Lung cancer in combined pulmonary fibrosis and emphysema: a series of 47 Western patients.
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The syndrome of combined pulmonary fibrosis and emphysema (CPFE) is characterized by imaging features consisting of the association of centrilobular and/or paraseptal emphysema and pulmonary fibrosis. Virtually all patients are smokers and thus at high risk of developing lung cancer METHODS: This retrospective multicentre study was conducted by the Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P). RESULTS: A total of 47 patients presenting with lung cancer and CPFE syndrome were identified. All patients were smokers, with a mean of 47 pack-years. A pathological diagnosis of lung cancer was obtained for 38 (81%) patients. Histological type was squamous cell carcinoma in 17 (36%) patients, adenocarcinoma in 14 (30%), non-small-cell lung cancer not otherwise specified in three (6%), small-cell lung cancer in three (6%), and sarcomatoid carcinoma in one (2%). Overall, 20 of the 47 patients could not receive standard-of-care treatment for lung cancer, as per international recommendations or guidelines; this limitation was considered to be directly related to the CPFE syndrome in eight (40%) cases. CONCLUSION: Lung cancer in patients with CPFE syndrome represents a specific entity with a poor prognosis, that further represents the most characteristic and severe model of tobacco-related disease.
OPN Polymorphism Is Related to the Chemotherapy Response and Prognosis in Advanced NSCLC.
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Osteopontin (OPN) is associated with prognosis of patients with non-small-cell lung cancer (NSCLC). However, little is known about the association between OPN gene polymorphism and the chemotherapy response in NSCLC patients.
Methods. A total of 497 patients with inoperable advanced stage of NSCLC (stages III B and IV NSCLC) were enrolled. All patients had received platinum-based chemotherapy. OPN gene polymorphisms at 156 GG/G, 443 C/T, and -66T/G were determined.
Results. The genotypes and allele frequency of -443C>T were significantly different between the responders and nonresponders. Responders had a markedly higher frequency of -443TT genotype than responders (40.71% versus 19.09%, P < 0.001). With CC as reference, the TT genotype carriers had a higher chance to be well responders (adjusted OR = 4.43, 95% CI: 2.60-7.53, adjusted P < 0.001). The median overall survival time for patients with -443CC, -443CT, and -443TT genotype carriers was significantly different. Multivariate Cox proportional hazards regression models showed that OPN -443C>T gene polymorphisms were closely correlated to poor NSCLC prognosis.
Conclusion. OPN -443C>T gene polymorphism may be used as a molecular marker to predict the treatment response to chemotherapy in advanced NSCLC patients.
Perimenstrual Asthma as a Gynecological and Pulmonological Clinical Problem.
Asthma is one of the most common chronic diseases of the respiratory system. It is estimated that up to 40% of asthmatic women of childbearing age may experience a cyclical exacerbation of asthmatic symptoms during the perimenstrual period, which is called perimenstrual asthma (PMA). The precise prevalence of this particular phenotype of asthma is difficult to determine due to a lack of explicit diagnostic criteria and appropriate epidemiological surveys. According to one of the best documented hypotheses regarding perimenstrual exacerbations of asthma, the impact of female steroid sex hormones on the function of the respiratory system and inflammations in the bronchi may play a central role in this phenomenon. Although the basic medical approach to PMA is similar to that used in other asthma phenotypes, unconventional methods of "experimental" treatment have also been tried. Unfortunately, current knowledge about the pathogenic mechanisms of this phenotype of asthma is incomplete and inconsistent, which justifies the need for further interdisciplinary studies with the participation of specialists in both gynecology and lung diseases. The knowledge thus acquired will help to individualize and focus future therapy on specific cellular and/or hormonal mechanisms to optimize asthma control in patients with PMA.