ABSTRACT
Data on ten variables and 16 biomarkers were obtained on 119 patients with newly diagnosed pulmonary cancer. The prognostic value of 16 biomarkers (alpha-1-antitrypsin [AAT], adrenocorticotropic hormone [ACTH], alpha-fetoprotein [AFP], carcinoembryonic antigen [CEA], human chorionic gonadotropin [HCG], immune complexes, immunoglobulins, N-terminal peptide of proopiomelanocortin [NTERM], and tumor-associated antibody [TAA]) was tested by adding these to the model of age, gender, stage, morphology, Feinstein's classification of symptoms, Karnofsky scale, leukocyte count, recent weight loss, and liver enzymes. Using Cox's regression method and a forward stepwise procedure, seven biomarkers (ACTH, AAT, AFP, calcitonin, HCG, TAA, and prolactin) entered the model. Elevated levels of cortisol and TAA were associated with longer survival. The selection of biomarkers by stepwise regression needs to be interpreted with caution, especially since the Z scores were found to be dependent on the particular variables included in the model. Furthermore, when dichotomized on maximum of the normal laboratory values, HCG and AFP were infrequently (2%) elevated. The lack of correlation among the biomarkers supports the hypothesis of random derepression of the genome of cancer cells. Further studies in improved modeling and the formulation of a biomarker index could enhance our understanding of the biology of cancer.
Subject(s)
Adenocarcinoma/epidemiology , Biomarkers, Tumor/blood , Carcinoma, Small Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Lung Neoplasms/epidemiology , Adenocarcinoma/blood , Adult , Aged , Aged, 80 and over , Analysis of Variance , Canada , Carcinoma, Small Cell/blood , Carcinoma, Squamous Cell/blood , Chi-Square Distribution , Cohort Studies , Female , Humans , Likelihood Functions , Lung Neoplasms/blood , Male , Middle Aged , Models, Biological , Prognosis , Survival AnalysisABSTRACT
After left pneumonectomy cardiac herniation occurred and caused a new radiologic finding, "the displaced chest tube." Diagnostic pneumothorax was helpful. The emergency chest radiograph enables rapid diagnosis of this life-threatening condition.
Subject(s)
Cardiomyopathies/diagnostic imaging , Pneumonectomy/adverse effects , Aged , Cardiomyopathies/etiology , Female , Hernia/diagnostic imaging , Hernia/etiology , Humans , Radiography , Time FactorsABSTRACT
It is important to recognize the true nature of the rare superior vena caval aneurysm with nonoperative techniques, in order to avoid needless diagnostic thoracotomy. Two distinct types exist--the fusiform and the saccular. The presence of such an aneurysm should be suspected if there is size variation during respiration on roentgenographic evaluation, and can be confirmed venographically. That these aneurysms do not enlarge, rupture, or thrombose argues for conservative management.
Subject(s)
Aneurysm/congenital , Vena Cava, Superior/surgery , Adolescent , Adult , Aneurysm/diagnosis , Aneurysm/surgery , Child , Female , Humans , Middle Aged , Radionuclide Imaging , Tomography, X-Ray Computed , Vena Cava, Superior/diagnostic imagingABSTRACT
A case is reported in which anticoagulant therapy for thrombophlebitis and pulmonary embolism produced bilateral massive intrarenal hematomas (pseudotumors). The role of radiologic investigation (nephrotomography, renal scan and selective high dose arteriography) was found to identify and localize the intrarenal hematomata and exclude underlying renal pathology. Although an abnormal kidney is more likely to bleed, this case presentation demonstrates that even carefully monitored anticoagulation within the therapeutic range can induce massive intrarenal hemorrhage in previously normal kidneys. The renal architecture returned to normal on late follow-up examination on simple conservative management.
