Monosomy 3 predicts death but not time until death in choroidal melanoma.

PURPOSE: To study whether monosomy 3 can predict time until death caused by metastatic melanoma, whether life expectancy can be predicted in patients after surgical excision of a melanoma displaying monosomy 3, and to confirm the prognostic value of monosomy 3 and its correlation with tumor histology. METHODS: Archival specimens from 71 patients who died of metastatic melanoma and 40 patients who were living or had died of other causes were identified. The number of copies of chromosome 3 was assessed by chromosome in situ hybridization, and monosomy 3 was compared with clinicopathologic features. RESULTS: Monosomy 3 was detected in 47 of 71 metastasizing melanomas (66.1%) and was significantly associated with metastasis-related death (P < 0.0001). All 40 nonmetastasizing tumors were balanced for chromosome 3 (two copies). In 70% of cases, epithelioid cells and vascular loops in combination predicted the presence of monosomy 3 (P < 0.0001). Among the 71 patients who had died of metastasizing melanoma, there was no difference in time until death between monosomic and balanced tumors. However, a survival curve corrected for age of the patients at the time of surgery suggested that very-long-term survival with monosomy 3 is probably rare. CONCLUSIONS: Monosomy 3 is an important predictor of death in melanoma and is in some cases predicted by histology. However, death of metastatic disease occurs in a significant number of patients without monosomy 3. There is no significant difference in time until death between metastatic melanomas, with and without monosomy 3. However, survival of patients with tumors displaying monosomy 3 is generally short.

Short and long-term effects of cigarette smoking independently influence exhaled nitric oxide concentration in asthma.

BACKGROUND: The fractional concentration of nitric oxide in exhaled breath (FeNO) is elevated in asthma. FeNO measurement has been proposed as a noninvasive index of disease activity. Cigarette smoking suppresses FeNO, which limits its use in smokers. OBJECTIVE: To identify and model short-term and long-term influences of cigarette smoking on FeNO. METHODS: The smoking history, FeNO, and fractional concentration of carbon monoxide in exhaled breath (FeCO) were measured in 53 subjects with asthma and 51 control subjects. A mathematical model of the short-term and long-term effects of cigarette smoking on FeNO was derived. RESULTS: Subjects with asthma had higher FeNO than controls ( P < .001). Smokers had increased FeCO ( P < .001). The short-term effect (hours since last cigarette) was associated with increased FeNO ( P < .01) and decreased FeCO ( P < .05). The long-term effect (years smoked) was associated with decreasing FeNO only in the subjects with asthma ( r = -0.62; P = .005). These short-term and long-term effects were independent and were combined in a model predicting FeNO, predicted log 10 FeNO = 1.23 - 0.58 e -0.34t - 0.00000103 x (lifetime cigarettes), where t = hours since the last cigarette. This gave a convincing prediction of FeNO ( r = 0.83; P < .0001). CONCLUSION: Short-term and long-term effects of smoking influenced the measurement of FeNO. We defined a model that describes these effects. The use of this formula may improve the value of FeNO measurements in smokers with asthma.