204 Abstracts/kg Cancer 13 (1995) 185-232

A clinical study on superior sulcus tumors Kobara Y, Ishii Y, Kitamura S. Department o~Pulr?ronary Medicine, Jichi Medical School, 3311-1, Yakushiji, Minamikawauchi, Tochigi 329 04. Jpn J Thorac Dis 1995;33:257-61.

Twenty nine patients with superior sulcus tumors (26 men and 3 women) were studied. The incidence was 2.1% of 1350 patients with lung cancer. The mean age was 66.2 years, and 27 patients (93.1%) had a history of smoking (B.I. = 1193.7). There were 10 adeno- carcinomas, 9 squamous cell carcinomas, 5 large cell carcinomas, 4 small cell carcinomas, and 1 that cotdd not be classified. Fit&n patients (51.7%) had Stage IV disease on admission. Eight patients (27.6%) presented with symptoms outside the chest. Pancoast syndrome was recognized in 9 patients (3 1 .O%). In 15 patients (5 1.7%) the diagnosis was made by transbronchial biopsy and in 10 patients (34.5%) it was made by echoguided needle biopsy Tumors were located in a posterior lesion in 13 patients (44.8%). Twenty patients were given radiation therapy. Clinical staging, irradiation, and surgical treatment were related to the length of survival The median survival time was 7 months.

Primary lung cancer in young patients Makimoto T, Tsuchiya S, Nakano H, Watanabe S, Takei Y, Nomoto T et al, Department ofInternalMedicine, National Nishigunma Hospital, Gunma University School of Medicine, Gunma 377. Jpn J Thorac Dis 1995;33:241-6.

We studied the clinical characteristics and prognosis of patients, 40 years old or younger, in whom primary lung cancer was diagnosed and treated at National Nishigunma Hospital between 1982 and 1993, anti compared them with those of 978 patients more than 40 years old. Younger patients numbered 30 (3.0%). Females accounted for 16 of the 30 cases (53.30/o), a proportion higher than the female: male ratio for the older patients (27.8%). There were more smokers among the older patients (72.8%) than among the younger patients (53.3%) @ < 0.01). Adenocarcinoma was significantly more common (19/30, 63.3% vs 43.8%, p < 0.05) and squamous cell carcinoma was less common (3.30, 10.0% vs 34.3%, p < 0.05) in the younger patients than in the older patients, Median survival time in younger patients was 30.0 months, and in older patients it was 14.6 months, but we found no significant difference in survival between younger and older patients. In the younger group, all the cases of stage I or II disease were discovered during mass screening.

Optimum scanning protocol for FDG-PET evaluation of pulmonary malignancy Lowe VJ, DeLong DM, Hoffman JM, Coleman RE. PETImaging Cente,: St. Louis University Medical Centec 3635 Msta Ave. at Grand Blvd., St. Louis, MO 63110-0250. J Nucl Med 1995;36:883-7.

FIX-PET can differentiate benign from malignant focal pulmonary opacities. We performed dynamic FDG-PET studies to determine the optimum time for emission data acquisition. Methods: Patients with focal pulmonary abnormalities demonstrated by biopsy to be malignant (n = 10) or benign (n = 4) were evaluated with dynamic FDG-PET. Dynamic PET data were acquired as sequential 5-min images for 2.5 hr. Radioactivity concentration measurements of the focal abnormality, a similar ares in the opposite lung, and both lungs in the field of view were made throughout the period of acquisition. Standardized uptake ratios (SUR) of the lesions were calculated. SUR data and Iesion-to- background ratios were plotted, The time that the SUR provided the maximum separation between benign and malignant masses after FDG arhninistration was determined. Results: The SUR values provided the greatest separation between benign and malignant abnormalities beginning at 50 min and no advantage was identified in imaging later.

Achievement of a 4: 1 lesion- to-background ratio occurred by 50 min in malignant lesions. Conclusion: The acquisition of the emission data used in the evaluation of pulmonary malignancy should begin approximately 50 min after FDG administration.

Detecting recurrent or residual lung cancer with FDG-PET Inoue T, Kim EE, Komaki R, Wong FCL, Bassa P, Wong W-H. DepartmentofNuclearMedicine, TexarM.D. Anderson Con. Ctx Univ., IS15 Holcombe Blvd.. Houston, TX 77030. J Nucl Med 1995;36:788- 93.

We investigated the diagnostic accuracy of FDG-PET in the detection of recurrent lung cancer. Methods: Thirty-nine lesions in 38 patients with clinically suspected recurrent or residual lung cancer were studied with PET. Al1 PET images were visually interpreted in conjunction with thoracic CT or MRI. Semiquantitative analysis using standardized uptake values (SWs) was also performed in 25 lesions. FDGPET diagnoses were correlated with pathological diagnoses and clinical outcome. Results: The sensitivity and specificity of FDG-PET for detecting recurrent tumors were 100% (26/26) and 61.5% (8113). respectively. The difference in mean SW between recurrent tumors and noncancerous lesions was statistically significant [ Il.2 f 5.7 (n = 16) vs. 3.5 * 1.8 (n = 9), p < O.OOOl]. False-positive results showed relatively lower SUVs than tree-positives and also demonstrated increased uptake in a curvilinear rather than nodular shape. Conclusion: FDG-PET is useful for detecting recurrent lung cancer after treatment. False-positive diagnoses might be reduced by analysis of uptake shape and serial changes in SW, but further study is needed.

Carcinoembryonic antigen in the diagnosis of lung cancer using bronchoalveolar lavage: A comparative study with healthy subjects, chronic bronchitis, respiratory infections and interstitial pulmonary diseases Alvarez-SaIa R Prados C. Gomez De Terreros FJ, BIasco R Pino JM, Gomez L et al. C/Julio Danvito, I 38, 28033 Madrid. Int J Oncol 1995;6:1093-8.

The use of serum CEA values in the prognosis and in monitoring the course of lung cancer is well accepted. However, the main problem presented by using serum CEA determinations for diagnosis is the lack of sensitivity. In this study, sensitivity was increased by determining CEA using bronchoalveolar lavage (BAL) of the affected lung. We studied CEA in the BAL of healthy subjects and patients with chronic bronchitis, respiratory infections and interstitial pulmonary diseases to observe ifCEA could differentiate malignancies from benign pulmonary pathologies. Five groups of patients (previously described) were studied using BAL in the affected area of the patients with lung pathologies or in the middle lobe and lingula of healthy people. CEA was analyzed in the BAL using radioimmunoanalysis according to the Behring Institute recommendations. CEA levels in BAL of lung cancer patients were higher than in the other groups. No correlation was found between CEA concentrations in BAL and tumor histology, CEA studies in BAL may be usehrl in the diagnosis of lung cancer and in the screening of the high risk people to develop bronchial carcinoma.

Molecular and pathologic markers in stage I non-small-cell carcinoma of the lung Strauss GM, Kwiatkowski DJ, Harpole DH, Lynch TJ, Skarin AT, Sugarbaker DJ. Division of Medical Oncologv Dana-Farber Cancer Institute. 44 BinneySt, Boston, u4 02115. J Clin OncoI 1995;13: 1265- 79.

Purpose: Although standard treatment of stage I non-small-cell lung cancer (NSCLC) consists of surgical resection alone, approximately