A Miniature Bio-Photonics Companion Diagnostics Platform for Reliable Cancer Treatment Monitoring in Blood Fluids.

In this paper, we present the development of a photonic biosensor device for cancer treatment monitoring as a complementary diagnostics tool. The proposed device combines multidisciplinary concepts from the photonic, nano-biochemical, micro-fluidic and reader/packaging platforms aiming to overcome limitations related to detection reliability, sensitivity, specificity, compactness and cost issues. The photonic sensor is based on an array of six asymmetric Mach Zender Interferometer (aMZI) waveguides on silicon nitride substrates and the sensing is performed by measuring the phase shift of the output signal, caused by the binding of the analyte on the functionalized aMZI surface. According to the morphological design of the waveguides, an improved sensitivity is achieved in comparison to the current technologies (<5000 nm/RIU). This platform is combined with a novel biofunctionalization methodology that involves material-selective surface chemistries and the high-resolution laser printing of biomaterials resulting in the development of an integrated photonics biosensor device that employs disposable microfluidics cartridges. The device is tested with cancer patient blood serum samples. The detection of periostin (POSTN) and transforming growth factor beta-induced protein (TGFBI), two circulating biomarkers overexpressed by cancer stem cells, is achieved in cancer patient serum with the use of the device.

Combined pulmonary fibrosis and emphysema characteristics in a Greek cohort.

BACKGROUND: Combined pulmonary fibrosis and emphysema (CPFE) has recently received great attention, with studies suggesting that it presents a distinct clinical entity while others have challenged this hypothesis. This nationwide study aimed to describe a large cohort of Greek CPFE patients and to examine potential prognostic factors for survival. METHODS: This retrospective study included 97 patients with CPFE. Demographic and clinical data, pulmonary function tests, echocardiography results and bronchoalveolar lavage analysis were recorded. RESULTS: Most patients were male (94.8%) and 92% were current or ex-smokers. Spirometry results were abnormal (forced vital capacity (FVC) 72.9±19.9% pred and forced expiratory volume in 1 s/FVC 82.9±9.7%) with reduced diffusing capacity of the lung for carbon monoxide (D LCO) (42.3±17.4% pred). Mean systolic pulmonary arterial pressure was 41.9±19.7 mmHg and pulmonary hypertension was present in 58.8% of patients. Mean 6-min walk distance was 335.4±159.4 m. Mean emphysema score was 14.23±8.69% and mean interstitial lung disease (ILD) extent was 39.58±19.82%. Mean survival was 84 months (95% CI 72-96 months). Patients with D LCO ≥39% pred had better survival than patients with D LCO <39% pred (p=0.031). Patients with ILD extent ≥30% had worse survival than patients with ILD extent <30% (p=0.037). CONCLUSIONS: Our results indicate that CPFE patients have preserved lung volumes associated with disproportionately reduced D LCO, while reduced D LCO and increased ILD extent was associated with worse prognosis.

Comparative analysis of induced sputum and bronchoalveolar lavage fluid (BALF) profile in asbestos exposed workers.

BACKGROUND: Biological monitoring of healthy workers exposed to hazardous dusts lack validated screening tools. Induced sputum (IS) cellular profile was compared with bronchoalveolar lavage fluid (BALF) profile in asbestos exposed workers in order to assess its usefulness in monitoring workers exposed to asbestos for a long period of time. METHODS: IS and BALF analysis was performed in 39 workers of a car brakes and clutches factory that uses chrysotile asbestos. Selection criteria were an employment history of > 15 years and the absence of a diagnosis of pneumonoconiosis. The type of cells, the existence of dust cells, of iron laden macrophages and of asbestos bodies were assessed and compared between IS and BALF samples. RESULTS: 35 IS samples (90%) had dust cells, 34 (87%) iron laden macrophages and in 8 samples (21%) asbestos bodies were found. In most samples neutrophils were dominated. Samples with asbestos bodies (ABs) had significantly higher lymphocytes and lower neutrophils count compared with the samples without ABs. Macrophages and neutrophils in IS and BALF exhibited significant inter-relations (Spearman's rho: 0.26-0.29, p < 0.05) while IS lymphocytes count showed an inverse relation with BALF neutrophils (Spearman's rho: -0.36). Neutrophils and dust cells were highly correlated between the samples (Spearman's rho: 0.35, p < 0.05) while IS dust cells and lymphocytes were inversely related (Spearman's rho: -0.36, p < 0.05). More years of employment in the company was related with more neutrophils (Spearman's rho: 0.26) and less lymphocytes (Spearman's rho: -0.33) count. In multivariate analysis the presence of AB in IS samples was strongly related to the presence of asbestos bodies and lymphocytes count in BALF samples. CONCLUSIONS: IS and BALF analysis showed a similar cellular profile indicating that IS sampling in exposed workers to asbestos as a less invasive and expensive method may be useful in providing an insight both for inhalation of dusts and inflammatory processes in the lung.

Involvement of lymphatic metastatic spread in non-small cell lung cancer accordingly to the primary cancer location.

OBJECTIVES: The purpose of the study is to investigate the contribution of lymphatic spread in operable non-small cell lung cancer (NSCLC) in relation to the cancer location. METHODS: We retrospectively studied 557 consecutive patients [514 males and 43 females, mean age 62.5 +/- 9.1 years (range, 20-84)] who underwent a major lung resection due to NSCLC in our department, from January 1995 to December 1999. Preoperative staging for metastatic disease was negative. Extended mediastinal lymph node dissection was performed in all lung resections. RESULTS: The pathology report revealed 220 adenocarcinomas, 276 squamous-cell, 34 undifferentiated, 25 adenosquamous and 2 large-cell carcinomas. The TNM stage was IA in 52 patients, IB in 109, IIA in 20, IIB in 146, IIIA in 190, IIIB in 35 and IV in 5. The classification of disease was N0 in 240 (40.1%) patients, N1 in 179 (32.1%) and N2 in 138 (24.8%). Twenty-eight patients (5.03%) presented a skip metastasis to hilar lymph nodes, while 27 patients (4.85%) presented with skip metastasis to the mediastinum. The size of the primary tumors presenting with metastases was significantly smaller in adenocarcinomas compared to squamous-cell carcinomas (P = 0.046). Regarding the right lung, tumors originating in the upper lobe mainly metastasized to level No. 4, while tumors of the middle lobe spread to stations Nos. 4 and 7, and those in the lower lobe to level No. 7. Regarding the left lung, tumors originating in the upper lobe metastasized to level No. 5, while tumors within the lower lobe spread to stations, Nos. 7-9. CONCLUSIONS: Mediastinal lymph nodal dissection is necessary for the accurate determination of pTNM stage. It seems that there is no definite way for lymphatic spreading in relation to the location of the cancer. Skip metastasis to the mediastinal lymph nodes was present in 4.85% of our patients, while adenocarcinomas, even small-sized ones, are more aggressive than squamous-cell carcinomas.