281

vided into three treatment groups; a surge- ry group (S), a radiation therapy group (R), and a combined cytostatic and radiation therapy group (C). A follow-up was carried out 4 to 6 months after treatment. The the- rapeutic measures} resection, irradiation, and chemotherapy, produced a decrease in the total leucocyte and lymphocyte counts, in the number of T-cells, and in the leuco- cyte transformation response to PPD. In the surgically treated group the decrease was transient. In the groups treated with radi- ation therapy and combined cytostatic and radiation therapy the values remained low throughout the follow-up. The lymphocyte response to PHA was not altered in any of the groups during initial treatment or fol- low-up. The results did not suggest a cor- relation between the immunologic parameters used and the stage and histologic type of lung cancer. The tests were of no clinical value in the determination of the individual prognosis.

10, OTHER TREATMENT MODALITIES

Controlled Trial of RSV, Herbs or Placebo as Adjuvants to Complete Resection of Squa- mous Cell Lung Cancer. Osterlind, K., Hansen, M., Hansen, H.H., Dombernowsky, P. Department of Oncology I I , Finsen Institute, DK-2100 Copenhagen, Den- mark. Eur. J. Surg. Oncol. ii: 349-351, 1985.

152 completely resected patients with high or intermediate differentiated squamous cell lung cancer were randomized to receive 6 months adjuvant therapy with RSV (1,2- diphenyl-abeta-diketone) herbs or placebo. No significant differences were observed in duration of survival or relapse rates between the three groups.

Endobronchial Management of Lung Cancer. Cortese, D.A. Division of Thoracic Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MD 55905, U.S.A. Chest 89: 234S-236S, 1986.

Bronchoscopic phototherapy is available now for 2 distinct categories of tracheo- bronchial cancer: roentgenographically oc- cult superficial squamous cell carcinoma and advanced malignancy causing significant airway obstruction. Laboratory and clinical experience show that the photodynamic effect of hematoporphyrin derivative phototherapy (HpD~PT) may be useful for treating super- ficial cancers that penetrate less than 5 mm into bronchial mucosa. The larger, ob- structing cancers are better managed by high~ power laser sources, such as the YAG laser, which are effective by hyperthermal photo- coagulation, thermal necrosis, and tissue vaporization.

Irresectable Bronchial Carcinoid with a 32- Year Natural History. A Report of Two Cases

Treated with Neodymi~u-YAG-Laser, Initially Misinterpreted as Small Cell Lung Cancer. Berendsen, H.H., Postmus, P.E., Edens, E.T., Slutter, H.J. Department of Pulmonary Dis- eases, State University Hospital, 9713 EZ Groningen, Netherlands. Eur. J. Respir. Dis. 68: 151-154, 1986.

Two patients are described with bronchi- al carcinoid. In both, the initial diagno- sis was small cell lung carcinoma (SCLC). This diagnosis was discordant with the cli- nical course; a second evaluation yielded the diagnosis of carcinoid. Good palliation was achieved with YAG-laser therapy.

11, REVIEWS

Recent Advances in the Biology of Small Cell Lung Cancer. Carney, D.N. The Mater Hospital, Dublin, Ireland. Chest 89: 253S-257S, 1986.

Advances in the techniques for culturing human tumors in vitro, especially lung can- cer cells, have greatly facilitated studies of the biologic properties of both small cell and nonsmall cell lung cancer cells. Detailed analysis has been done of well- characterized cell lines of both groups with respect to growth properties, biomar- ker and antigen expression, cytogenetics, and oncogene amplification and expression. Two major conclusions have emerged from these studies: (i) considerable heterogenei- ty exists within a given tumor type (eg, SCLC) in the expression of a given biomar- ker, and (2) overlap in the expression of biomarkers exists between cells of SCLC and non-SCLC, suggesting a common stem cell for all types lung cancer. In the future, cli- nical trials on the impact of the biological properties of cells on responses to therapy and survival will need assessment.

Bronchioloalveolar Carcinomas. Cell Types, Patterns of Growth, and Prognostic Corre- lates. Calyton, F., Department of Pathology, Uni- versity of Utah Hospital, Salt Lake City, UT, U.S.A. Cancer 57: 1555-1564, 1986.

Forty-five bronchioloalveolar carcinomas were studied, including 27 cases by electron microscopy. Bronchioloalveolar carcinomas can be classified by routine sections or by diastase-digested periodic acid-Schiff (PAS) stains, but electron microscopy is useful in confirming Clara cell or type II pneumocyte (noum~clnous) differentiation and excluding metastases. Mucinous bronchi- oloalveolar carcinoma can mimic metastatic adenocarcinoma histologically and ultrastruc- turally. Of the nine tumors with mucinous differentiation, eight had aerogenous dis- semination (multifocal or with pneumonic spread), and seven of those eight were fatal.

Twenty-four of 36 nonmucinous bronchiolo- alveolar tumors had aerogenous spread; all