The clinical value of new tumor biomarker cytokeratin 2G2 detection in non-small cell lung cancer patients.

BACKGROUND: Many tumor markers are analyzed for usefulness in diagnosis, prognosis, and monitoring. The purpose of this study was to evaluate a new type of tumor biomarker, cytokeratin (CK)-2G2, in serum for the early diagnosis, confirmative diagnosis as well as assessment of treatments of non-small cell lung cancer (NSCLC). METHODS: Use a chemiluminescent method to examine the serum CK-2G2 levels in 100 patients with non-malignant lung diseases and 100 cases from the healthy population, as well as 124 cases of NSCLC patients prior to chemotherapy, after one course of treatment and after two courses of treatment. RESULTS: The average levels of CK-2G2 in the serum of NSCLC patients was found to be significantly higher than that of the group of non-malignant patients as well as the healthy control group (p < 0.01). It was further observed that CK-2G2 is markedly higher in squamous-cell carcinoma than in adenocarcinoma (p < 0.05) whereas CK-2G2 was found to be higher in stages III and IV than stages I and II (p < 0.05) and CK-2G2 is markedly higher in large tumor size (> 3cm) than in small tumor size (< or = 3cm) (p < 0.05). Serum CK-2G2 levels for patients with cancer progression were found to increase after two courses of chemotherapy (p < 0.01) whereas patients with stabilized tumorigenesis or tumor regression showed a significant trend of CK-2G2 decrease (p < 0.01). CONCLUSIONS: Detection of the new tumor biomarker CK-2G2 has certain clinical values for early diagnosis, verification of diagnosis as well as classification of patients. Thus it is warranted that CK-2G2 be widely deployed as a new type of cost effective parameter for evaluating efficacy of chemotherapy of NSCLC.

[Management of short-term complications after pneumonectomy for pulmonary tuberculosis].

OBJECTIVE: To explore the diagnosis and management of short-term complications after pneumonectomy for pulmonary tuberculosis. METHODS: The clinical data and management of short-term complications in patients with pulmonary tuberculosis after pneumonectomy were retrospectively reviewed and analyzed. RESULTS: From September 2000 to September 2010, 206 patients with pulmonary tuberculosis underwent pneumonectomy, of whom 26 experienced complications shortly after the surgery. Postoperative acute type II respiratory failure occurred in 5 within 14 months post-operation, acute respiratory distress syndrome (ARDS) in 2 within 3 months post-operation, chest hemorrhage in 7 within 20 days post-operation, empyema in 8 within 4 years post-operation, and bronchopleural fistula in 4 cases within 50 days post-operation. Of the 7 cases with chest hemorrhage, 2 were cured and 5 dead. All the 8 cases with empyema were cured. Of the patients with bronchopleural fistula, 2 were cured, 1 failed, and 1 was dead. CONCLUSIONS: Pneumonectomy for pulmonary tuberculosis carries a higher risk of developing serious complications such as chest hemorrhage, acute type II respiratory failure and bronchopleural fistula. Most complications can be managed successfully if diagnosed and treated early.

[Application of vascular surgery in the treatment of thoracic neoplasm].

OBJECTIVE: To investigate superior vena cava (SVC) and anonymous vein resection with prosthesis replacement for lung carcinoma and mediastinal tumor, and to assess the surgical procedure and prognosis. METHODS: Experimental research: Eighteen adult dogs were divided randomly into two groups. Group A (n = 9) underwent blocking of the SVC system, and Group B (n = 9) underwent SVC resection with prosthesis replacement. The SVC pressure and histological changes of brain tissue were measured and evaluated for group A. The histological changes of prosthesis were studied in group B. Clinical research: Fifty-six patients with thoracic neoplasm were studied, of which 42 were lung carcinoma and 14 were mediastinal tumor. Resection of primary lesions and metastatic lymph nodes with replacement of SVC system were performed for all patients. Long-term follow-up was performed. RESULTS: Experimental research: In Group A, the pressure of SVC was higher when both SVC and the azygous vein were blocked as compared to SVC blocking only (P < 0.05); hyperemia and edema of brain tissue were not observed in two-hour obstruction. The inner face of vascular prosthesis was covered with fibrin two months after operation in group B. Vascular endothelial cells were found to grow in it, and there was no thrombosis without anticoagulation. Clinical research revealed that there was no death associated with the operation and there was no early or late obstruction of SVC. The survival rates of the patients with lung carcinoma in 1, 3 and 5 years were 84.2% 40.9% and 38.9% respectively. The patients with mediastinal tumor were all alive except 1 patient who died of metastasis. CONCLUSIONS: Radical resection combined with prosthesis replacement of SVC system extends the indications of thoracic neoplasm resection and improve the long-term survival rate and living qualities of the patients. It may be recommended in the surgical treatment of thoracic tumor.