RESUMO
El sarcoma sinovial pleuropulmonar (SSPP) es un tumor primario de pulmón, maligno, infrecuente en pediatría (prevalencia 0,1-0,5 %) que afecta predominantemente a adolescentes y adultos jóvenes. Se ha descrito una sobrevida global cercana al 30 % a los 5 años. Se reporta el caso de un paciente de 12 años de edad, previamente sano, que presentó tos, dolor torácico y disnea de comienzo súbito, como manifestación inicial de neumotórax izquierdo, el que persistió a los 4 días y requirió resección quirúrgica de lesión bullosa pulmonar. Se realizó diagnóstico histológico de sarcoma sinovial pleuropulmonar confirmado por estudio molecular, que evidenció la translocación cromosómica entre el cromosoma X y el 18: t(X;18) (p11.2;q11.2) de la pieza quirúrgica extirpada. Ante pacientes con neumotórax persistente o recidivante, es importante descartar causas secundarias, entre ellas, sarcoma sinovial pleuropulmonar. Su ominoso pronóstico determina la necesidad de arribar a un diagnóstico temprano e implementar un tratamiento agresivo
Pleuropulmonary synovial sarcoma (PPSS) is a primary malignancy of the lung, uncommon in pediatrics (prevalence: 0.10.5%) that predominantly affects adolescents and young adults. Overall survival has been reported to be close to 30% at 5 years. Here we report the case of a previously healthy 12-year-old male patient who presented with cough, chest pain, and dyspnea of sudden onset as initial manifestation of left pneumothorax, which persisted after 4 days and required surgical resection of pulmonary bullous lesion. A histological diagnosis of pleuropulmonary synovial sarcoma was made and confirmed by molecular study, which showed chromosomal translocation between chromosomes X and 18: t(X;18) (p11.2;q11.2) in the surgical specimen removed. In patients with persistent or recurrent pneumothorax, it is important to rule out secondary causes, including pleuropulmonary synovial sarcoma. Such poor prognosis determines the need for early diagnosis and aggressive treatment.
Assuntos
Humanos , Masculino , Criança , Pneumotórax/complicações , Pneumotórax/etiologia , Sarcoma Sinovial/complicações , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Tosse , Pulmão/patologiaRESUMO
The biochemical existing tool of diagnostic methods to lung cancer cases need to be improved. In order to validate an early screening of primary tumor patients, a developed a simple procedure or technique was demanded. The aims of this study were to provide an overview of alkaline Placental Alkaline Phosphatase activity in lung cancer. Using heating inactivation method regarding the measurement of Placental Alkaline Phosphatase activity as an early diagnosis marker in lung cancer cases. Total alkaline phosphatase and Placental alkaline phosphatase activity were measured in patients of Lung cancer patients who were classified according to the site of tumor by histological picture. ALP isoenzymes were identified by heat inactivation, and compared with the most frequently applied method (ELISA). Monitoring of the Total ALP and Placental ALP activity in the studied groups using two different methods were shown a highly performance of heating method by an experimental assessment to confirm the accuracy and validity of the proposed method. The distribution of serum placental ALP isoenzyme activity in patients and control groups which was measured by two different methods were found to be (20.2-43.1) IU/L respectively (measured by heating method) and (394.3- 454.5) pg/mL measured by ELISA method) respectively. Placental ALP isoenzyme showed a high significant activity in lung cancer patients than healthy control with p value less than (0.05). That application of the heat inactivation method yields similar indication to the ones obtained by the highly and specific enzyme-linked immunosorbent assay. The results of detection Placental alkaline phosphatase in serum were in excellent agreement and could have a potentially extensive application for Placental alkaline phosphatase quantification.
RESUMO
OBJECTIVE： To compare the cost-effectiveness of long-effect and short-effect granulocyte stimulating factor in prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies， and to provide reference for rational drug use in the clinic. METHODS： A retrospective analysis was conducted for 132 cases who used granulocyte stimulating factor to prevent and treat bone marrow suppression induced by chemotherapy for lung malignancies in the Affiliated Tumor Hospital of Zhengzhou University during Jan. 2017 to Jun. 2018. Among them， 60 cases were treated with Recombinant human granulocyte stimulating factor injection （short-effect， group A）， and 72 cases were treated with Polyethylene glycol recombinant human granulocyte stimulating factor injection （long-effect， group B）. Clinical efficacies， the occurrence of bone marrow suppression and ADR were compared between 2 groups. Cost was calculated， and cost-effectiveness analysis was conducted. Sensitivity analysis was conducted by down-regulating 20％ drug price. RESULTS： The total response rates of group A and B were 71.7％ and 75.0％， without statistical significance （P＞0.05）. There was no statistical significance in the incidence and duration of bone marrow suppression or the incidence of ADR （P＞0.05）. Average treatment costs of the two groups were （335.91±180.34） and （1 982.75±603.15） yuan； the cost of group A was significantly lower than that of group B （P＜0.05）. The cost-effectiveness ratio of them were 4.69 and 26.44， while group A as a reference， incremental cost-effectiveness ratio of group B was 494.55. The sensitivity analysis results were in agreement with the cost-effectiveness analysis. CONCLUSIONS： The effectiveness of Recombinant human granulocyte stimulating factor injection is similar to that of Polyethylene glycol recombinant human granulocyte stimulating factor injection for the prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies. But the cost-effectiveness ratio of the former is lower than that of the latter.