Abstracts/ Lung Cancer 12 (1995) 113-160 139

Analysis of lectin aftioity pmfiles in A case of adeaocaniooma of the lung associated with elevated alpha-fetoprutein in Serum and sputum Okano R, Sekiguchi M, Uraguchi T, Kuratomi Y, Yamada S, Sakurabayashi I. Deparhnent ofIntegrated Medicine, Omiya Medical Center: Jichi Medical School, Kawachi-gun 329-04. Lung Cancer (Japan) 1994;34:267-73. We report a case of adenocarcinoma of the lung that was strongly suggested to have produced alpha-fetoprotein (AFP). Sputum cytology and TBLB showed adenocarcinoma. Sermn AFP was 230 rig/ml and the concentration of AFP in sputmn was 120 @ml. Liver cirrhosis, hepatocellular carcinoma, carcinomas of gastrointestinal tract, mediastinal tumor and testicular tumor were excluded in the present case. These results indicated the present case tobe a primary lung cancer producing AFP. The concamtvalin A (Con A) non-reactive fraction rate for serum AFP was 56%. The lentil agglutinin (LCH) strongly reactive and weakly reactive subfraction were 36% and SO% respectively. In summary, our case and 13 previously reported cases in Japan in which APP was produced by primary lung cancer did not have uniform afllnity for Con A and were seemed to have LCH binding properties. These results resembled those of yolk sac tumor and gastrointestinal carcinomas. At present, we consider that the study of lectin affinity of AFP does not have any obvious clinical signilicance to differentiate primary lung cancers from metastatic malignant tumors.

Thirteen cases of subxiphoid pericardiotomy due to pericarditis associated with lung cancer Dobashi K, Nakahashi H, Yoshimatsu T, Horiuchi Y, Miyazaki Y, Kitagawa K et al. Deparhnent o/Sutgery, Respiratoty Disease Centes National Oita Hospital, Oita. Lung Cancer (Japan) 1994;34:223-8. Thirteen cases of subxiphoid periw.rdiotomy for primary lung cancer with pericarditis were observed during the period from September, 1986 to July, 1992. Seven cases were males and 6 were females. The average age was 59.5 years. Eleven cases were diagnosed as adenocarcinoma and two as small cell carcinoma. In the operation, 7 out of 13 cases received treatment by only removal of pericardial eflirsion and the remaining six cases also had local instillation of antineoplastic agents (THP-ADM) afler drainage. There was no postoperative complication. Postoperative survival time ranged from 15 to 420 days and the median smvival time was 64 days. There was no signiticant difference. in the prognosis between the operation with and without local chemotherapy (THP-AIM). Six out of 13 cases could leave hospital after operation and their survival time after discharge ranged from 24 to 2 13 days with a mean of 91 days. There was no recm7ettce of cardiac tamponade. In the eases who lived for more than thirty days after removal of the drainage tube the response rate was 100%. The cause of death in all cases was cancer, and respiratory failure caused by carcinomatous lymphangiosis was the main factor affecting the prognosis. We suggest that subxiphoid pericardiotomy is one of the most effective and safe therapeutic method for pericarditis associated with primary lung cancer.

‘,iaical usefkdness of human cytokeratin 19 fragment (CYFRA Zl- 1) a9 serum tumor marker for lung cancer Masaoka A, Fukai I, Ariyoshi Y, Naito Y, Kuriyama T, Kimura Y et al. Second Department of Su&ev, Nagoya City Univ. Medical School, Nagoya. Lung Cancer (Japan) 1994;34:209-21. The clinical usefulness of cytokeratin 19 fragment (CYFRA 21-1) as a tmnor marker for lung cancer was investigated. In 273 healthy subjects, selum CYFM 21-1 level was 0.6+0.5 rig/ml (mean *SD), and there was no correlation between senun CYFRA 21-1 levels in relation to sex or age. When the upper limit of the normal level was fixed at 2.0 @ml, the SpeciEcities for healthy subjects and non-malignant lung discasc were 98.5% and 90.8% mpectively. The positive rate of serum CYFRA 21-1 was 43.0% (139/323 cases) in primary lung cancer.

Histologically, the positive rate was 63.3% (76/120 cases) in the squamous cell carcinoma group, 28.8% (38/132 cases) in the adenocarcinoma group, 45.0% (9/20 cases) in the small cell carcinoma group, 35.0% (7120 cases) in the large cell carcinoma group and 45.5% (5/11 cases) in the adeno-squamous cell carcinoma group, showing statistical differentiation between the squamous cell carcinoma group and the others. In relation to the clinical stage of squamous cell lung carcinoma, the positive rate was 40.6% (13/32 cases) in the stage 1 group, 54.5% (6/l 1 cases) in the stage II group, 82.4% (14/17 cases) in the stage III A group, 85.7% (6/7 cases) in the stage III B group and 75.0% (618 cases) in the stage IV group. With regard to serum CYFRA 21-1 level and T-, N-, M-factors or tumor size in primary lung cancer, serum CYFRA 21-1 levels were signiticantly higher as each factor became progressively worse. When the levels of serum CYFRA 21-1 before and after curative surgery and radiotherapy were compared, post- treatment serum CYFRA 21-l levels were found to be signiticantly lower. In advanced or recurrent cases, follow-up of serum CYFRA 21- 1 reflected the efficacy of treatment. These results show that CYFRA 2 l-l is useful as a serum tmnor marker for lung cancer.

The EORTC QLQ-LC13: A modular supplement to the EORTC corr quality of life questionnaire (QLQ-C30) for use in lung cancer clinical trials Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. Deparhnent of Pulmonary Medicine, Renstromska Hospital, PO. Box 17301, S-402 64 Goteborg. Eur J Cancer Part A Gen Top 1994;30:635- 42. The EORTC Study Group on Quality of Life has developed a modular system for assessing the quality of life of cancer patients in clinical trials composed of two basic elements: (1)) a core quality of life questionnaire, the EOT(TC QLQC30, covering general aspects of health- related quality of life, and (2) additional disease- or treatment-specific questionnaire modules. Two international field studies were carried out to evaluate the practicality, reliability and validity of the core questionnaire, supplemented by a 13-item lung cancer-specific questionnaire module, the EORTC QLQLC13. In this paper, the results of an evaluation of the QLQ-LC13 are reported. The lung cancer questionnaire module comprises both multi-item and single-item measures of lung cancer-associated symptoms (i.e. coughing, haemoptysis, dyspnoea and pain} and side-effects from conventional chemo- and radiotherapy (i.e. hair loss, neuropathy, sore mouth and dysphagia). It was administered to patients with non-msectable lung cancer recruited from 17 countries. In total, 883 and 735 patients, respectively, completed the questionnaire prior to and once during treatment. The symptom measures discriminated clcafly between patients differing in performance status. All item scores changed signiticantly in the expected direction (i.e. lung cancer symptoms decreased and treatment toxicities increased) during treatment. With one exception (problems with a sore mouth), the change of toxicity measures over time was related specilically to either chemo-or radiotherapy. However, the single item on neuropathy did not measure adequately the full range of symptoms. The hypothesised scale structure of the questionnaire was partially supported by the data. The multi-item dyspnooa scale met the minimal standards for reliability (Cronbach 6 coefficient z-0.70), while the pain items did not form a scale with reliability estimates acceptable for group wmparisons. In wnclusion, the results from international field testing lend support to the EORTC QLQ-LC 13 as a clinically valid and useful tool for assessing disease- and treatment-specilic symptoms in lung cancer patients participating in clinical trials, when combined with the EORTC core quality of life questionnaire. In a few areas, however, the questionnaire module could benefit from further refinements. In addition, its performance over a longer period of time still needs to be investigated.