coorte hospitalar com 1.194 pacientes. As probabilidades de sobrevida doença-específica em 60 meses foram calculadas com o método de Kaplan-Meier para três grupos de estadiamento. A importância dos fatores estudados foi avaliada por um modelo teórico hierarquizado após o ajuste de modelos de regressão múltipla de Cox. Resultados: Foi estimada uma taxa de letalidade doença-específica em 60 meses de 86,0%. A probabilidade de sobrevida doença-específica em 60 meses variou de 25,0%, nos estádios iniciais, a 2,5%, no estádio IV. A situação funcional, a intenção e a modalidade do tratamento inicial foram os principais fatores prognósticos identificados na população estudada. Conclusões: As probabilidades de sobrevida doença-específica estimadas na amostra estudada foram muito baixas, e não foram identificados fatores que pudessem ser modificados após o diagnóstico visando uma melhora da sobrevida. A prevenção primária, como a redução da prevalência do tabagismo, ainda é a melhor forma de evitar que mais pessoas sofram as consequências do câncer de pulmão.

Proposals for the prevention of lung cancer in the health system of Mexico / Propuestas para la prevención de cáncer de pulmón en el sistema de salud en México

Abstract The management of lung cancer is challenging. However, nowadays the main goal is to achieve a significant overall survival accompanied by a good quality of life. Because smoking is associated with up to 71% of cancer deaths, the first policy that should be established is one that promotes strategies for healthy lifestyles by providing information about lung cancer, risk factors, protection factors, and precautionary data. Furthermore, an effective screening method that would allow early diagnosis should be established. Following diagnosis, the patient should be genotyped to identify predisposing mutations to give personalized medicine to the patient. The health system policies should include information that affects the health of the population and simultaneously allows for early diagnoses, resulting in a higher survival rate.

Resumen El manejo del cáncer de pulmón es un reto que tiene como objetivo una supervivencia global significativa que se vea rodeada de una buena calidad de vida. Si se considera que el tabaquismo está asociado hasta con 71% de las muertes por cáncer, la primera política que debe establecerse es la de proporcionar información sobre el cáncer de pulmón, factores de riesgo, factores de protección y datos de alarma mediante una estrategia de salud de línea de vida, además del establecimiento de un método de tamizaje efectivo que permita un diagnóstico temprano. Después del diagnóstico, debe realizarse una genotipificación para identificar mutaciones sensibles y para proporcionar un tratamiento personalizado al paciente. Las políticas del sistema de salud deben incluir información para que la población incida en su salud y también se puedan realizar diagnósticos tempranos que permitan una mayor supervivencia.

Enfoque práctico en la asociación de la clínica con la variedad histológica en el cáncer del pulmón / Practical approach to clinical association with histological variety in lung cancer

INTRODUCCIÓN: el cáncer de pulmón es un problema de salud que afecta de forma significativa a la humanidad. OBJETIVO: describir las características clínicas de la enfermedad y su asociación con la variedad histológica. MÉTODOS: se realizó un estudio descriptivo transversal en 107 pacientes con cáncer de pulmón hospitalizados en los servicios de Medicina Interna y Neumología del Hospital "Hermanos Ameijeiras", en el período de marzo 2012 a febrero de 2013. RESULTADOS: el 66,4 % de los pacientes fueron hombres con una edad media de 65,9 años y el 61,7 %, fumadores. La forma clínica de presentación más común fue la bronconeumónica en el 20,6 %, y el síntoma, la tos en 63,6 %. En el adenocarcinoma de pulmón, el 30,4 % presentó la forma bronconeumónica. CONCLUSIONES: la atelectasia y la forma clínica de presentación pleural se asociaron al carcinoma escamoso y al adenocarcinoma, respectivamente.

INTRODUCTION: lung cancer is a health problem that significantly affects how mankind. OBJECTIVE: describe the clinical features and its association with histological subtype in patients with lung cancer. METHODS: across-sectional study was conducted in 107 patients with lung cancer hospitalized in the services of internal medicine and pneumology at Hermanos Ameijeiras Hospital from March 2012 to February 2013. RESULTS: 66.4 % of the patients were men with a mean age of 65.9 years and 61.7 % had smoking habits. Broncho-pneumonia was the most common clinical form of presentation in 20.6 % and symptom, cough in 63.6 %. In lung adeno-carcinoma, 30.4 % had the broncho-pneumonic form. CONCLUSIONS: atelectasis and pleural clinical form of presentation were associated with squamous cell carcinoma and adeno-carcinoma, respectively.

Influência da composição corporal sobre a qualidade de vida de pacientes com câncer / The influence of body composition on cancer patients' quality of life / Influencia de la composición corporal sobre la calidad de vida de pacientes con cáncer

Introdução: O câncer tem reflexos na composição corporal, frequentemente causando sarcopenia, o que impacta na capacidade funcional e prognóstico dos doentes, podendo afetar sua qualidade de vida. Objetivo: Avaliar a influência da composição corporal sobre a qualidade de vida de pacientes com câncer de trato gastrointestinal e de pulmão. Método: Estudo transversal com pacientes portadores de câncer gastrointestinal e de pulmão, no serviço de quimioterapia do Hospital Escola da Universidade Federal de Pelotas. A composição corporal foi estimada por meio da bioimpedância elétrica e da qualidade de vida por meio do instrumento European Organization for Research and Treatment of Cancer ­ Quality of Life Questionnaire Core-30. Resultados: Foram avaliados 74 pacientes, sendo a maioria do sexo masculino (56,8%). Os tumores mais prevalentes foram os de trato gastrointestinal (75,4%). Aproximadamente 24% dos pacientes apresentaram déficit de massa muscular e nenhum apresentou excesso de adiposidade. Na análise da relação entre composição corporal e as diferentes escalas de qualidade de vida, os pacientes com déficit de massa muscular apresentaram escores mais baixos nas escalas de Saúde Geral/QV e funcional, e maiores pontuações na escala de sintomas, demonstrando pior qualidade de vida quando comparados aqueles sem déficit de massa muscular. Conclusão: A composição corporal com déficit de massa magra se associou à pior Qualidade de Vida em pacientes com câncer de trato gastrointestinal e de pulmão.

Introduction: Cancer has effects on body composition, often causing sarcopenia, which impacts on the functional capacity and prognosis of these patients, which may affect their quality of life. Objective: To evaluate the influence of body composition on the quality of life of patients with cancer of the gastrointestinal tract and lungs. Method: A cross-sectional study was carried out in patients with gastrointestinal and lung cancer, in the chemotherapy service of the Hospital School of the Federal University of Pelotas. Body composition was estimated by bioelectrical impedance, performed with instrument BIA and quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 Instrument. Results: We evaluated 74 patients, the majority of whom were male (56.8 %). The most prevalent tumors were those in the gastrointestinal tract (75.4 %). Regarding body composition, it was found that 24.3% of the patients showed a deficit in muscle mass and none had excess adiposity. When analyzing the relationship between body composition and differing scales of quality of life, patients with muscle mass deficit had lower scores on the General Health scales / QOL and functional, and higher scores on the symptoms, demonstrating worse quality of life when compared to those without muscle mass deficit. Conclusion: Body composition was related significantly to the QOL of patients with cancer of the gastrointestinal tract and lungs, keeping the association between the deficit of muscle mass and worse QOL of these patients.

Introducción: El cáncer tiene efectos sobre la composición corporal, a menudo causando la sarcopenia, lo que repercute en la capacidad funcional y el pronóstico de estos pacientes, que pueden afectar su calidad de vida. Objetivo: Evaluar la influencia de la composición corporal en la calidad de vida de los pacientes con cáncer del tracto gastrointestinal y los pulmones. Método: Se realizó un estudio transversal en pacientes con cáncer gastrointestinal y pulmón, en el servicio de quimioterapia Hospital Escuela de la Universidad Federal de Pelotas. La composición corporal se calcula por impedancia bioeléctrica y la calidad de vida fue evaluada utilizando el instrumento Organización Europea para la Investigación y el Tratamiento del Cáncer Cuestionario de Calidad de Vida de 30. Resultados: Se evaluaron 74 pacientes, la mayoría del sexo masculino (56,8 %). El tamaño de los tumores eran los más prevalentes entre el tracto gastrointestinal (75,4 %). Se encontró en la composición corporal que el 24,3 % de los pacientes presentaron un déficit en la masa muscular y ninguno presentó exceso de adiposidad. Al analizar la relación entre la composición corporal y las diferentes escalas de calidad de vida, los pacientes con déficit de masa muscular tuvieron puntuaciones más bajas en la salud general de las escalas / CDV y funcional, y puntuaciones más altas en los síntomas, lo que demuestra peor calidad de vida en comparación con los que no tienen déficit de masa muscular. Conclusión: La composición corporal con déficit de masa muscular se relaciona significativamente con la peor Calidad de Vida en los pacientes con cáncer del tracto gastrointestinal y de pulmones.

Caryocar brasiliense camb protects against genomic and oxidative damage in urethane-induced lung carcinogenesis

The antioxidant effects of Caryocar brasiliense Camb, commonly known as the pequi fruit, have not been evaluated to determine their protective effects against oxidative damage in lung carcinogenesis. In the present study, we evaluated the role of pequi fruit against urethane-induced DNA damage and oxidative stress in forty 8-12 week old male BALB/C mice. An in vivo comet assay was performed to assess DNA damage in lung tissues and changes in lipid peroxidation and redox cycle antioxidants were monitored for oxidative stress. Prior supplementation with pequi oil or its extract (15 µL, 60 days) significantly reduced urethane-induced oxidative stress. A protective effect against DNA damage was associated with the modulation of lipid peroxidation and low protein and gene expression of nitric oxide synthase. These findings suggest that the intake of pequi fruit might protect against in vivo genotoxicity and oxidative stress.

La fuerza de tareas de Estados Unidos recomienda el rastreo de cáncer de pulmón por medio de la tomografía axial computada: ¿es suficiente la evidencia para apoyar su adopción en el contexto sanitario de nuestro país? / The Task Force recommends the US Lung cancer screening using computed tomography: is it sufficient evidence to support its adoption in healthcare context of our country?

A fines del 2013, la Fuerza de Tareas de Servicios Preventivos de Estados Unidos (USPSTF) recomendó el rastreo anual para el cáncer de pulmón con tomografía computarizada de baja dosis (TCBD). Dada la ausencia de guías nacionales sobre esta práctica, existe incertidumbre sobre si debe adoptarse o no esta r recomendación. El presente estudio tuvo como objetivo evaluar la calidad y exhaustividad del cuerpo de evidencia que sustenta esta recomendación a través de métodos rigurosos. La calidad de la guía y la revisión sistemática sobre la que se sustenta la recomendación de uso del rastreo difundida por la USPSTF es de calidad intermedia. Se identificaron otras revisiones sistemáticas no incluidas en esta guía, cuyos resultados no son tan contundentes respecto al balance de riesgos y beneficios de esta práctica. La adopción de una práctica como política o programa en nuestro país, mas aun cuando es de relativo alto costo, y no está exenta de efectos adversos, requiere una evaluación rigurosa, exhaustiva y, por sobre todo, participativa. Los resultados que se presentan buscan aportar elementos para el debate, al que deben sumarse entidades gubernamentales, sociedades científicas, aseguradores y otros grupos de interés, incluyendo las voces de los propios pacientes. PALABRAS CLAVE: Neoplasias Pulmonares, Tamizaje Masivo, Tomografía Computarizada Multidetector, Guías de Práctica Clínica.

In 2013 the United States Preventive Services Task Force (USPSTF) recommended annual screening for lung cancer with low-dose (TCBD) CT for certain population. Given the absence of national guidelines on this practice, there is uncertainty about whether this recommendation should be adopted or not. The present study aimed to evaluate the quality and completeness of the body of evidence that underpins this recommendation through rigorous methods. The quality of the guideline, and the systematic review on which is based the recommendation by the USPSTF is of intermediate quality, identified. Other systematic reviews not included, whose results are not so conclusive about the balance of risks and benefits of this practice were identified. The adoption of these recommendations policy or regular program in our country requires a rigorous, exhaustive and participatory evaluation, because it is costly, and it is not free of side effects The results aim to provide elements for this debate that should include the government, the scientific societies, insurers and other stakeholders, and the voices of patients as well. KEYWORDS: Lung Neoplasms, Mass Screening, Multidetector Computed Tomography Practice Guidelines.

Meta-tyrosine: A powerful anti-metastatic factor with undetectable toxic-side effects

Concomitant tumor resistance (CR) is a phenomenon in which a tumor-bearing host is resistant to the growth of secondary tumor implants and metastasis. While former studies have indicated that T-cell dependent processes mediate CR in hosts bearing immunogenic small tumors, the most universal manifestation of CR induced by immunogenic and non-immunogenic large tumors had been associated with an antitumor serum factor that remained an enigma for many years. In a recent paper, we identified that elusive factor(s) as an equi-molar mixture of meta-tyrosine and ortho-tyrosine, two isomers of tyrosine that are not present in normal proteins and that proved to be responsible for 90% and 10%, respectively, of the total serum anti-tumor activity. In this work, we have extended our previous findings demonstrating that a periodic intravenous administration of meta-tyrosine induced a dramatic reduction of lung and hepatic metastases generated in mice bearing two different metastatic murine tumors and decreased the rate of death from 100% up to 25% in tumor-excised mice that already exhibited established metastases at the time of surgery. These anti-metastatic effects were achieved even at very low concentrations and without displaying any detectable toxic-side effects, suggesting that the use of meta-tyrosine may help to develop new and less harmful means of managing malignant diseases, especially those aimed to control the growth of metastases that is the most serious problem in cancer pathology.

La resistencia concomitante antitumoral (RC) es el fenómeno según el cual un individuo portador de tumor inhibe el crecimiento de implantes tumorales secundarios y metástasis. Si bien desde hace tiempo se sabe que la RC inducida por tumores inmunogénicos de pequeño tamaño es generada por mecanismos inmunológicos dependientes de células T, por otro lado, la manifestación más universal de la RC, generada tanto por tumores inmunogénicos como no-inmunogénicos de gran tamaño, había sido asociada con un (unos) factor sérico antitumoral cuya naturaleza permaneció elusiva por años. En un trabajo reciente, nuestro grupo de trabajo identificó este factor como la mezcla equi-molar de meta-tirosina y orto-tirosina, dos isómeros de tirosina que no están presentes en proteínas normales y que demostraron ser responsables del 90% y 10%, respectivamente, de la actividad antitumoral total del suero. En este trabajo, continuamos nuestras investigaciones demostrando que la administración periódica de meta-tirosina reducía drásticamente el número de metástasis pulmonares y hepáticas en ratones portadores de dos tumores murinos altamente metastásicos y disminuía dramáticamente la mortandad (de 100% a 25%) de ratones con metástasis ya establecidas al momento de la extirpación quirúrgica del tumor. Estos efectos anti-metastásicos se lograron aun con muy bajas concentraciones de meta-tirosina y sin efectos tóxicos perceptibles, lo que sugiere que su uso puede ayudar a diseñar nuevas y menos nocivas estrategias para el tratamiento del cáncer, especialmente aquellas destinadas a controlar el crecimiento metastásico, que es el problema más grave en la enfermedad oncológica.

Evaluation of changes in the attitudes and behaviors of relatives of lung cancer patients toward cancer prevention and screening.

BACKGROUND: Cancer diagnosis affects all the relatives living with the patient; however, whether the behavior of family members changes or not is unknown. To end this we evaluated the relatives of lung cancer patients. MATERIALS AND METHODS: Forty-one questions were used to collect data from the relatives of lung cancer patients who had been living with them for at least one year, to evaluate changes in their attitudes and behaviors related to cancer prevention. RESULTS: The study included 246 lung cancer patients’ relatives, of them 172 (69.9%) were women and 74 (30.1%) were men. The median age was 46 years (range: 20-83 years). Patients and their relatives had been living together for an average of 28 years (range: 1-68 years), and 88 (35.7%) of the patients’ relatives were their children. We found changes in the attitudes and behaviors toward prevention and screening for cancer in 92 (37.4%) of the relatives. Fifty-two (21.1%) of them changed their smoking habits, 34 (13.8%) altered their eating habits, 25 (10.2%) changed their exercise habits, 13 (5.3%) visited a doctor due to a suspicion of having cancer, 12 (4.9%) changed their lifestyles, seven (2.8%) underwent cancer screening tests, three (1.2%) started using alternative medicines, and three (1.2%) started using vitamins for cancer prevention. CONCLUSIONS: Important changes occur in the attitudes and behaviors of patients’ relatives toward cancer prevention and screening after the patients are diagnosed with lung cancer. Being aware of how patients’ relatives react to a family member’s cancer diagnosis may provide healthcare professionals with more incentive to address the relatives’ special needs.

Statin use and risk of lung cancer in males: a case-control study in Taiwan

To explore the association between statin use and lung cancer risk in men in Taiwan. A nested case-control study. Data from the Taiwan National Health Insurance Program, 2000 to 2010 Two thousand two hundred and ninety male patients aged 20 years or older with newly diagnosed lung cancer as cases and 9160 male subjects without lung cancer as controls. The association between statin use and lung cancer risk was estimated After adjustment for confounders including pulmonary tuberculosis, chronic obstructive pulmonary disease, asbestosis and tobacco use, multivariate logistic regression showed the adjusted odds ratio of lung cancer was 0.79 for the statins-use group [95% CI: 0.68, 0.91], when compared with no use of statins. We found an association between statin use and lung cancer risk in men in Taiwan

Modelo para la prevención y manejo del cáncer de pulmón en Cuba, 2010 / A form designed to prevent and to manage the lung cancer in Cuba, 2010

Introducción: El cáncer de pulmón es un grave problema sanitario en Cuba y afecta a uno y otro sexos. Su alta incidencia y mortalidad tienen una tendencia al incremento, más ostensible en mujeres. Su diagnóstico se realiza frecuentemente en etapas avanzadas. Objetivos: Estandarizar procederes que permitan, desde el nivel primario de atención, un procedimiento organizado para la prevención y el manejo del cáncer de pulmón, con énfasis en las personas en riesgo, así como contribuir a reducir el diagnóstico tardío de la enfermedad. Métodos: Para la construcción del algoritmo se tuvieron en cuenta los principales factores de riesgo del cáncer de pulmón, y entre ellos el de mayor contribución: el tabaquismo. Se organizó una secuencia estructurada de pasos que incluyó la aplicación de la estrategia de las 3 A (Averiguar, Animar, Asesorar), propuesta por la Organización Mundial de la Salud, adecuada a nuestro contexto y modificada, al ser aplicada por primera vez a fumadores pasivos. El modelo fue sometido a validación según criterios de expertos. Resultados: Fue construido el algoritmo que partió de explorar los principales factores de riesgo del cáncer de pulmón, orientado a sistematizar una conducta preventiva del tabaquismo, así como la sistemática de manejo del individuo en riesgo, con la participación activa del médico y la enfermera de la familia durante todo el proceso de atención. El resultado de la validación fue satisfactorio y se incorporaron las recomendaciones de los expertos. Consideraciones finales: Para el logro del diagnóstico en estadios más tempranos de la enfermedad y de la contribución a la reducción de la morbilidad y mortalidad, retos de la salud pública cubana actual, deberá tenerse en cuenta la propuesta de este modelo de prevención y adecuado manejo del cáncer de pulmón desde el nivel primario de atención

Introduction: The lung cancer is a serious health problem in Cuba affecting both sexes. Its high incidence and mortality have a trend to increase more evident in women. Its diagnosis frequently is made in the advanced stages. Objectives: To standardize procedures allowing from the primary level of care a procedure organized for prevention and management of lung cancer emphasizing the persons in risk, as well as to contribute to reduce the late diagnosis of disease. Methods: To construction of algorithm authors took into account the main risk factors of lung cancer and among them that of great contribution: smoking. A structured sequence of steps was organized including the implementation of "strategy" of three A (to find out, to encourage, to advice) proposed by WHO, suitable for our context and modified when it was applied for the first time in passive smokers. The form was submitted to validation according to the expert criteria. Results: An algorithm was designed from the exploration of main risk factors of lung cancer, directed to systematize a preventive behavior of smoking, as well as the management systematics of individual in risk with the active participation of family physician and nurse over all the care process. The result of validation was satisfactory and the expert recommendations were incorporated. Final considerations: To achieve the diagnosis in earlier stages of disease and of the contribution to reduction of morbility and mortality which are challenges of current Cuban public health, we must to take into account the proposal of this form of prevention and appropriate management of lung cancer from the primary care level

Cáncer pulmonar: prevención y pesquisa precoz / Lung cancer: screening and prevention

El cáncer pulmonar es el más mortal de todos los cánceres. Debido a que la gran mayoría de los cánceres pulmonares son causados por el hábito de fumar, su erradicación es la mejor estrategia de prevención primaria. El diagnóstico del cáncer pulmonar en etapas tempranas mejora significativamente su pronóstico, por lo que ésta es la mejor estrategia de prevención secundaria. Recientemente se ha reportado que un programa de pesquisa de cáncer pulmonar con escáner de tórax (TAC) reduce la mortalidad por cáncer. El objetivo de esta revisión es, en primer lugar, apelar a la evidencia en cuanto al rendimiento de los programas de pesquisa de cáncer pulmonar en poblaciones de alto riesgo, y en segundo lugar, analizar las distintas estrategias que tiene un médico cuando se enfrenta a un paciente a quien se le ha encontrado incidentalmente un nódulo pulmonar.

Lung cancer is a deadly disease. Since this cancer is closely related to tobacco smoke, the best way to avoid this disease is smoking prevention. Unfortunately smoking is a worldwide epidemic and in Chile its prevalence is not decreasing. The second best strategy is an early detection. For the first time there is a report showing that screening with the use of low dose CT reduces mortality from lung cancer. The prognosis is much better in early stages. The purpose of this publication is to review the evidence about screening of lung cancer, and to analyze the different strategies to deal, in the general practice, with a finding of a lung nodule.