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The diagnostic significance of gastrin measurement of bronchoalveolar lavage fluid for lung cancer Zhou Q, Yang 2, Yang J, Tian Z, Zhang H. lhoracic Cardiovawdar Surg. Dept., First Aj‘iliated Hospital, West China Univ. of Med. Sciences, Chengdu, Sichuan 610041. J Surg Oncol 1992;50: 121-4.

In this study, determination ofgastrin concentration in bronchoalveolar lavage fluid and serum has been detected by radioimmunoassay in 30 case.s of lung cancer and 24 caseaof non-cancer pulmonary diseases. The results show that the gastrin concentration and its positive rate of lavage fluids from cancer lung are much higher than those from healthy lung and serum in lung cancer patients, and those from serum and both disease and healthy lung in non-cancer pulmonary disease patients (P < 0.01). The gastrin ratio of lavage fluids from cancer lung to serum is also significantly higher than the ratio of lavage fluid fmm healthy lung to serum and all the ratios in the non- cancer pulmonary disease gmup. These results suggest that there is a high gastrin concentration in local tissue of lung cancer, which is signified by the high concentration of gastrin and its high positive rate in lavage fluids from the lung with cancer. Therefore, the gastrin determination in lavage fluids and gastrin ratio of lavage fluids to serum are more. reliable in the differential diagnosis of benign from malignant pulmonary diseases than gastrin determination of serum alone.

Prognostic significance of tumor deoxyribonucleic acid content in surgically raw&d small-cell carcinoma of lung Carey FA, Prasad US, Walker WS, Cameron EWJ. Lamb D, Bird CC. Depattment of Pathology, University Medical School, Tevior Place, Edinburgh EH8 9AG. J Thorax Cardiovasc Surg 1992;103: 1214-7.

The prognostic role of deoxyribonucleic acid flow cytometry was investigated in 53 cases of surgically resected small-cell lung cancer. Deoxyribonucleic acid aneuploidy was detected in 26 patients (49.1%), the remaining tumors beiig either diploid or tetraploid. Patients with aneuploid tumors had a significantly reduced Z-year survival (38.5 %) when compared with patients with diploid or tetraploid tumors (70.3 % ; p < 0.05). This finding was independent of tumor stage on multiple logistic regression analysis. Diploid or tetraploid deoxyribonucleic acid content was associated with a particularly good 2-year survival (85 96) in NO or N 1 disease. Tumor deoxyribonucleic acid ploidy should be taken into account in planning of management and assessment of prognosis in small-cell lung cancer.

ras Gene mutations as a prognostic marker in adenocarcinoma of the human lung without lymph node metastasis Sugio K, Ishida T, Yokoyama H, Inoue T, Sugimachi K, Sasazuki T. Department of Surgery II. Faculty of Medicine, Kyashu University, Fakaoka 812. Cancer Res 1992;52:2903-6.

Adenocarcinoma of the long obtained at surgical resection was examined for mutation at codons 12.13, and61 of theoncogenas K-w, H-ras, and N-ras, using polymerase chain reaction and oligonucleotide hybridization techniques. The mutation was detected in 18 of the 115 casea (15.7%). and 15 of 18 were at codon 12, 2 were at codon 13 of K-ras. and 1 was at codon 61 of N-ras. G to T transversions were most common. The ras gene mutations were more frequent in the male patients (P = 0.0048). No significant differences were found to be related to stage of the disease or tumor-nodes-m&stases classification between Positive and negative groups of the ras gene mutations. A history of tobacco usewas not always a factor contributing to mutation. Of the completely resected group without lymph node metastasis, the S- year survival rate in the w-positive group was 53.3%. which was significantly poorer than the 83.6% survival rate in the ras-negative group (P < 0.05). Our findings suggest that ras gene mutations may be prognostic, e.specially in the early stage adenocarcinoma of the lung.

Clinical significance of tumor necrosis factor in patients with bronchogenic carcinoma and benign lung diseases: A comparative study Rapellino M, Pecchio F, Aimo G, Priolo G, Baldi S, Ruftini E et al. Serv. di Fisiopatologia Respiratoria, Ospedale Molinette, Via t&nova 3, 10126 Torino. Int J Biol Markets 1992;7:103-6.

Tumor Necrosis Factor (TNF) was determined in the serum of 72 lung carcinoma patients. Twenty-four healthy subjects younger than 50 years and 10 healthy subjects older than 70 years were considered as control group. TNF was also measured in 20 patients with stage I sarcoidosis and in 15 patients with pulmonary fibrosis. The marker was detected in 32% of cases in the neoplastic group, in 37.5% of disease confined to the chest and in 25% of advanced disease cases. A large proportion of TNF-positive samples was found in sarcoidosis (30%), and even larger in pulmonary fibrosis (66.6%). TNF was also present in healthy subjects older than 70 (40%). We conclude that TNF is not specific of malignancy, being demonstrable in other benign pulmonary diseases and even in the course of physiological aging.

Lung cancer in association with human immunodeficiency virus infection Fraire AE, Awe RJ. Department of Pathology, University of Marsachasetts, Medical Center, 55 Lake Avenue, North Worcester, MA 0165s. Cancer 1992; 70~432-6.

The association of lung cancer and infection by the human immunodeficiency virus (HIV) is uncommon. This report and critical review of the medical literature defines a clinical profile of22 patients affected with this uncommon association. This clinical profile includes young age (median, 38 years), intravenous drug abuse (14 of 22 patients), preponderance of adenocarcinomn over other cell subtypes (11 of 22 patients), and advanced clinical stage at presentation (10 of 15 patients with staging data had Stage III or IV disease). This study also examines a possible increased risk for lung cancer in patients infected by HIV. Continued surveillance and reporting of lung tumors (other than lymphomas and Kaposi sarcomas) in patients infected by HIV should help to define the frequency of the association and the validity of the clinical profile.

Cardiac metastasis of lung cancer: A study of metastatic pathways and clinical manifestations Tamura A, Matsubara 0, Yoshimura N, Kasuga T, Akagawa S, Aoki N. Department of Pathology, Tokyo Medical and Dental University, 5- 45, Ywhima, I-Chome, Bunkyo-ka. Tokyo 113. Cancer 1992;70:437- 42.

Background. Although lung cancer frequently spreads to the heart, details of cardiac metastases of lung cancer have not been fully discussed. The authors attempted to elucidate the relationship behveen the mechanisms of cardiac metastasis and a variety of clinical manifestations caused by cardiac metastasis. Methods. Clinical and autopsy records were reviewed in 74 autopsied cases of lung cancer. In cases with cardiac metastasis, the metastatic pathways to the heart were determined by the macroscopic examinations, and the relationship between the metastatic pathways and the clinical manifestations were studied. Results. Metastases to the pericardium or heart were seen in 23 cases (31 W). A lymphatic metastatic pathway was detected in 18 cases (hilar lymphatic routing in 12 cases, and media&al lymphatic routing in 6 cases), and a hematogenous metastatic pathway was detected in 5 cases. Malignant pericardial effusion wasdocumented in 15 of23 cases. The metastatic pathway in 14 of 15 cases was lymphatic (hilar lymphatic routing in 10 cases, and mediastinal lymphatic routing in 4 cases). Patients showing lymphatic metastasis had higher incidence of malignant pericardial effusion than those with hematogenous metastasis (P < 0.05). Of 23 cases of cardiac metastasis, myocardial infarction was