Pleural and Mediastinal Malignancies最新文献_第7页

Intrapleural anaesthesia for medical thoracoscopy - a pilot study 医学胸腔镜胸膜内麻醉的初步研究

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.OA497

M. Reda, A. Gomaa, Maged Hassan, M. Shaheen, Salah Sorour

{"title":"Intrapleural anaesthesia for medical thoracoscopy - a pilot study","authors":"M. Reda, A. Gomaa, Maged Hassan, M. Shaheen, Salah Sorour","doi":"10.1183/13993003.congress-2018.OA497","DOIUrl":"https://doi.org/10.1183/13993003.congress-2018.OA497","url":null,"abstract":"Background: Medical thoracoscopy (MT) has major role in diagnossis of exudative pleural effusion. MT is usually performed under conscious sedation (CS). Some patients suffer considerable pain during pleura biopsy or pleurodesis. The use of CS is occasionally complicated by respiratory failure. This study aimed to evaluate if intrapleural anaesthesia (IPA) using lidocaine via chest drain improves patient9s tolerability of MT. Mehtods: Patients were divided to 2 groups. In group 1: CS using IV midazolam with standard doses was done. In group 2: a chest drain was inserted to dry the affected side overnight. 20 min before procedure, 1 mg/kg of 1% lidocaine in 20 ml saline were instilled via drain and then clamped. Rigid scope was used. At the start of the MT, drain was removed, and pneumothorax was allowed to develop. The remainder of the MT procedure was carried out in the same manner in both groups. 10-cm Visual analogue score (VAS) for pain was recorded after the procedure. Results: Mean age in group 1 was 56+10 yrs while in group 2 it was 58+12 yrs. 2/10 patients were females in CS group, while in IPA group 7/10 were females. 50% of CS patients had CV comorbidities, which affected 60% of group 2 patients. Diagnosis was successfully made in all patients. 90% of patients in both groups had malignant pleural disease. The median VAS for pain during MT in CS was 8 (6.75-9), while with IPA it was 1 (0-3.75) (p 0.001). One major complication occurred in a case in CS group who had acute hypoventilation. 8/10 patients in CS and 1/10 patient in IPA group required IV analgesia after procedure. Conclusion: IPA appears to be associated with less pain during MT without decreasing yield. It might be a safer choice than CS.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88584394","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: 2

Malignant Mesothelioma (MM) is still the leading cause of death in Karain villagers in Turkey and/or abroad due to erionite exposure 恶性间皮瘤(MM)仍然是土耳其和/或国外Karain村民因暴露于间皮瘤而死亡的主要原因

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2876

A. S. Emri, Dorina Esendağlı, M. Carbone

{"title":"Malignant Mesothelioma (MM) is still the leading cause of death in Karain villagers in Turkey and/or abroad due to erionite exposure","authors":"A. S. Emri, Dorina Esendağlı, M. Carbone","doi":"10.1183/13993003.CONGRESS-2018.PA2876","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2876","url":null,"abstract":"Karain is a village in Cappadocia, Turkey, which experience an epidemic of MM. Total population was 875 in 1975. By 2014 it was reduced to 139 as approximately 400 of them died of MM and others migrated to Sweden, Ausralia, Urgup, and Western Europe hoping to reduce the risk of dying of MM. A mortality study performed in Karain between 1970-1994 showed that 58% of deaths were due to cancer:85% of cancer deaths were due to MPM(malignant pleural mesothelioma) and 4% to MPEM(malignant peritoneal mesothelioma). The M to F ratio was 1.4 and the median age of death was 55(YI Baris, J Natl Cancer Inst 2006). We linked MM to genetic predispositon to erionite carcinogenesis(Roushdy-Hammady, Lancet 2001). The aim of this study was to investigate the mortality rate in Karain villagers within the period 2010-2017 and compare it with previous studies. We review medical records and death certificates of people buried in Karain cemetery in the years 2010-2017. Of note, when Karain villagers die abroad their corpse were transported to Karain.124 villagers died in this time period. 67/124 (54%) were males.66 of 124(53%) died of cancer, and 54/66 of cancer deaths were caused by mesothelioma. Specifically,52 of 124(79%) died of MPM,2/124(3%) of MPEM. Their median age was 68 years. Other cancers: GIS(4.5%), genitourinary(4.5%), lung(3%), etc. Our results are similar to the previous study by Baris, except the median age which in our study is 13 years older. We speculate that reduced exposure to erionite in people who had left the village account for this difference. In total,127 new houses were built and entire village was moved to a new geological site free of erionite in 2014.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82845491","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

The DIAPHRAGM study: Diagnostic and prognostic biomarkers in the rational assessment of Mesothelioma 横膈膜研究:间皮瘤合理评估中的诊断和预后生物标志物

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA493

S. Tsim, C. Kelly, L. Alexander, A. Shaw, James Paul, R. Woodward, J. Foster, K. Blyth

{"title":"The DIAPHRAGM study: Diagnostic and prognostic biomarkers in the rational assessment of Mesothelioma","authors":"S. Tsim, C. Kelly, L. Alexander, A. Shaw, James Paul, R. Woodward, J. Foster, K. Blyth","doi":"10.1183/13993003.CONGRESS-2018.OA493","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.OA493","url":null,"abstract":"Introduction: Fibulin-3 (F3) and SOMAscan® (SS) are blood biomarkers with reported sensitivity and specificity >90% for Malignant Pleural Mesothelioma (MPM) but results are limited by inconsistent results and retrospective study design. The primary objective of DIAPHRAGM was to determine the diagnostic performance of F3 and SS in an adequately-powered, prospective study, compared to Mesothelin. Methods: DIAPHRAGM recruited an ‘intention-to-diagnose’ suspected pleural malignancy (SPM) cohort from 22 UK/Irish centres (Dec ’13 – Dec ‘16). Biomarker sampling simulated clinical use and diagnostic assessment was robust (Figure 1). Inclusion criteria were SPM (unilateral pleural effusion/mass), fit for sampling and consent. Patients with recent or in-situ chest drain were excluded. Target sample size was 600 SPM cases (including at least 120 MPM) and 109 asbestos-exposed controls (AEC). Results: 639 SPM and 109 AEC cases were recruited. 156 (24%) SPM patients had MPM, 213 (33 had secondary pleural malignancy and 241 (38%) benign disease. Final diagnoses are awaited in 5% (n=29). Biomarker assays are in progress. Complete results will be available by ERS congress. Conclusion: DIAPHRAGM was an appropriately-designed, multi-centre study that will clearly define the diagnostic performance of F3, SS and Mesothelin in MPM. A large, well-phenotyped bioresource has been created for future biomarker studies.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84831038","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

The clinical benefits of immune checkpoint inhibitors for thymic carcinomas 免疫检查点抑制剂治疗胸腺癌的临床疗效

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2878

Naohiro Uchida, K. Fujita, O. Kanai, M. Okamura, K. Nakatani, T. Mio

{"title":"The clinical benefits of immune checkpoint inhibitors for thymic carcinomas","authors":"Naohiro Uchida, K. Fujita, O. Kanai, M. Okamura, K. Nakatani, T. Mio","doi":"10.1183/13993003.CONGRESS-2018.PA2878","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2878","url":null,"abstract":"Aim and Objectives: Thymic carcinomas arise in the anterior mediastinum. The Masaoka staging system has been widely used for staging thymic carcinomas and most patients with them are diagnosed as being at high clinical stages due to the aggressiveness nature. In such cases, chemotherapy is the primary treatment modality. However, its effect on tumours are limited and a standard chemotherapy regimen has not been established. Recently, immune checkpoint inhibitors have changed conventional chemotherapy regimen due to their effectiveness against various types of cancers. The effects of these inhibitors on thymic carcinomas are unknown because any immunotherapy has not been approved for them. Patients and Case Presentation: We administered nivolumab, anti-Programmed Cell Death (PD)-1 antibody, to four patients with unresectable thymic carcinomas who had previously undergone conventional chemotherapy. A histopathology on tumours from these patients revealed the presence of squamous cell carcinoma and PD-L1 expression. After treatment with nivolumab, all patients showed improvements. Three patients showed partial improvements as observed in computed tomography images, and the tumour biomarkers of the fourth patient was decreased although radiological evaluation showed stable disease. None of them experienced severe immune-related adverse events. Conclusions: Although large clinical trials for the evaluation of immune checkpoint inhibitors for the treatment of thymic carcinoma are necessary, our results suggest the potential benefits of using these inhibitors to treat thymic carcinomas.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83796187","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

Is there a need for Vedio-assisted Thoracoscopic surgical (VATS) pleural biopsy following a Medical Thoracoscopy (MT)? 内科胸腔镜检查(MT)后是否需要进行外科胸膜活检(VATS) ?

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2886

M. Abdulla, J. Hadfield, Thida Aung, A. El-Nayal

{"title":"Is there a need for Vedio-assisted Thoracoscopic surgical (VATS) pleural biopsy following a Medical Thoracoscopy (MT)?","authors":"M. Abdulla, J. Hadfield, Thida Aung, A. El-Nayal","doi":"10.1183/13993003.CONGRESS-2018.PA2886","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2886","url":null,"abstract":"Background: MT has a diagnostic sensitivity 92-93% for malignancy. Major complications are rare and negates the need for General Anaesthesia required for VATS. The conventional practice is to refer for VATS biopsy if the MT is inconclusive or negative for malignancy. Aim: To find out the diagnostic yield of MT, assess concordance of histology between MT and VATS biopsy, review major complications, deaths, length of hospital stay and success rate following talc poudrage. Method: We retrospectively analysed all patients who underwent MT over a 2 year period (2015 and 2016) using a semi-rigid thoracoscope.37cases were identified. Histology results for all cases reviewed along with the lung MDT decision on the diagnosis. Results: 37 patients underwent MT over 2 years. 32/37 had a representative pleural biopsy and a conclusive diagnosis following MT. 5/37 was referred for VATS pleural biopsy. 1/5 likely Mesotheloma, 2/5 showed inflammation but felt the pleural appearance warrants further biopsy. 2/5 did not have a representative sample from MT due to severe adhesions and lcoulation therefore needed surgical pleural biopsy but were not fit. Therefore 3/5 underwent VATS pleural biopsy and histology result showed similar findings as of MT. No deaths were noted. Major complication rate was 2.7%. Succcessful Talc Poudrage was noted in 87%. Diagnostic yield was 35/37 (95%). Average hospital stay was 2.5 days. Conclusion: There was 100% concordance between MT and VATS pleural biopsy. If good pleural biopsies are obtained via MT there is little merit doing a surgical biopsy, though we are cautious due to small sample size. Our data also suggest semi-rigid MT has excellent diagnostic yield.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73100528","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

Role of markers C-Reactive Protein, Procalcitonin and TREM-1 in diagnosis of infection pleural effusion c反应蛋白、降钙素原和TREM-1在感染性胸腔积液诊断中的作用

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2863

V. Alvarenga, M. Acencio, R. Sales, A. Silva, J. Silva, C. Silva, L. Teixeira, E. Marchi

引用次数: 0

Evaluation of chemotherapy response determined by volumetric method in malignant pleural mesothelioma and its effect on determination to survival 体积法评价恶性胸膜间皮瘤化疗反应及其对生存率的影响

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa2893

F. Urfalı, S. Metintaş, A. Gurgen, Guntulu Ak, R. Ozkan, M. Metintaş

引用次数: 0

Effects of 2-Deoxy-glucose with Cisplatin-Pemetrexed in mesothelioma sphere formation. 2-脱氧葡萄糖联合顺铂培美曲塞对间皮瘤球形成的影响。

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2866

R. Jagirdar, Irini Georgianni, E. Pitaraki, Eleftherios D. Papazoglou, Chrissy Hatzoglou, K. Gourgoulianis, S. Zarogiannis

{"title":"Effects of 2-Deoxy-glucose with Cisplatin-Pemetrexed in mesothelioma sphere formation.","authors":"R. Jagirdar, Irini Georgianni, E. Pitaraki, Eleftherios D. Papazoglou, Chrissy Hatzoglou, K. Gourgoulianis, S. Zarogiannis","doi":"10.1183/13993003.CONGRESS-2018.PA2866","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.PA2866","url":null,"abstract":"Introduction: Glycolytic metabolism is enhanced in neoplasms, described as Warburg effect. Cisplatin (Cis) and Pemetrexed (Pem) are the only approved frontline therapies in malignant pleural mesothelioma (MPM). The exploitation of metabolic inhibition of glycolysis is not reported in mesothelioma studies. Aim: To examine the effects of 2-Deoxy-glucose (2DG) in combination with with Cis and Pem in reducing 3D tumor sphere formation in MPM cell lines. Methods: Three MPM cell lines were used in this study, M14K (epithelioid), MSTO (biphasic), ZL34 (sarcomatoid). Hanging drop method was used for tumor sphere formation (50 cells/drop) over 4 days [Controls (Con):10% FBS RPMI]. 2DG (2mM) alone and in combination with Cis 10μM or/and Pem 200μM was also used. Sphere sizes were measured by microscopic imaging for statistical analyses. Baseline perimeters were considered 100%. Results: 2DG significantly reduces sphere growth in MSTO (Con 100±2.7% vs. 2DG 85.11±1.8%; p Conclusions: In this preliminary work M14K sphere formation was unaffected by 2DG alone, while there was significantly reduced growth of MSTO, ZL34 spheres. In combination with Cis the spheres were smaller in all cell types, while in combination with Pem or Cis+Pem spheres were smaller only in MSTO and ZL34, but not in M14K.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91010521","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

ADAM10 membrane-bound protease mediates malignant pleural mesothelioma invasiveness ADAM10膜结合蛋白酶介导恶性胸膜间皮瘤侵袭

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.PA2865

C. Sépult, M. Bellefroid, C. Gilles, A. Ludwig, B. Duysinx, Agnès Noël, D. Cataldo

引用次数: 0

Recurrence rates in primary spontaneous pneumothorax: results of systematic review 原发性自发性气胸的复发率:系统回顾的结果

Pleural and Mediastinal Malignancies Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA494

S. Walker, P. White, N. Maskell

引用次数: 2