75

gional metastases at operation is clinical-

ly free from carcinoid in 17 cases, in ten

of which regional metastases were found at operation. Three of these ten patients are alive 6 to 16 years postoperatively, but two without regional metastases at opera- tion died of local recurrence and distant metastases after 3 to 4 years. Carcinoid syndrome was not seen in these 17 patients. There was one peroperative death. Altoge- ther ten patients (12%) died of recurrence. Among the cases judged at the "blind" hi- stologic review to be suspectedly malig- nant, the corresponding figure was 50%. For typical carcinoids, conservative resection, including lymph-node metastases, is the treatment of choice. Wedge or sleeve re- section with or without pulmonary resec- tion were employed in ten cases. Suspec- tedly malignant carcinoid tumours may require more extensive surgery.

Immuno-Oncological Monitoring in Patients with Lung Cancer. Note II. Evaluation of Plasma Fibronectin. Mancuson, M., Leonardo, E., Sanfilippo, B., et al. Universita di Torino, Cattedra di Chirurgia Toraco-Polmonare, Istituto di Anatomia e Istologia Patologica, Torino, Italy. Minerva Med. 76: 85-90, 1985.

Recent attempts implicating glycopro- teins have been focused on the study of fibronectin. This glycoprotein was observed especially in cellular adhesivity processes. Some work was directed to detect the fi- bronectin concentration in plasma and in other biological fluids and to relate increased or decreased levels on plasma fibronectin in lung cancer patients during the course of the disease.

InTnuno-Oncological Monitoring in Patients with Lung Cancer. Note I. Carcinoembryonic Antigen (CEA). Mancuso, M., Leonardo, E., Sanfilippo, B., et al. Universita di Torino, Cattedra di Chirurgia Toraco-Polmonare, Istituto di Anatomia e Istologia Patologica, Torino, Italy. Minerva Med. 76: 15-19, 1985.

Plasma levels of carcinoembyonic antigen (CEA) were determined in 82 lung cancer patients before surgery and during the clinical course of the disease. Results were compared to those obtained in normal controls and in patients with lung inflam- matory diseases. Furthermore, relationships between plasma CEA levels and survival were carried out. While CEA levels were not use- ful to make differential diagnosis, in our study, we suggest the possibility to use CEA in prognostic evaluations.

Malignant Mes0thelioma Secondary to Chronic Inflan~nation and 01d Scars. Two New Cases

and Reviews of the Literature.

Hillerdal, G., Berg, J. Department of Lung

Medicine, University Hospital, Uppsala, Sweden. Cancer 55: 1968-1972, 1985.

Old scars of the pleura, for example from chronic empyema or therapeutic pneumothorax, can cause a malignant mesothelioma appearing some decades later. The authors describe two cases of primary pleural tumors, which proba- bly had such an etiology. A literature review revealed 20 further cases, the majority of which were squamous cell carcinomas. Whether these tumors developed from metaplastic meso- thelium or inplanted cells from the skin is not clear.

Comparison of Tumour Markers in Malignant Me- sothelioma and Pulmonary Adenocarcinoma. Gibbs, A.R., Harach, R., Wagner, J.C., Jasani, B. Pathology Department, Welsh National School, Cardiff, United Kingdom. Thorax 40: 91-95, 1985.

Immunohistological methods were used to in- vestigate the presence of carcinoembryonic antigen, betasub 1 pregnancy specific glyco- protein, beta subunit of human chorionic gona- dotrophin, human placental lactogen, calcito- nin, and k~ratin in formalin fixed tissue from 29 malignant mesotheliomas and 27 pulmonary adenocarcinomas. Malignant mesotheliomas were negative for tumour markers except for the be- ta subunit of human chorionic gonadotrophin and keratin, one and 13 cases respectively being positive for these. Pulmonary adenocar- cinomas, however, were frequently positive for tumour markers - namely, carcinoembyonic an- tigen (24), betasub 1 pregnancy specific gly- coprotein (23), beta subunit of human chorio- nic gonadotrophin (8), human placental lacto- gen (2), carcinonin (3), and keratin (12). The presence of carcinoembyonic antigen and beta- sub 1 pregnancy specific glycoprotein within an intrathoracic tumour is strong evidence against its being of mesothelial origin.

Neurone Specific Enolase: A Useful Diagnostic Ser~n ~rker for Small Cell Carcinoma of the Lung.

Esscher, T., Steinholtz, L., Bergh, J. et al. Department of Paediatric Surgery, Lung Medicine, and Pathology, University Hospital, Uppsala, Sweden. Thorax 40: 85-90, 1985.

Among lung cancers small cell carcinoma ~s the most sensitive to chemotherapy and radi- ation. This has emphasized the importance of an accurate diagnosis of this cell type, and the present study examined the use of serum neurone specific enolase (NSE) as a diagnostic marker for small cell carcinoma. NSE was measured in pretreatment sera from 103 patients with small cell carcinoma and in sera from relevant con- trols, including patients with other lung cancers, non-malignant lung diseases, and healthy adults. Serum NSE concentration was raised (> 25 ng/ml) in 72% of patients with

small cell carcinoma. Ninety one per cent of