Pleural and Mediastinal Malignancies最新文献_第5页

Negative predictive value of pleural fluid cytology in patients with a background of cancer 有癌症背景的患者胸膜液细胞学阴性预测价值

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa494

O. C. Añón, R. Mercer, R. Asciak, D. McCracken, E. Bedawi, Maged Hassan, A. Dudina, Qianj Lu, M. Tsikrika, R. Varatharajah, G. Shepherd, A. Thayanandan, R. Hallifax, J. Wrightson, N. Rahman

引用次数: 0

Three Year Retrospective analysis of Pleural Procedure Services 胸膜手术服务三年回顾性分析

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3087

Narendrababu Rampura Chinnappa, Amir Mushtaq, Joy M. Thomas

{"title":"Three Year Retrospective analysis of Pleural Procedure Services","authors":"Narendrababu Rampura Chinnappa, Amir Mushtaq, Joy M. Thomas","doi":"10.1183/13993003.congress-2019.pa3087","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3087","url":null,"abstract":"Introduction: Pleural diseases are recognized as important subspecialty in respiratory medicine as the incidence rises internationally. Pleural daycase services offer one-stop clinical assessments, imaging and intervention aiding early diagnosis, improved patient care and admission avoidance. They offer educational benefits including procedural skills and clinical research opportunities. Method: A retrospective analysis of patients presenting to the Ambulatory Pleural Procedure Services (APPS) between September 2015 to November 2018 was conducted. Patient characteristics, source of referral, diagnosis, outcome and intervention conducted were evaluated including patient satisfaction survey. Results: 721 patients were reviewed during this time. Total pleural procedures performed were 378. 106 were therapeutic, 219 diagnostic and therapeutic, 29 diagnostic only and 24 Indwelling Pleural Catheters. Majority of the referrals are from the secondary care (70%) and 30% are from the primary care. With this service we saved 2443 days of hospital bed days. On average referral to appointment time for urgent suspected cancer was 8 days and for others it was 13 days indicating the efficiency of this service, feedback survey from the patients was very positve. Conclusion: Our dedicated pleural services have resulted in improved patient outcomes and positive feedback from the patients. It has facilitated early diagnosis, appropriate MDT referral and avoided prolonged inpatient admissions. In addition it has had educational benefits to junior doctors in improving their pleural procedure competencies. Reference: Hooper CE, Welham SA, Maskell NA. Pleural procedures and patient safety: a national BTS audit of practice. Thorax 2013;70(2):189-191.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87105040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

LENT score - useful clinical tool? LENT评分-有用的临床工具?

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3083

B. Vijayakumar, T. Hosack

{"title":"LENT score - useful clinical tool?","authors":"B. Vijayakumar, T. Hosack","doi":"10.1183/13993003.congress-2019.pa3083","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3083","url":null,"abstract":"Background: Malignant pleural effusions (MPE) are very common and infer a poor prognosis, with a median survival of 3-12 months. The pleural intervention chosen to manage symptomatic MPE is determined by the clinician involved, patient preferences and services available. The LENT score is a validated tool to help predict mortality in those with MPE. Objective: The clinical usefulness of the LENT score is unclear and we aimed to evaluate this at our district general hospital. Methods: We performed a retrospective analysis of patients who underwent pleural intervention for MPE at Royal Berkshire Hospital between May 2015 - September 2017. The LENT score was calculated retrospectively. Data was gathered for the number of patients undergoing talc pleurodesis and subsequent success rates, as well as the number underdoing IPC insertion and subsequent complication rates. Results: 40 patients were identified. Only 19 had a full data set to calculate the LENT score. Most patients had a primary diagnosis of lung cancer (30%), breast cancer (25%) or mesothelioma (18%). 26/40 patients underwent talc pleurodesis with 7 having further symptomatic fluid re-accumulation post talc (73% success rate). 25 patients had an IPC inserted, with the main complications being pleural infection (12%) and blocked catheter (8%). 5/19 (26%) patients were “high risk” as per LENT criteria. All “high risk” patients either died on the same admission or shortly post discharge. Conclusion: Using the LENT score will help risk-stratify patients with MPE to enable the most appropriate pleural intervention to be chosen from the outset, so as to alleviate breathlessness, whilst minimizing hospital stay and avoiding unnecessary procedure-related complications.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83797133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elevated circulating activin A levels in malignant pleural mesothelioma patients are related to cancer cachexia and poor response to platinum-based chemotherapy 恶性胸膜间皮瘤患者循环激活素A水平升高与癌症恶病质和铂基化疗反应差有关

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa3795

J. Paajanen, I. Ilonen, H. Lauri, T. Järvinen, E. Sutinen, H. Ollila, E. Rouvinen, K. Lemström, J. Räsänen, O. Ritvos, K. Koli, M. Myllärniemi

引用次数: 0

Technical limitation of semi-automated volumetric analysis using CT in patients with Malignant Pleural Mesothelioma 恶性胸膜间皮瘤CT半自动化体积分析的技术局限性

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3100

A. Kidd, S. Tsim, K. Blyth

{"title":"Technical limitation of semi-automated volumetric analysis using CT in patients with Malignant Pleural Mesothelioma","authors":"A. Kidd, S. Tsim, K. Blyth","doi":"10.1183/13993003.congress-2019.pa3100","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3100","url":null,"abstract":"Introduction: Volumetric tumour measurement of malignant pleural mesothelioma (MPM) using contrast-enhanced CT could be used to assess MPM tumour stage as an alternative to RECIST response reporting. Aims and Objectives: We attempted to deploy a recently reported semi-automated method of volumetric MPM tumour assessment developed using Magnetic Resonance Imaging (MRI) (Armato S, Lung Cancer In press) on CT images acquired in the same patients. The MRI method requires tumour regions to be grown from seed points placed within a pre-defined volume of parietal pleural tumour, based on differential tumour enhancement after contrast. Methods: 23 patients with MPM were studied. 15 regions of interest (ROI) were placed on visible areas of pleural tumour. Similar ROIs were placed on intercostal muscle, pleural fluid, diaphragm and liver and Hounsfield Units (HU) generated for all ROIs. Pleural volume contours were then drawn every 8–10 axial CT slices and propagated throughout the volume (Myrian, Intrasense, France). Tumour regions were then grown within these volumes based on the measured range HU of pleural tumour. Results: The median (range) HU of pleural tumour, intercostal muscle and diaphragm overlapped: 49 (15–127), 21 (4–55) and 38 (7–65), respectively. Inter-slice interpolation artefacts were common and tumour region growing often resulted in ‘bleeding’ of the tumour regions into adjacent normal structures. Conclusions: It was not possible to accurately deploy a semi-automated volumetric analysis method for MPM developed using MRI on contrast-enhanced CT images. Reduced definition between tumour and adjacent structures was a major contributor, manifested as overlapping HU values.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76071404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Heterogeneous delivery of definitive interventions in malignant pleural effusions – results from a Danish survey 来自丹麦的一项调查结果:恶性胸腔积液的明确干预措施的异质性交付

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3088

U. Bødtger, Karin Armbruster, S. Skaarup, Henrik Kirstein, C. Laursen

{"title":"Heterogeneous delivery of definitive interventions in malignant pleural effusions – results from a Danish survey","authors":"U. Bødtger, Karin Armbruster, S. Skaarup, Henrik Kirstein, C. Laursen","doi":"10.1183/13993003.congress-2019.pa3088","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3088","url":null,"abstract":"Background: Malignant pleural effusion (MPE) is common with an annual incidence of around 5000 cases in Denmark. Danish health-care is free for all citizens as it is fully financed by the government. MPE is associated with short survival and high disease burden. There is solid evidence for reduced symptom burden and hospital use by definitive pleural procedures: indwelling pleural catheders (IPC) or pleuradesis. Difficult access to definitive pleural procedures is associated with reduced use. We aimed at investigating national differences in delivery of this care. Materials and Methods: An anonymous, one-page, multiple choice paper survey on delivered pleural service completed by pulmonologists at the annual conference in the Danish Respiratory Society, 23 November 2018. Results: Responses from delegates representing the ten largest departments of respiratory medicine (and all five regions of Denmark) were collected. IPC service were available in eight and pleuradesis in six centres. All centres had implemented ultrasound-based pleural techniques, and five had a training program for pleural interventions. In a few centres, IPC were administered by non-pulmonologists (radiologists, anesthesiologists) without a supporting pleural service. Conclusion: Access to definitive interventions for MPE is highly heterogeneous and therefore a common challenge for patients and clinicians. There is an imminent need for improved collaboration between oncologists and pulmonologists to provide evidence-based care to patients with MPE. National differences in health-care organisation may hamper external validity.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75930192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Success rate of talc pleurodesis 滑石胸膜固定术的成功率

Pleural and Mediastinal Malignancies Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa3084

Yanika Gatt, Joanna Grech, James A. Farrugia, C. Zammit, Stephen Montfort

引用次数: 0

68Ga-DOTA-NT-20.3. An innovative probe for neurotensin receptor-positive tumor imaging in the diagnosis of malignant pleural mesothelioma 68年ga -队伍- nt - 20.3。神经紧张素受体阳性肿瘤影像诊断恶性胸膜间皮瘤的创新探索

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.oa499

Manuela Marenco, V. Frangipane, M. Hodolič, S. Inghilleri, G. Stella, F. Meloni, L. Lodola

引用次数: 0

Treatment with Anti-VEGF and anti-EGFR in a model of malignant pleural effusion: Genic evaluation 抗vegf和抗egfr治疗恶性胸腔积液模型:基因评价

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2862

L. Teixeira, V. Alvarenga, R. Sales, C. Silva, N. Almeida, L. Sousa, A. C. Santos, V. Capelozzi, E. Marchi, M. Acencio

{"title":"Treatment with Anti-VEGF and anti-EGFR in a model of malignant pleural effusion: Genic evaluation","authors":"L. Teixeira, V. Alvarenga, R. Sales, C. Silva, N. Almeida, L. Sousa, A. C. Santos, V. Capelozzi, E. Marchi, M. Acencio","doi":"10.1183/13993003.CONGRESS-2018.PA2862","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2862","url":null,"abstract":"Introduction: Malignant pleural effusion treatment is limited to primary tumor and control of pleural effusion (PE). Intrapleural therapy could lead to a less permissive microenvironment for the development of malignant pleural disease. Objectives: To evaluate anti-VEGF and anti-EGFR in malignant pleural disease and to study tumor gene expression in a model of lung adenocarcinoma. Methods: Mice received intrapleural injection of lung adenocarcinoma cells (Lewis). After 3, 7, 10 and 14 days they were treated intraplerally with anti-VEGF, anti-EGFR, anti-VEGF+anti-EGFR or saline. It was evaluated survival, gene expression of Akt1, Akt2, Bcl2, Erbb2, NF-kB, Nras and PDGF, and KRAS and EGFR mutation. Results: All animals developed malignant pleural disease with PE and tumor implants. There was no difference in survival times between the animals treated or untreated. We observed tumor overexpression of AKt1, Akt2, Bcl2, Grb2, NF-kB and Nras genes compared to normal mouse lung tissue. We did not observe differences in PDGF gene. Only treatment with anti-VEGF showed decreased expression of Erbb2. A mutation was identified in exon 2 of the KRAS gene in tumor tissue. No mutation of EGFR gene was observed. Conclusions: Anti-VEGF and/or anti-EGFR intrapleural did not have a positive impact on survival. Tumors from Lewis cells show gene overexpression of proto-oncogenes, genes related to growth and signaling cell and anti-apoptosis. It was observed KRAS mutation. Anti-VEGF had a discrete action in decrease of the Errb2 expression without impact in the survival. These findings characterize the high aggressiveness of this tumor, which could have influenced the ineffective action of these therapies.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86347626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Results of pre-EDIT; a randomised feasibility trial of Elastance-Directed Intra-pleural catheter or Talc Pleurodesis (EDIT) in malignant pleural effusion 预编辑结果;弹性导向胸膜内导管或滑石粉胸膜固定术(EDIT)治疗恶性胸腔积液的随机可行性试验

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA495

G. Martin, A. Kidd, S. Tsim, R. Woodward, T. Hopkins, J. Foster, P. McLoone, K. Blyth

{"title":"Results of pre-EDIT; a randomised feasibility trial of Elastance-Directed Intra-pleural catheter or Talc Pleurodesis (EDIT) in malignant pleural effusion","authors":"G. Martin, A. Kidd, S. Tsim, R. Woodward, T. Hopkins, J. Foster, P. McLoone, K. Blyth","doi":"10.1183/13993003.CONGRESS-2018.OA495","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.OA495","url":null,"abstract":"Introduction: Non-expansile lung (NEL) is a common cause of talc pleurodesis (TP) failure in malignant pleural effusion (MPE), but is often occult prior to drainage. Reliable detection of NEL would allow patients to be allocated between IPC (required in NEL) and TP (often effective if NEL absent; avoids prolonged drainage). High Pleural Elastance (PEL) has been associated with NEL in observational studies. Pre-EDIT is a randomised feasibility trial of Elastance-Directed IPC or TP (EDIT) management using a novel, purpose-built digital pleural manometer (Rocket Medical, UK). Methods: Consecutive patients with symptomatic MPE, no prior evidence of NEL or preference for IPC are randomised 1:1 between standard care (attempt at TP) and EDIT management (see Figure 1). The primary objective is to determine whether it is feasible to recruit and randomise 30 patients within 12 months (or 15 within 6 months). Secondary objectives include safety and refinement of the EDIT design, including validation of the current PEL definition using 4D volumetric Magnetic Resonance Imaging pre- and post-fluid aspiration. Results: Recruitment is on target (14/30 at time of submission) and will close on 28/8/18. Conclusion: Pre-EDIT will determine whether a multi-centre Phase III trial of EDIT management of MPE is feasible. Results will be ready for presentation at ERS Congress 2018.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83449982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0