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Clinical Usefulness of D2-40 in Non-Small Cell Lung Cancer

D2-40 is a recently developed monoclonal antibody that reacts with a 40 kDa O-linked sialoglycoprotein and has been used for the assessment of lymphatic invasion in tumor specimens.

We have evaluated the diagnostic usefulness of D2-40 and association of its immunopositivity with clinicopathological parameters in adenocarcinoma and squamous cell carcinoma of the lung.

We investigated 97 cases of surgically resected adenocarcinoma or squamous cell carcinoma of the lung for the determination of D2-40 positivity in tumor cells and peritumoral lymphatic vessel density (LVD) using an immunostaining method. D2-40 immunoreactivity in tumor cells was invariably negative in adenocarcinoma but 47% of squamous cell carcinomas were positive. D2-40 positivity in the tumor was significantly associated with high LVD in squamous cell carcinoma (P < 0.006). There was no significant association between peritumoral LVD and clinicopathologic parameters, including lymphatic vessel invasion, lymph node metastasis, and survival in adenocarcinoma and squamous cell carcinoma.

These results suggest that D2-40 immunoreactivity in tumor cells can be used for distinguishing between adenocarcinoma and squamous cell carcinoma and that the reactivity of tumor cells with D2-40 is positively correlated with LVD in squamous cell carcinoma but not with lymph node metastasis in adenocarcinoma and squamous cell carcinoma.

Association Between Smoking and Respiratory Function Before and After Menopause

 

There is a lack of evidence about whether menopausal status influences the effect of smoking on lung function.

This study examined the association between smoking and menopausal status and lung function independent of each other. Data were from a cohort of women attending the 21-year follow-up of the Mater University of Queensland Study of Pregnancy. The study was based on 2020 women who provided data on respiratory function, smoking, and menopausal status. A Spirobank G spirometer system was used to measure forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and forced expiratory flow between 25 and 75% of forced vital capacity (FEF25–75). Smoking and menopausal status were assessed by self-report.

Respiratory function was associated with cigarette smoking, menopausal status, and hormone replacement therapy. Regardless of smoking status, postmenopausal women had poorer lung function when compared with premenopausal women. In multivariate analysis, cigarette smoking was associated with lower FVC, FEV1, and FEF25–75, with the magnitude of effect being stronger for women who were postmenopausal. The data suggest that the impact of smoking intensifies after menopause.

It seems plausible that effective quit-smoking programs, particularly after menopause, may lead to better lung function and reduced morbidity and mortality in women.

Improving adherence with inhaler therapy in COPD

Chronic obstructive pulmonary disease (COPD) is a major public health problem, associated with considerable morbidity and health care costs. The global burden of COPD morbidity is predicted to rise substantially in the coming decade, but could be moderated by better use of existing management strategies.

Smoking cessation, medication therapy, and pulmonary rehabilitation have all been shown to diminish morbidity and improve patient outcomes. But each of these strategies requires adherence. Adherence is crucial for optimizing clinical outcomes in COPD, with nonadherence resulting in a significant health and economic burden. Suboptimal medication adherence is common among COPD patients, due to a number of factors that involve the medication, the delivery device, the patient, and the health professionals caring for the patient. Lack of medication adherence needs to be identified and addressed by using simplified treatment regimens, increasing patient knowledge about self-management, and enhancing provider skills in patient education, communication, and adherence counseling.

This article reports some of the challenges of medication nonadherence faced by the clinician in the management of COPD, and suggests ways to evaluate and improve adherence effectively in primary care.

Biomarkers in lower respiratory tract infections

Biomarkers, and particularly procalcitonin (PCT), are useful tools as antibiotic treatment duration indicators both in pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD).

Even if more data are required to fully appreciate the role of biomarkers in lower respiratory tract infections (LRTIs) management, there is emerging evidence that biomarkers have the potential to improve the daily clinical management of LRTIs.

Vitamin D and asthma

Asthma is a disease that continues to carry a significant health burden on humanity. Vitamin D is thought to play a role in many chronic diseases as it may possess immunomodulatory properties.

Vitamin D has a complex role on the immune system and its regulation of various aspects of immunity has allowed speculation on its potential role in asthma. However, the net effect of vitamin D on the immune system and its role in asthma still remains unanswered.

More research needs to address the diagnostic and therapeutic implications vitamin D may have in the future of asthma management.

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