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Pathology and genetics of tumours of the lung , pleura, thymus and heart

In the past 25 years, a majority of cancer studies have focused on examining functional consequences of activating and/or inactivating mutations in critical genes implicated in cell cycle control. These studies have taught us a great deal about the functions of oncogenes and tumor suppressor genes and the signaling pathways regulating cell proliferation and/or cell death. However, such studies have largely ignored the fact that cancers are heterogeneous cellular entities whose growth is dependent upon reciprocal interactions between genetically altered “initiated” cells and the dynamic microenvironment in which they live. This review highlights the aspects of cancer development that, like organogenesis during embryonic development and tissue repair in adult mammals, are regulated by interactions between epithelial cells, activated stromal cells, and soluble and insoluble components of the extracellular matrix.

Tumor stroma and regulation of cancer development.

Disease progression in cancer is dependent on the complex interaction between the tumor and the host inflammatory response. There is substantial evidence in advanced cancer that host factors, such as weight loss, poor performance status and the host systemic inflammatory response, are linked, and the latter is an important tumor-stage-independent predictor of outcome. Indeed, the systemic inflammatory response, as evidenced by an elevated level of C-reactive protein, is now included in the definition of cancer cachexia. This review examines the role of the systemic inflammatory response in predicting survival in patients with primary operable cancer. Approximately 80 studies have evaluated the role of the systemic inflammatory response using biochemical or hematological markers, such as elevated C-reactive protein levels, hypoalbuminemia or increased white cell, neutrophil and platelet counts. Combinations of such factors have been used to derive simple inflammation-based prognostic scores, such as the Gl...

Role of systemic inflammatory response in predicting survival in patients with primary operable cancer

Purpose of reviewThere is now good evidence in humans that a chronic systemic inflammatory response results in the cardinal features of cancer cachexia, principally the progressive loss of weight (in particular lean tissue). This review examines the role of recent simple objective systemic inflammat

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Systemic inflammation, nutritional status and survival in patients with cancer.

Carcinoembryonic antigen (CEA) as tumor marker in lung cancer

https://www.annalsthoracicsurgery.org/article/S0003-4975(00)01160-7/pdf

Effect of mast cells on tumor angiogenesis in lung cancer

We evaluated the significance of the preoperative serum C-reactive protein (CRP) level as a prognostic indicator in patients with non-small cell lung cancer (NSCLC) Patients and Methods: Two hundred and three patients who had undergone a curative resection of NSCLC were retrospectively reviewed Results: The proportion of the tumor size over 3 cm per patient in the CRP-positive group (≥05 mg/dL: n=38) was significantly higher than that in the CRP-negative group (<05 mg/dL: n=165) The proportion of the adenocarcinoma in CRP-positive group was significantly lower than that in CRP-negative group The overall and disease specific survival rates in the CRP-positive group were significantly lower than the rates in the CRP-negative group Based on a multivariate analysis, the preoperative serum CRP level was selected as one of the unfavorable indicators regarding survival Conclusion: The preoperative serum CRP level is an independent and significant indicator predictive of a poor prognosis in patients with NSCLC C-reactive protein (CRP) is an acute-phase reactant The preoperative serum elevation of CRP has been identified to be a significant prognostic factor in patients with colorectal (1, 2), esophageal (3, 4), hepatic (5), and pancreas cancer (6) The plasma CRP level has been shown to be associated with non-small cell carcinoma (NSCLC) (7) and the prognosis of advanced NSCLC (8) However, no previous study has ever described a relationship between the preoperative peripheral CRP level and the prognosis in NSCLC patients who underwent a curative operation The aim of this study was to investigate the significance of CRP in the long-term prognosis in a NSCLC patient population who had all undergone a curative operation Patients and Methods Two hundred and three patients who had undergone a curative resection of NSCLC between January 1998 and December 2003 were enrolled in this study Curative operations were defined those of the patients with no residual macroscopic disease after surgery Blood samples were obtained prior to the surgery The serum levels of CRP were measured by a latex photometric immunoassay (Mitsubishi Kagaku Iatron, Tokyo, Japan) Patients with serum CRP levels <05 mg/dL were assigned to the CRP-negative group, whereas patients with serum CRP levels ≥05 mg/dL were assigned to the CRP-positive group according to the manufacturer's instructions We also measured the serum levels of lactate dehydrogenase (LDH) (normal limits, 119-229 U/L) and white blood cell (WBC) count (5000-9000/mm 3 ) The Mann-Whitney U-test was used for the statistical analysis The categorical data were compared using the ¯ 2 test Survival was evaluated by the Kaplan-Meier method, and differences among the survival curves were tested using the log-rank test Multivariate analyses according to the Cox's proportional hazards model was used to assess the overall and disease-specific survivals as well as the influence of the clinical parameters Statistical calculations were conducted with JMP (SAS Institute Inc Cary, NC, USA) and values of p less than 005 were accepted as significant

Preoperative serum C-reactive protein level in non-small cell lung cancer.

Correlation between tumor angiogenesis and invasiveness in thymic epithelial tumors.

Intrapleural perfusion hyperthermo-chemotherapy for malignant pleural dissemination and effusion

Objectives: Clinical significance of measurement of preoperative serum carcinoembryonic antigen (CEA) level in patients with non-small cell lung cancer was investigated. Methods: Consecutive 271 adenocarcinoma and 112 squamous cell carcinoma patients of nonsmall cell lung cancer referred to our institute were included in this study. There were 214 men and 169 women, ages ranged from 19 to 90 years, with an average of 64.46 years. Curative resection was performed for 220 adenocarcinoma and 93 squamous cell carcinoma patients. Serum level of CEA was measured before staging or resection of cancer. Results: There is a trend toward a correlation between serum CEA level and stage of the diseases, however, serum CEA level was not always related to tumor node metastasis (TNM) status. In patients with adenocarcinoma, survival rate of patients with an elevated serum CEA level was significantly lower than that with a normal serum CEA level. Multivariate analysis showed that prognostic significance of serum CEA level was TNM staging independent in patients with adenocarcinoma. On the other hand, serum CEA level was not related to patients’ survival in patients with squamous cell carcinoma. Conclusions: Elevated preoperative serum CEA level is a TNM staging independent prognostic factor for patients with adenocarcinoma but not for those with squamous cell carcinoma. (Ann Thorac Cardiovasc Surg 2004; 10: 76‐80)

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Yasunori Matsuzaki

Papers

Effect of mast cells on tumor angiogenesis in lung cancer

Preoperative serum C-reactive protein level in non-small cell lung cancer.

Correlation between tumor angiogenesis and invasiveness in thymic epithelial tumors.

Intrapleural perfusion hyperthermo-chemotherapy for malignant pleural dissemination and effusion

Prognostic significance of preoperative serum carcinoembryonic antigen level in lung adenocarcinoma but not squamous cell carcinoma.