Adrenomedullin expression does not correlate with survival in lung cancer.

It is suggested that adrenomedullin (AM) plays a role in lung carcinogenesis although, to confirm this suggestion, further clinical studies are needed to determine its relationship with prognosis in lung cancer. Archived 50 paraffin-embedded tumor samples of the lung were retrospectively evaluated for AM expression by immunohistochemistry and analyzed for a possible correlation with patient characteristics and survival. Quantitation of immunoreactivity was accomplished using an immunohistochemical scoring system. The pulmonary resection specimens contained 22 squamous cell carcinomas, 15 adenocarcinomas, and 13 small cell carcinomas. Non-small cell carcinomas of the lung were more likely to express AM than small cell carcinomas of the lung. Ninety-one percent of squamous cell carcinomas and 87% of adenocarcinomas expressed AM at a moderate to strong level and grade2-4 (30-100%), which were significantly higher from the non-neo-plastic lung tissue. Twenty-three percent of small cell carcinomas of lung expressed AM. Interestingly, AM immunoreactivity was essentially weak and grade 1 (<%30) in this group. AM expression is upregulated in non-small cell carcinomas of the lung, whereas it is downregulated in small cell carcinomas and non-neo-plastic lung tissues. AM expression did not show any correlation with the differentiation of the tumor, the stage of cancer, and the overall survival of patients. These results did not support the role of adrenomedullin as an independent survival factor for lung cancer. However, AM inhibition in conjunction with other anti-angiogenic agents may be useful in the prevention and treatment of malignancies.

The prevalence of hepatitis G virus in cancer patients.

Hepatitis G virus (HGV) is transfusion-transmissible and has a global distribution. However, its frequency and clinical impact have not been well established in extrahepatic cancer patients. In this study, we determined the prevalence of HGV RNA positivity, and its relationship with history of transfusion, amount of transfusion, age and sex in patients with hematological and solid malignancies in Southeastern Turkey. Sixty-one patients (35 males and 26 females) followed up for various malignancies and 60 healthy subjects were included in the study. HGV RNA was investigated by the reverse transcription polymerase chain reaction. HGV RNA was detected in none of the patients with cancer (0%) and only one person (1.6%) in the control group. There was no difference between the groups. This observation indicates that the prevalence of HGV is very low in cancer patients and healthy people in our geographical area. In addition, the role of HGV in the pathogenesis of extrahepatic malignancies seems insignificant.

Early multimodal therapy in adult Wilms' tumor: case report.

Wilms' tumor occurs rarely in adults, especially after the third decade. In adults, the prognosis of Wilms' tumor is worse than in children. In this case report, we present a 48-year old patient who relapsed with advanced stage shortly after primary surgery. A definitive treatment plan has not been established because of the rarity of this tumor in adults. After surgical removal, multimodal therapy should be begun immediately for long-lasting, complete remission.

Superior vena cava syndrome caused by chemotherapy-induced fibrosis.

We report a case of a 51-year old man with small cell lung cancer who developed superior vena cava syndrome due to obstruction of the superior vena cava at the junction of the brachiocephalic vein by a fibrotic band, 2 months after completing six cycles of chemotherapy with cisplatin and etoposid. Superior vena cava syndrome caused by chemotherapy-induced pulmonary fibrosis should be kept in mind during follow-up.

The effect of continuous ambulatory peritoneal dialysis on serum CA-125 levels.

Malignant and non-malignant serosal fluids were found to be associated with high serum levels of CA-125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. In this study, we investigated the relationship between serum CA-125 levels and peritoneal irritation during continuous ambulatory peritoneal dialysis (CAPD). We performed a clinical study in 24 stable patients (15 amenstrual females and 9 males), aged 46 +/- 14 years on CAPD. The control group consisted of 32 healthy volunteers (20 females, 12 males) aged 44 +/- 12 years. CA-125 levels were determined prior to the CAPD dwell (without dialysate in abdomen) and during the CAPD dwell (dialysate in abdomen 4 hours after). As a result, serum CA-125 levels were found to be 14.86 +/- 5.98 U/ml and 15.23 +/- 6.05 U/ml respectively, whereas it was 8.32 +/- 5.54 U/ml in the control group. Serum CA-125 levels were found to be significantly elevated in CAPD patients when compared with healthy volunteers. However, serum CA-125 levels detected prior to and after CAPD did not differ between the groups. Interestingly, all of the patients in our study group were detected to have normal serum CA-125 levels (< 35 U/ml). We concluded that CAPD-induced abdominal artificial ascites did not affect serum levels of CA-125. Moreover, short and non-inflammatory mechanical pressures in the CAPD procedure do not have any effect on serum CA-125 levels.

Plasma lipid peroxidation products and antioxidant enzyme activities in patients with type 2 diabetes mellitus.

Diabetes is associated with a significant increase in thiobarbituric acid reactive substances (TBARS) which are considered as an index of endogenous lipid peroxidation. The human body has a complex antioxidant defense system that prevents the initiation of free radical chain reactions. We measured plasma TBARS levels, superoxide dismutase (SOD) and catalase (CAT) activities and compared their relation to the metabolic control of diabetes and diabetic microangiopathy. Sixty-four patients (19 men), aged 52.35+/-9.31 years with type 2 diabetes mellitus were included in the study. Thirty-six healthy subjects (12 men), aged 51.02+/-7.01 years formed the control group. TBARS levels and SOD activity were elevated in the diabetic group when compared with the control group ( p<0.001 and p<0.00001, respectively). However CAT activity was significantly decreased in the diabetic group when compared with the control group ( p<0.00001). Patients with diabetic nephropathy and retinopathy, but not neuropathy, had elevated TBARS levels but there was no statistically significant difference when compared with diabetic patients without microangiopathy ( p>0.05). There was a positive correlation between plasma TBARS levels and SOD activity (r=0.770, p=0.0001) and a negative correlation between plasma TBARS levels and CAT activity (r=0.482, p=0.0001). There was also a negative correlation between SOD and CAT activities (r=-0.609, p=0.0001). We found significantly elevated TBARS levels in diabetic patients. We did not observe any correlation between TBARS levels and blood glucose and HbA(1c) levels. Elevated TBARS levels and SOD activity and decreased CAT activity may be due to a compensation mechanism of the body.

The relation between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus.

We evaluated the possible relation between plasma endothelin-1 (ET-1) levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy, including nephropathy, neuropathy, and retinopathy in patients with Type 2 diabetes and healthy control group. Sixty-eight (39 females and 29 males) patients with Type 2 diabetes and 14 (6 females and 8 males) healthy subjects were included in the study. Plasma ET-1 levels were found to be 10.46+/-1.24 pmol/l in the diabetic group, whereas 7.97+/-0.41 pmol/l in the control group, which was statistically significant (P<.01). We also found elevated plasma ET-1 levels in patients with the least one microvascular complication when compared with the uncomplicated diabetes group (P=.02). Moreover, plasma ET-1 levels of the uncomplicated group was higher than the control group (P<.05). Plasma ET-1 levels were significantly elevated in hypertensive diabetics than normotensive diabetics (t=2.58, P=.012). It was also found to be elevated in diabetic patients with diabetes duration of more than 10 years when compared with patients less than 10 years (P=.02). These findings can be interpreted as the increased damage of microvascular complications in the disease process that may lead to elevated ET-1 levels. Mean plasma ET-1 levels in diabetic patients with a family history of diabetes was found to be higher than patients with no family history of diabetes. Genetical and environmental factors may have an effect on ET-1 level. We also studied the correlations of plasma ET-1 levels on age, sex, fasting blood glucose levels, treatment modalities HbA1c, hyperlipidemia, C-peptide, Body Mass Index, and smoking, but did not find any statistically significant difference. In conclusion, plasma ET-1 levels are well correlated with microangiopathy, hypertension, increased disease duration, and family history of diabetes, but poorly correlated with metabolic control, treatment modalities, age, sex, hyperlipidemia, obesity, and smoking.

Elevated serum CA-125 levels in patients with nephrotic syndrome-induced ascites.

CA-125 is a sensitive, but not a specific, tumour marker especially used in the diagnosis and follow-up of ovarian cancer. Because of the elevated levels of CA-125 encountered during the etiological investigation of nephrotic syndrome (NS) a clinical study was designed to investigate the probable relationship between elevated CA-125 levels in patients with NS, with and without ascites. Twenty-four patients with NS due to non-tumoural pathologies, aged 24 to 56 (15 females and 9 males), were investigated. We detected elevated levels of serum CA-125 (275.92 +/- 154.71 U/mL) in 14 (70%) NS patients with ascites (p < 0.05). In the other 10 NS patients without ascites (Group 2) and in the control group, consisting of 52 age and sex-matched healthy volunteers, the serum CA-125 levels were found to be 13.60 +/- 5.12 U/mL and 8.50 +/- 5.02 U/mL, respectively (p > 0.05). There was no statistically significant difference between the control group and the patients without serosal fluids (p > 0.05). We concluded that serum CA-125 levels were elevated in NS patients with ultrasonographically detected ascites in the absence of an ovarian tumour or other diseases known to increase the levels of CA-125.

Elevated serum CA-125 levels in hemodialysis patients with peritoneal, pleural, or pericardial fluids.

OBJECTIVE: Serum CA-125, an ovarian tumor marker, is used especially in the follow-up of ovarian cancer for monitoring the efficacy of therapy and for early detection of recurrence. A number of benign gynecologic as well as benign and malignant nongynecologic conditions are associated with elevated serum CA-125 levels. Malignant and nonmalignant serosal fluids were also found to be associated with high serum levels of CA-125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. METHODS: We performed a clinical study in 39 patients (21 females, 18 males) on chronic hemodialysis who were divided into two groups based on the presence of fluid in the serosal cavities (peritoneum, pleura, or pericardium) without clinical and radiologic evidence of neoplasia. There were 26 patients (16 females, 10 males) aged 50.11 +/- 13.86 years (range, 20-76 years) in the serosal fluid-negative group (group 1) and 13 patients (8 females, 5 males) aged 45.30 +/- 18.84 years (range, 17-73 years) in the serosal fluid-positive group (group 2). The control group consisted of 52 healthy volunteers (30 females, 22 males) aged 44.19 +/- 12.59 years (range, 19-68 years). RESULTS: Significantly elevated serum CA-125 levels were found in hemodialysis patients with serosal fluid (P < 0.05) when compared with both the hemodialysis patients without serosal fluid and the control group. There was no statistically significant difference between the control group and the patients without serosal fluids (P > 0.05). CONCLUSION: Although CA-125 can be considered a reliable tumor marker in patients undergoing hemodialysis, it should be interpreted with caution in patients with serosal fluids.