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Different immune functions of peripheral blood, regional lymph node, and tumor infiltrating lymphocytes in lung cancer patients. Nakamura H, Ishiguro K, Mori T. Deparrmen~ of Surgery, Totlori University School of Medicine, Tottori. Cancer 1988;62:2489-97.

Immune functions of peripheral blood (PBL), regional lymph node (RLNL), and tumor infiltrating lymphocytes (TIL) were evauated in lung cancer patients. PBL had many natural killer (NK) cells and the highest NK activity, and it showed the highest augmentation of NK activity by interferon-gamma (IFN-gamma) + recombinant interleukin- 2 @IL-2) among the three groups of lymphocytes. PBL had high lymphokine-activated killer (LAK) activity of against abroad spectrum of cell lines and moderate activity against autologous tumor cells by increased effector to target (ET) ratio but the lowest ability of IL-2 production of the three groups of lymphocytes. The RLNL not ass&- ated with tumor metastasis had a few NK cells and lower NK activity than PBL, but its LAK activity was almost the same but not greater than that of PBL. RLNL had the highest ability of IL-2 production among the three groups of lymphocytes. All activities of RLNL associated with tumor metastasis were lower than those not associated with tumor metastasis. TIL exclusively consisted of T-cells, especially cytotoxic/ suppressor T-lymphocytes. NK activity and lymphocyte hlastogenesis of TIL were lower than those of other groups. The LAK activity of TIL differed greatly with the case, and it was the highest against autologous tumor cells among the three groups of lymphocytes in three of eight cases. These findings showed that PBL, RLNL, and TIL had character- istic subpopulations of lymphocytes and different functions of host immune responses in lung cancer. Efficient augmentation of the char- acteristic immune response will lead to a more effective total cancer therapy.

Hypouricemia and urate excretion in small cell lung carcinoma patients with syndrome of inappropriate antidiuresis. Sorensen JB, Osterlind K, Kristjausen PEG, Hammer M, Hansen M. Deparrmen~ofOncology ONB. FinsenInstirure,DK-21OOCopezhagen. Acta Oncol 1988;27:351-5.

Urate concentrations in serum and renal urate clearance were pro- spectively evaluated in patients with small cell lung cancer (SCLC). Serum urate and renal urate clearance were measured before and during cytostatic treatment until disease progression (PD) in 12 patients with the syndrome of inappropriate antidiuresis (SIAD) and in 8 patients without. Hypouricemia occurred in 4 SIAD patients before treatment and also when tumor regression was obtained. Two normomicemic SIAD patients developed hypouricemia when PD occurred. No patient without SIAD experienced hypouricemia. Serum urate in patients with SIAD was lower than iu those without SIAD before cytostatic treatment but not 3 months after the treatment. Hypouricemic patients had higher urate clearance than normouricemic and it remained higher even after tumorregression. Serum uratewas invalidasmarkeroftumorregression or relapse. SIAD patients have higher glomerular filtration rates than patients without SIAD, which may influence the renal excretion of cytostatic drugs.

Lung cancer in acute myelomonocytic leukemia: A report of two cases. Marm R, Pagan0 L, Storti S, Nicoletti G, Teofili L, Rabitti C, Leone G. Istiruto di Semeiorica Medica, Universita Catlolica de1 Sacro Cuore. 00168 Roma. Tumori 1988;74:553-4.

The authors describe two cases of acute nonlymphoblastic leukemia, FAB subtype M4, who developed a lung cancer while in complete remission of the leukemia. The possible interrelations between the two diseases are discussed.

Correlation between serum tumor marker levels and tumor prolif- eration in small cell lung cancer. Lehtinen M, Wigren T, Lehtinen T et al. Deparrment of Oncology, Universiry of Tampere Central Hospital, SF-33101 Tampere. Tumor Biol 1988;9:287-92.

We analyzed serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE) and thymidine kinase (TK) levels in 22 patients with

small cell lung cancer. Tumor proliferation was expressed as the proportion of S-phase cells (SPF), determined by DNA flow cytometry, from concomitantly taken biopsy samples. A positive correlation be- tweenserumNSE(r=0.41)orLDH(r=0.65,p=O.O5)levelsandtumor SPF was noted, but was not found between serum TK levels and the SPF. The correlation between NSE and SPF was even more pronounced if only patients with extensive disease were considered (r = 0.77). The serumNSEandLDH, but notTK levels,were significantlygreaterin the patients with extensive disease (NSE 50.4 r&ml, LDH 621 U/ml) compared to the patients with limited disease (NSE 21.0 @ml, LDH 272U/ml,p=O.O5). Ourresults suggestthatthecombineddetermination of serum LDH and NSE levels gives valuable data on the primary tumor mass and its proliferative activity in small cell lung cancer.

Necrotising pancreatitis and diabetes associated with disseminated small cell carcinoma of lung. Evans AT. Departmenf ofPathology, Ninewells Hospital andhfedical School, Dundee DDI 9SY. Scott Med J 1988;33:377.

Although tumour metastases to the pancreas and peripancreatic lymph nodes are found commonly at necropsy in cases of small cell carcinoma of lung, tumour-induced acute pancreatitis is described rarely. A case of metastasis-associated necmtising pancreatitis with the unusualpresentationofepigastricpainfollowedbydiabetesisdescribed here. Patients (particularly cigarette smokers) with none of the conven- tional risk factors for acute pancreatitis merit chest radiography and if indicated prompt cytotoxic treatment.

Determination of serum neurone-specific enolase in bronchial tumours of neuroendocrine origine. Rapellino M, Pecchio F, Cunazza M et al. Ospedale Maggiore S. Giovanni Bat&a, Torino. Minerva Med 1988:79: 105 1-2.

Neurone-specific enolase, a Serum marker of neuroendocrine tu- mourn has been determined in small-cell anaplastic bronchial carcino- mas, in typical and atypical carcinoid. The marker presents good sensitivity in small-cell tumours and in atypical carcinoids, whileblood levels are within normal limits in cases of typical carcinoid. The low serum levels of neurone-specific enolase found in typical carcinoid suggest a failure of the enzyme to express itself in the circulation owing to the poor or lack of cellular necrosis.

Correlation behveen the endowopic aspects and histologic types in lung neoplasia. Salatino G, Berm D, NicoIin E, Salatino A, Sgro M. Divisione di Broncopnemologia, Sezione di Chirurgia Toracica, BWO Arsirio (VA). Minerva Med 1988;79:1053-6.

Four-hundred and thirty-six patients recognized affected by primitive lung neoplasia have been examined to pmve possible correlation between the endoscopic aspects, histologic type and central or periferi- cal localization of the neoplasia. The diagnostic sensibility of the different cyto-histological techniques used in fiberoptic bronchoscopy have been valued too. For the peripherical localizations the diagnosis has been obtained in most cases by using fine needle percutaneous aspiration.

Evaluation of tumor markers NSE and CEA for the diagnosis and follow-up of small cell lung cancer. Ebert W, Hug G, Stabrey A, Bulzebruck H, Drings P. Thoraxklinik Heidelberg-Rohrbach. D-6900 Heidelberg. Aratl Lab 1989;35: l-10.

Pretherapy serum concentrations of neuron-specific enolase (NSE) and/or carcinoembryonic antigen (CEA) were measured in 65 patients with small cell lung carcinoma (SCLC) and in 108 patients with non- small cell lung carcinoma (NSCLC) as well as in 79 patients with benign lung diseases and in 92 healthy individuals. Elevated NSElevels (a 12.5 *g/l) were detected in 73.9% and elevated levels of CEA (> 5 *g/l) in 46.9% of patients with SCLC. Elevated NSE (CEA) levels were also found in 14.8% (46.3%) of patients with NSCLC and in 5.1% (13.9%) of patients with benign lung diseases. Specificity of the NSE assay was 94.9%. that of the CEA assay 86.1% in patients with benign lung diseases.ThedifferencesoftheNSElevelsbetweenpatientswithSCLC