Prognostic implication of Ki-67 immunostaining in treating subclinical pleural cancer found at thoracotomy in lung cancer patients.

BACKGROUND: Therapeutic principles for managing subclinical pleural cancer found unexpectedly during intraoperative examination are unclear. We analyzed prognostic factors including the tumor proliferative marker Ki-67 in these circumstances. METHODS: The cases of 65 surgically treated patients with lung cancer and subclinical T4 pleural cancer, microscopic in 25 and macroscopic in 40, were reviewed. RESULTS: The overall 5-year survival rate of patients undergoing lobectomy was 14.3%. For patients with T4 NO disease, the 5-year survival rate was 46.7%. In patients with a low Ki-67 labeling index, the 5-year survival rate was 28.6%. The Ki-67 labeling index was a significant (p < 0.05) indicator of survival. Multivariate analysis demonstrated Ki-67 labeling index, lymph node involvement, and tumor differentiation to be the most influential prognostic factors for postoperative survival (p < 0.01). CONCLUSIONS: In the treatment of lung cancer patients with subclinical pleural cancer found at thoracotomy, tumor resection is not necessarily contraindicated. Resection appears to be beneficial in patients with no nodal involvement or a low tumor Ki-67 labeling index. This index is a good therapeutic indicator for lung cancer patients.

Ki-67 immunostaining and other prognostic factors including tobacco smoking in patients with resected nonsmall cell lung carcinoma.

BACKGROUND: To estimate the effectiveness of expression of the tumor proliferative marker Ki-67 antigen (Ki-67) as a postoperative prognostic marker, the authors analyzed Ki-67 expression and its correlation with postoperative survival and other clinicopathologic factors, including preoperative smoking habits, in patients with resected nonsmall cell lung carcinoma (NSCLC). METHODS: A total of 156 patients with resected NSCLC at the study institution were investigated. Postoperative survival rates were estimated based on demographic and clinicopathologic factors, including Ki-67 expression and preoperative tobacco smoking habits. RESULTS: The overall postoperative 5-year survival rate in patients with high Ki-67 labeling indices (>/= 20%) was 39.6% compared with 67.7% in patients with low Ki-67 labeling indices. This finding was significant for all resected cases and for each pathologic disease stage (P < 0.05). The postoperative 5-year survival rate in patients with a history of heavy smoking (>/= 30 pack-years) was 47.6% compared with 62.5% for other patients (P = 0.027). This result was especially significant in patients with International Union Against Cancer Stage I disease and in patients with nonsquamous cell carcinoma (P < 0.03). The authors also observed a positive correlation between the Ki-67 labeling index and preoperative smoking habits (P = 0.0002). Multivariate analysis demonstrated that lymph node involvement, tumor differentiation, and Ki-67 labeling index were significant prognostic factors in NSCLC (P < 0.01). CONCLUSIONS: Tumor Ki-67 expression is a strong prognostic factor in NSCLC, especially adenocarcinoma. It may be hypothesized that tobacco mutagenicity may play a role in the growth and extension of NSCLC, which is one of the major impediments to postoperative survival in patients with a history of heavy smoking.

Signaling of lysophosphatidic acid-evoked chloride current: calcium release from inositol trisphosphate-sensitive store.

In Xenopus oocytes, lysophosphatidic acid (LPA) evoked inward currents at the holding potential of -60 mV, which were quickly desensitized upon repeated challenges of the compound at 10 nM or 1 microM. This desensitization was prevented by pretreatment with protein kinase A inhibitor or recovered by its post-treatment, but not by the pretreatment with an inhibitor of protein kinase C or calmodulin kinase II. From pharmacological studies, the LPA-evoked currents were found to be mediated by phospholipase C, calcium-mobilization from thapsigargin-sensitive Ca2+ stores, araguspongine E-sensitive inositol trisphosphate receptor, and calcium-dependent chloride channels.

Parallel stimulations of in vitro and in situ [35S]GTPgammaS binding by endomorphin 1 and DAMGO in mouse brains.

Metabotropic activities of endomorphin 1, a candidate for endogenous mu-opioid receptor ligands, were examined in comparison with the actions of [D-Ala2, N-Me-Phe4, Gly5ol]-enkephalin/DAMGO, a well-known synthetic mu-opioid agonist. Endomorphin 1 stimulated [35S]GTPgammaS binding to synaptic membranes from the mouse amygdala in a naloxone-reversible manner. DAMGO had the same effect in such preparations. In in situ [35S]GTP-gammaS binding experiments using brain sections, both endomorphin 1 and DAMGO similarly stimulated this binding in specific cellular locations throughout the brain regions. These findings strongly support the view that endomorphin 1 selectively acts on a mu-opioid receptor.

[The advantages of laser assist in parenchyma-sparing pulmonary resection].

The advantages of laser irradiation were investigated retrospectively, using a total of 89 parenchyma-sparing pulmonary resection (PSPR) for localized lung lesions which included 42 conventional wedge resection (CWR), 8 PSPR using electrocoagulator (PE) and 39 PSPR using CO2 laser or Nd:YAG laser (PCYL). The major axes of the lesions in PNYL (25.4 +/- 10 mm) were significantly (p = 0.0387) longer than that in CWR (20.3 +/- 11.3 mm). The amount of bleeding during operation was similar in three groups. The mean value of the amount of postoperative exudation from the thoracic drains in PCYL (615 ml) was only 60 ml more than that in CWR. Bloody sputum was observed for 4.8 days in PCYL and 5.0 days in CWR, whereas 7.1 days in PE. Air leak was observed 33.3% in PCYL, 37.5% in PE, whereas 22.5% in CWR, that continued for 1.7 days (mean value) in PCYL, 1.6 days in PE and 2.0 days in CWR. Decrease (differences between preoperative and postoperative lung functions/volume of the lesions) in FVC and FEV1.0 in PCYL (mean values = 221, 158) and PE (174, 135) were less than that in CWR (339, 204). Laser assist in PSPR revealed advantages in hemostasis comparing with PE, and in parenchyma-sparing comparing with CWR. And no clear difference between PCYL and CWR in bleeding during operation, the amount of postoperative exudation and postoperative air leak. CO2 laser is reported that has higher potential in vaporization or cutting but lower ability in hemostasis comparing with Nd:YAG laser, so authors would express that Nd:YAG laser assist is most safe and effective in parenchyma-sparing lung resection.

[Experience of the malignant complete intrathoracic goiter: discussion on 13 cases of Japan].

A 56-year-old woman was found to have a mediastinal mass on routine examination. Chest X-ray, CT scan, MRI and superior vena cavography showed a right upper mediastinal tumor invading the SVC. And it was diagnosed malignant intrathoracic goiter by histological examination by percutaneous needle biopsy. On thoracotomy and mediastinotomy, the tumor located only in the right upper mediastinum and had no relation to the cervical thyroid gland. Histological examination revealed papillary adenocarcinoma. We reported a malignant complete intrathoracic goiter and added discussion on another 12 cases seen in Japanese literature.

Ectopic ureter passing through the external urethral sphincter: report of a case.

A rare case of urethral ectopic ureter without urinary incontinence is reported. Urinary continence was preserved because of the ectopic ureter passing through the external sphincter.