A comparative analysis of angiopoietin 2 immunohistochemical staining in various stages of lung cancer.

OBJECTIVE: The role of Angiopoietin 2 (Ang 2), which is necessary for tumor growth, extension, and metastasis is not fully elucidated. The presented study aimed to investigate the relationship between Ang 2 staining intensity, expression rate in tumor tissue, and the stage of lung cancer. MATERIALS AND METHODS: Fifty cases of lung cancer (34 non-small and 16 small cell cases) were included in the study. Immunohistochemistry was done to evaluate Ang 2 staining intensity and expression rate in tumor and stromal cells of lung cancer tissue. RESULTS: Ang 2 was positive for 45 (90%) cases and negative for five (10%) cases (P = 0.04). There was a significant correlation between Ang 2 expression rate of expression and the histologic type of lung cancer (P = 0.033). Ang 2 expression rate in tumor cells of cancer tissues diagnosed with adenocarcinoma was low. There was a significant correlation between Ang 2 expression rate in stromal cells of cancer tissue and the type of lung cancer (P = 0.021). Stromal cell expression rate of Ang 2 in adenocarcinoma was found to be low. CONCLUSIONS: As a result, the relationship between lung cancer stage and Ang 2 was documented with this study and the expression rate was found to be lower in adenocarcinomas. By this analysis, we can suggest that angiopoietins may be used as an option for targeted treatment in lung cancer.

Does atopy affect the radiological extent of pulmonary tuberculosis?

BACKGROUND: Th1 cytokines, IL-2 and IFN-gamma , have critical importance in the CD4 cell driven antimycobacterial activity. Th2 type immune response is a characteristic feature of atopic disorders. Th1 and Th2 cells have been reported to negatively cross-regulate each other in vitro and in experimental animals. Our aim in the present study is to determine whether the atopy affects radiological extent of pulmonary tuberculosis (TB) and disease severity. MATERIALS AND METHODS: A total of 82 male patients with pulmonary TB were prospectively enrolled in the study between March 2005 and March 2006. All patients were evaluated for atopic symptoms and TB related systemic symptoms. Radiological dissemination was scored and cavitation was noted. The skin prick test (SPT) was performed and serum total IgE level was measured. RESULTS: The SPTs were positive in 28 of 82 (34.1 %) patients. There was no distinction between SPT-positive and negative patients in terms of pulmonary cavitation and radiological dissemination. The median IgE level of moderate-severe radiologically disseminated TB patients was significantly higher than that of mild radiologically disseminated TB patients (130 IU/ml vs. 58 IU/ml). Cavitary TB patients had also significantly higher median IgE levels (78 IU/ml vs. 46 IU/ml) (p < 0.05) CONCLUSION: This study suggests that SPT-positivity and atopic respiratory phenotype do not affect the formation of cavitation, radiological dissemination and systemic symptoms of pulmonary TB. The high level of IgE in patients with cavitary and radiologically disseminated TB may be a consequence of a dysregulated immune response to infection or reflect disease activity.

Does atopy affect the radiological extent of pulmonary tuberculosis?

Background: Th1 cytokines, IL-2 and IFN- , have critical importance in the CD4 cell driven antimycobacterial activity. Th2 type immune response is a characteristic feature of atopic disorders. Th1 and Th2 cells have been reported to negatively cross-regulate each other in vitro and in experimental animals. Our aim in the present study is to determine whether the atopy affects radiological extent of pulmonary tuberculosis (TB) and disease severity. Materials and methods: A total of 82 male patients with pulmonary TB were prospectively enrolled in the study between March 2005 and March 2006. All patients were evaluated for atopic symptoms and TB related systemic symptoms. Radiological dissemination was scored and cavitation was noted. The skinprick test (SPT) was performed and serum total IgE level was measured. Results: The SPTs were positive in 28 of 82 (34.1 %) patients. There was no distinction between SPT-positive and negative patients in terms of pulmonary cavitation and radiological dissemination.The median IgE level of moderate-severe radiologically disseminated TB patients was significantly higher than that of mild radiologically disseminated TB patients (130 IU/ml vs. 58 IU/ml). Cavitary TB patients had also significantly higher median IgE levels (78 IU/ml vs. 46 IU/ml) (p < 0.05) Conclusion: This study suggests that SPT-positivity and atopic respiratory phenotype do not affect the formation of cavitation, radiological dissemination and systemic symptoms of pulmonary TB. The high level of IgE in patients with cavitary and radiologically disseminated TB may be a consequence of a dysregulated immune response to infection or reflect disease activity

No disponible

Does the atopic phenotype prevent development of active tuberculosis infection?

This study investigated the relationship between the atopic phenotype and the development of active tuberculosis. A total of 82 human immunodeficiency virus negative males with active pulmonary tuberculosis and 88 healthy controls were enrolled into this prospective study. Serum immunoglobulin E (IgE) levels were measured and skin prick tests performed before initiation of treatment. Skin prick tests were positive in 34.1% of the tuberculosis patients and 39.8% of the controls. Allergic respiratory symptoms were significantly less frequent in skin prick test positive tuberculosis patients (21.4%) compared with skin prick test positive controls (62.9%). Median IgE levels in atopic tuberculosis patients were significantly higher than in atopic controls. The low rate of atopic respiratory complaints seen in the tuberculosis patients, despite having similar allergic skin prick test sensitivities to the controls, could be attributed to a weak T-helper (Th) 2 immune reaction and its effects on Th1-Th2 interaction.

Pyo-pneumothorax in patients with active pulmonary tuberculosis: an analysis of 17 cases without intrapleural fibrinolytic treatment.

OBJECTIVE: To review the medical records of patients with active pulmonary tuberculosis (TB) and pyo-pneumothorax (PPT). SUBJECTS AND METHODS: Medical records of 17 patients (14 male, 3 female, mean age 23.8 years, range 20-52) with PPT and active pulmonary tuberculosis at Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey, were reviewed from January 1998 to December 2002. The patients were treated with chest tube drainage and chemotherapy. Intrapleural fibrinolytic agents or irrigation was not performed. RESULTS: Pleural fluid samples were available in 14 patients and the mean levels of LDH, protein and glucose in the pleural fluid were 1,767 +/- 944 U/l, 5.2 +/- 1.4 g/dl and 31.7 +/- 22.6 mg/dl, respectively. Mycobacterium tuberculosis was detected in the pleural effusion of 3 patients. The duration of chest tube drainage was longer in cases who underwent open drainage (p = 0.014). At the end of the treatment period 10 patients developed pleural thickening, 4 of them underwent decortication and pneumonectomy was also done in 1 patient. The development of pleural thickening was related to the level of pleural fluid glucose (p = 0.04). CONCLUSION: This study shows that while taking care of patients with pulmonary TB the physician must be aware of the complication of PPT and that adequate chemotherapy and drainage must be duly performed.

The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients.

OBJECTIVES: To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases. METHODS: We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups. RESULTS: Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum (P < 0.001 and P < 0.05, respectively) and pleural effusion (P < 0.001 and P < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera (P < 0.001 and P < 0.05, respectively) and pleural effusions (P < 0.001 and P < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher (P < 0.001 and P < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST. CONCLUSION: We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.

Chemotherapy- and radiotherapy-induced cytologic alterations in the sputum of patients with inoperable lung carcinoma. Role in follow-up.

OBJECTIVE: To define the light microscopic cytologic changes due to chemotherapy (CT) and/or radiotherapy (RT); to evaluate the differentiation of those changes according to treatment; to find out whether a relation exists between treatment type and its duration and the cytologic findings; and to determine the role of sputum cytology in evaluating efficacy of treatment and follow-up in patients with inoperable lung cancer of various histology. STUDY DESIGN: A total of 1,605 periodic sputum samples from 80 cases of lung cancer obtained during treatment and follow-up were prospectively examined cytologically. The relationship of treatment type and duration to qualitative and semiquantitative data and the definability of the response to treatment as well as the relationship of progression-free survival (PFS) and total survival (TS) rates with cytologic data were evaluated. RESULTS: The majority of therapy-induced cellular changes were in the nucleus and were directly related to the duration of treatment. An increase in minimally affected tumor cells, tumor cells that lost their pathologic features and necrotic cell debris were good indicators of therapeutic efficacy. Cytologic changes did not reflect PFS and TS rates. CONCLUSION: Although light microscopic cytologic changes cannot be attributed objectively to either RT or CT, therapeutic efficacy is shown in follow-up sputum cytology, which can be used in monitoring and planning additional therapy or other therapeutic options in lung cancer patients.