ABSTRACT
The diagnosis of lung cancer and early knowledge of its histological type are very important; however, this is still a difficult subject for the physician. The aim of this study was to improve the diagnostic efficiency of tumour markers in the diagnosis of bronchial carcinoma by mathematical evaluation of a tumour marker profile employing fuzzy logic modeling. A panel of five tumour markers, including CYFRA 21-1, CEA, NSE, and five additional parameters was determined in 281 patients with confirmed primary diagnosis of bronchial carcinoma of different histology and stage. A further 131 persons, who had acute and chronic benign lung diseases, served as a control group. A classificator was developed using a fuzzy-logic rule-based system. The diagnostic value of the combined tumour markers was significantly better than that of the individual markers and of a combination of CYFRA 21-1, CEA, and NSE. The discrimination of malignant vs benign diseases was realized with a sensitivity of 87.5% and specificity of 85.5%. The rate of correct classification of small-cell vs non-small-cell lung carcinoma was 90.6% and 91.1%, respectively; for squamous cell carcinoma vs adenocarcinoma it was 76.8% and 78.8%, respectively. Our detailed analysis has shown that the fuzzy logic system improves diagnostic accuracy up to a rate of 20%, especially in early stages and in patients with all marker levels in the grey area. Our concept proved to be more powerful than measurement of single markers or the combination of CEA, CYFRA 21-1, and NSE. Its use may help in distinguishing between malignant and benign disease and make it possible to define different subgroups of patients earlier in the course of their disease.
Subject(s)
Biomarkers, Tumor/analysis , Carcinoma, Bronchogenic/diagnosis , Fuzzy Logic , Lung Neoplasms/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Bronchogenic/classification , Carcinoma, Bronchogenic/pathology , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Small Cell/diagnosis , Diagnosis, Differential , Female , Humans , Lung Diseases/classification , Lung Diseases/diagnosis , Lung Diseases/pathology , Lung Neoplasms/classification , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , ROC Curve , Sensitivity and SpecificityABSTRACT
The i.v. bolus application of 1 nmol/kg endothelin-1 (ET-1) in anaesthetized and ventilated guinea-pigs caused an increase in mean arterial blood pressure (BP) and a bronchoconstriction. Both have been reduced or abolished by COX inhibition (ASA) or substances specifically reducing the thromboxane A2 (TXA2) generation (HOE 944) or receptor binding (BM 13177). The significant increase in TXB2 concentrations in plasma and bronchoalveolar lavage (BAL) after ET-1 challenge (15-fold and 4-fold, respectively) have been reduced or abolished by ASA as well as HOE 944 and not altered by BM 13177.
Subject(s)
Bronchoconstriction/drug effects , Endothelins/pharmacology , Thromboxane A2/metabolism , Animals , Aspirin/pharmacology , Blood Pressure/drug effects , Blood Pressure/physiology , Bronchoalveolar Lavage Fluid/metabolism , Bronchoconstriction/physiology , Guinea Pigs , Imidazoles/pharmacology , Male , Naphthalenes/pharmacology , Prostaglandin-Endoperoxide Synthases/metabolism , Receptors, Thromboxane/antagonists & inhibitors , Sulfonamides/pharmacology , Thromboxane B2/blood , Thromboxane B2/metabolism , Thromboxane-A Synthase/antagonists & inhibitors , Vasopressins/physiologyABSTRACT
The amount of albumins and immunoglobulins in the broncho-alveolar lavage fluid of sarcoidosis patients were measured and correlated with cellular activity parameters in sarcoidosis. It could be shown that IgG and IgA, related to albumin, were increased in comparison with serum while the IgM fraction was decreased. In general, the highest values of immunoglobulins were found in active sarcoidosis.
Subject(s)
Bronchoalveolar Lavage Fluid/analysis , Immunoglobulins/analysis , Lung Diseases/immunology , Sarcoidosis/immunology , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysisABSTRACT
The activity of alveolitis in 25 patients with pulmonary sarcoidosis was determined by analysis of T-Lymphocytes and their subpopulations collected by broncho-alveolar lavage. The characterization of the lymphocytes was performed with monoclonal antibodies (BL-series). An amount of T-lymphocytes higher than 28% of all cells and a proportion of T4/T8-lymphocytes of 8:1 and over are signs of the activity of the alveolitis and an indication for corticoid therapy.
Subject(s)
Bronchoalveolar Lavage Fluid/cytology , Immunoglobulins/metabolism , Lung Diseases/immunology , Sarcoidosis/immunology , T-Lymphocytes/immunology , Antibodies, Monoclonal , Humans , Leukocyte Count , T-Lymphocytes, Helper-Inducer/immunology , T-Lymphocytes, Regulatory/immunologyABSTRACT
In two separate and independent experimental series it was studied, whether 8-arginine-vasopressin (AVP) or 8-lysine-vasopressin (LVP) administered daily in microgram amounts to pregnant rats, and/or to their offspring postnatally for 30 days, induce alterations that can be registered by a behavioral test. The realization of the test used, a foot-shock motivated brightness discrimination (BD) reaction, includes learning and memory processes. There is one general result of the two experimental series, which include 263 rats divided up in different combinations of pretreatment. Vasopressin (VP), AVP or LVP, pre- and postnatally administered, induces a significantly improved BD performance of approximately 40%, compared to the control groups. The improvement is detectable in different ages of the offspring, in females as well as in males. A smaller though also significant improvement was observed when AVP or LVP was injected only postnatally. The critical period in which the peptides are able to induce the alterations measured probably includes prenatal and postnatal periods in the lives of the rats. What molecular interactions actually underly the improved behavioral performance remain to be clarified.
