Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successful... more Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successfully in the palliative treatment of the patients with lung cancer. The patients with tracheobronchial obstruction may develop many symptoms like dyspnea, cough and haemoptysis, and atelectasis and pneumonia but these symptoms were recovered with applying interventional bronchoscopic methods. These methods are laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy and airway stents. The obstructed airway was reopened by these bronchoscopic methods and dyspnea, atelectasis and post-obstructive pneumonia were relieved. In addition, with establishment of the airway patency, chemotherapy and/or radiotherapy may be applied to the patients with lung cancer. The treatment of tracheobronchial obstruction was achieved a thorough evaluation of the etiology, physiology, diagnostic and treatment options of the disease and a multidisciplinary team approach including anesthesiology, medical oncology, thoracic surgery, radiology and interventional pulmonology. In this multidisciplinary team approach, all of the doctors dealing with the diagnosis and treatment of lung cancer should know interventional bronchoscopic methods, endobronchial treatment, and indications of these procedures. The aim of this review is to fresh our knowledge about the interventional bronchoscopic treatment methods in patients with lung cancer.
Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successful... more Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successfully in the palliative treatment of the patients with lung cancer. The patients with tracheobronchial obstruction may develop many symptoms like dyspnea, cough and haemoptysis, and atelectasis and pneumonia but these symptoms were recovered with applying interventional bronchoscopic methods. These methods are laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy and airway stents. The obstructed airway was reopened by these bronchoscopic methods and dyspnea, atelectasis and post-obstructive pneumonia were relieved. In addition, with establishment of the airway patency, chemotherapy and/or radiotherapy may be applied to the patients with lung cancer. The treatment of tracheobronchial obstruction was achieved a thorough evaluation of the etiology, physiology, diagnostic and treatment options of the disease and a multidisciplinary team appro...
Turkiye Klinikleri Journal of Pulmonary Medicine, 2004
Akciğer kanseri tüm dünyada milyonlarca insanın ölümüne yol açan en yaygın tümörlerden birisidir.... more Akciğer kanseri tüm dünyada milyonlarca insanın ölümüne yol açan en yaygın tümörlerden birisidir. 1 Yıllardır yapılan araştırmalara rağmen akciğer kanserinin prognozu hala çok kötüdür. Ancak erken evrelerde tanı konulan akciğer kanserlerinde kür sağlanabilir. İleri ...
Poor prognosis in the lung cancer result from early metastatic potential of the tumoral cells. Th... more Poor prognosis in the lung cancer result from early metastatic potential of the tumoral cells. The mechanisms of tumoral cell metastasis are complex. Adhesion molecules play an important role in metastatic process, which is cell-to-cell and cell-to-matrix interactions and chemokins which arrange the migration and growth of the cells are also important in metastatic biology. The aim of this study is to investigate the prognostic relevance of carcinoembrionic antigen cell adhesion molecule 1 (CEACAM1) and chemokine receptor CXCR4 expression in patients with non-small cell lung cancer (NSCLC). Using immunohistochemical analysis, we evaluated CEACAM1 and CXCR4 expression in parafine specimens from 50 patients with NSCLC confirmed histopathologically and the relationship between CEACAM1 and CXCR4 expression and the prognosis. Twenty-one (42%) patients were positive and 29 (58%) were negative for CEACAM1 expression. Patients whose tumors had CEACAM1-positive staining had a shorter duration of survival than patients whose tumors had no expression, but it was not significant statistically [8.93 ± 8, (median: 8) vs 12.3 ± 11.3, (median: 9), p> 0.36]. Twenty-three (46%) patients were positive and 27 (54%) were negative for CXCR4 expression. Patients whose tumors had CXCR4-positive staining had a longer duration of survival than patients whose tumors had no expression, but it was not significant statistically [12.8 ± 12.4, (median: 12) vs 9.3 ± 7.6, (median: 8), p> 0.14]. In conclusion, CEACAM1 and CXCR4 played a part in metastatic process in lung cancer may not affect on survival independently. The biologic mechanisms leading to the spread of tumor cells are complex and related multifactoriel process.
Chronic airway inflammation is reported to have an important role for the development of chronic ... more Chronic airway inflammation is reported to have an important role for the development of chronic obstructive pulmonary disease (COPD), in addition to smoking, genetic and environmental factors. The present study was aimed to investigate whether the airway inflammation differed in subjects with stable COPD and healthy smokers. A total of 35 subjects (18 patients with COPD and 17 healthy smokers) were enrolled in this study. Bronchoalveolar lavage (BAL) was performed via fiberoptic bronchoscope in all subjects and cell counts and profiles and lymphocyte subset were analyzed in BAL fluids. The number of neutrophils in BAL of subjects with stable COPD was significantly higher than that of the healthy smokers (p< 0.001), and the number of macrophages was significantly lower than that of the healthy smokers (p< 0.001). Although CD4+ T:CD8+ T lymphocyte ratio was higher in healty smokers, the difference was not significant (p> 0.05). As a result, the most marked cellular change in BAL of subjects with stable COPD is the increase in neutrophils and decrease in macrophages, suggesting a very important role in the chronic airflow limitation.
Collagen tissue diseases are multisystem and heterogeneous group disease mediated inflammatory di... more Collagen tissue diseases are multisystem and heterogeneous group disease mediated inflammatory disorders. The pulmonary manifestations is more common and all elements of the lung are involved. However, symptoms of the respiratory system may be masked by exercise limitation due to involvement of the musculoskeletal system. The involvement may be subclinical or determined fulminant and life-threatening dimension. In this review, the pulmonary involvement of the more common collagen tissue diseases are reviewed.
The International Association for the Study of Lung Cancer (IASLC) has conducted an extensive ini... more The International Association for the Study of Lung Cancer (IASLC) has conducted an extensive initiative to inform the revision of the lung cancer staging system. This involved development of an international database along with extensive analysis of a large population of patients and their prognoses. This article reviews the recommendations of the IASLC International Staging Committee for the definitions for the TNM descriptors and the stage grouping in the new non-small cell lung cancer staging system.
Turkiye Klinikleri Journal of Medical Sciences, 2009
Altmış bir yaşında larinks karsinomu öyküsü olan bir hasta hemoptizi şikâyeti ile acil servise ba... more Altmış bir yaşında larinks karsinomu öyküsü olan bir hasta hemoptizi şikâyeti ile acil servise başvurdu. Toraks bilgisayarlı tomografi (BT) incelemesinde, sağ üst lobda düzensiz sınırlı bir kitle görüldü. Fiberoptik bronkoskopi ve BT eşliğinde transtorasik biyopsi yapıldı ancak ...
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Aug 1, 2009
Differences between the individual variations in DNA may modulate lung cancer process. Many studi... more Differences between the individual variations in DNA may modulate lung cancer process. Many studies reported that Vitamin D Receptor (VDR) gene polymorphisms may influence the cancer risk due to their antiproliferative, antiangiogenic, antimetastatic and apoptotic effects. The genotype and haplotype frequencies of three polymorphisms of VDR, i.e. TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232), were studied using PCR-RFLP in 137 patients with lung cancer and 156 controls. Differences were observed in genotype (P=0.024) and allele (P=0.011) frequencies of TaqI polymorphism due to the "T" allele. Furthermore, compared with the "tt" genotype, the odds ratio for the "TT" genotype increased 2.24 times (95%CI=1.05-4.77, P=0.037). Comparing cases and controls, smoking habit (P=0.012) and gender distribution (P=0.005) were found to increase the risk of lung cancer in patients with "TT" homozygotes, demonstrating the role of gene-environment interaction in lung cancer. In addition, when age and gender within the case group only were evaluated in relation to genotype, the adjusted odds ratios for the "TT" genotype increased 2.20 times (95%CI=1.01-4.78, P=0.047) for age and 2.24 times (95%CI=1.05-4.80, P=0.037) for gender. However, no differences were observed for the distribution of variant genotypes of the BsmI and ApaI polymorphisms (P>0.05). To evaluate the joint effects of these polymorphisms, haplotype analysis was performed which showed that the haplotype baT was associated with higher lung cancer risk compared with the most common haplotype BAt (P=0.026). This is perhaps the first study suggesting that TaqI polymorphism of the VDR gene might be a risk factor for lung cancer and that age, gender, and smoking habit could have an impact on lung cancer risk.
Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successful... more Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successfully in the palliative treatment of the patients with lung cancer. The patients with tracheobronchial obstruction may develop many symptoms like dyspnea, cough and haemoptysis, and atelectasis and pneumonia but these symptoms were recovered with applying interventional bronchoscopic methods. These methods are laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy and airway stents. The obstructed airway was reopened by these bronchoscopic methods and dyspnea, atelectasis and post-obstructive pneumonia were relieved. In addition, with establishment of the airway patency, chemotherapy and/or radiotherapy may be applied to the patients with lung cancer. The treatment of tracheobronchial obstruction was achieved a thorough evaluation of the etiology, physiology, diagnostic and treatment options of the disease and a multidisciplinary team approach including anesthesiology, medical oncology, thoracic surgery, radiology and interventional pulmonology. In this multidisciplinary team approach, all of the doctors dealing with the diagnosis and treatment of lung cancer should know interventional bronchoscopic methods, endobronchial treatment, and indications of these procedures. The aim of this review is to fresh our knowledge about the interventional bronchoscopic treatment methods in patients with lung cancer.
Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successful... more Bronchoscopy used commonly in the diagnosis and staging of the lung cancer was applied successfully in the palliative treatment of the patients with lung cancer. The patients with tracheobronchial obstruction may develop many symptoms like dyspnea, cough and haemoptysis, and atelectasis and pneumonia but these symptoms were recovered with applying interventional bronchoscopic methods. These methods are laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy and airway stents. The obstructed airway was reopened by these bronchoscopic methods and dyspnea, atelectasis and post-obstructive pneumonia were relieved. In addition, with establishment of the airway patency, chemotherapy and/or radiotherapy may be applied to the patients with lung cancer. The treatment of tracheobronchial obstruction was achieved a thorough evaluation of the etiology, physiology, diagnostic and treatment options of the disease and a multidisciplinary team appro...
Turkiye Klinikleri Journal of Pulmonary Medicine, 2004
Akciğer kanseri tüm dünyada milyonlarca insanın ölümüne yol açan en yaygın tümörlerden birisidir.... more Akciğer kanseri tüm dünyada milyonlarca insanın ölümüne yol açan en yaygın tümörlerden birisidir. 1 Yıllardır yapılan araştırmalara rağmen akciğer kanserinin prognozu hala çok kötüdür. Ancak erken evrelerde tanı konulan akciğer kanserlerinde kür sağlanabilir. İleri ...
Poor prognosis in the lung cancer result from early metastatic potential of the tumoral cells. Th... more Poor prognosis in the lung cancer result from early metastatic potential of the tumoral cells. The mechanisms of tumoral cell metastasis are complex. Adhesion molecules play an important role in metastatic process, which is cell-to-cell and cell-to-matrix interactions and chemokins which arrange the migration and growth of the cells are also important in metastatic biology. The aim of this study is to investigate the prognostic relevance of carcinoembrionic antigen cell adhesion molecule 1 (CEACAM1) and chemokine receptor CXCR4 expression in patients with non-small cell lung cancer (NSCLC). Using immunohistochemical analysis, we evaluated CEACAM1 and CXCR4 expression in parafine specimens from 50 patients with NSCLC confirmed histopathologically and the relationship between CEACAM1 and CXCR4 expression and the prognosis. Twenty-one (42%) patients were positive and 29 (58%) were negative for CEACAM1 expression. Patients whose tumors had CEACAM1-positive staining had a shorter duration of survival than patients whose tumors had no expression, but it was not significant statistically [8.93 ± 8, (median: 8) vs 12.3 ± 11.3, (median: 9), p> 0.36]. Twenty-three (46%) patients were positive and 27 (54%) were negative for CXCR4 expression. Patients whose tumors had CXCR4-positive staining had a longer duration of survival than patients whose tumors had no expression, but it was not significant statistically [12.8 ± 12.4, (median: 12) vs 9.3 ± 7.6, (median: 8), p> 0.14]. In conclusion, CEACAM1 and CXCR4 played a part in metastatic process in lung cancer may not affect on survival independently. The biologic mechanisms leading to the spread of tumor cells are complex and related multifactoriel process.
Chronic airway inflammation is reported to have an important role for the development of chronic ... more Chronic airway inflammation is reported to have an important role for the development of chronic obstructive pulmonary disease (COPD), in addition to smoking, genetic and environmental factors. The present study was aimed to investigate whether the airway inflammation differed in subjects with stable COPD and healthy smokers. A total of 35 subjects (18 patients with COPD and 17 healthy smokers) were enrolled in this study. Bronchoalveolar lavage (BAL) was performed via fiberoptic bronchoscope in all subjects and cell counts and profiles and lymphocyte subset were analyzed in BAL fluids. The number of neutrophils in BAL of subjects with stable COPD was significantly higher than that of the healthy smokers (p< 0.001), and the number of macrophages was significantly lower than that of the healthy smokers (p< 0.001). Although CD4+ T:CD8+ T lymphocyte ratio was higher in healty smokers, the difference was not significant (p> 0.05). As a result, the most marked cellular change in BAL of subjects with stable COPD is the increase in neutrophils and decrease in macrophages, suggesting a very important role in the chronic airflow limitation.
Collagen tissue diseases are multisystem and heterogeneous group disease mediated inflammatory di... more Collagen tissue diseases are multisystem and heterogeneous group disease mediated inflammatory disorders. The pulmonary manifestations is more common and all elements of the lung are involved. However, symptoms of the respiratory system may be masked by exercise limitation due to involvement of the musculoskeletal system. The involvement may be subclinical or determined fulminant and life-threatening dimension. In this review, the pulmonary involvement of the more common collagen tissue diseases are reviewed.
The International Association for the Study of Lung Cancer (IASLC) has conducted an extensive ini... more The International Association for the Study of Lung Cancer (IASLC) has conducted an extensive initiative to inform the revision of the lung cancer staging system. This involved development of an international database along with extensive analysis of a large population of patients and their prognoses. This article reviews the recommendations of the IASLC International Staging Committee for the definitions for the TNM descriptors and the stage grouping in the new non-small cell lung cancer staging system.
Turkiye Klinikleri Journal of Medical Sciences, 2009
Altmış bir yaşında larinks karsinomu öyküsü olan bir hasta hemoptizi şikâyeti ile acil servise ba... more Altmış bir yaşında larinks karsinomu öyküsü olan bir hasta hemoptizi şikâyeti ile acil servise başvurdu. Toraks bilgisayarlı tomografi (BT) incelemesinde, sağ üst lobda düzensiz sınırlı bir kitle görüldü. Fiberoptik bronkoskopi ve BT eşliğinde transtorasik biyopsi yapıldı ancak ...
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Aug 1, 2009
Differences between the individual variations in DNA may modulate lung cancer process. Many studi... more Differences between the individual variations in DNA may modulate lung cancer process. Many studies reported that Vitamin D Receptor (VDR) gene polymorphisms may influence the cancer risk due to their antiproliferative, antiangiogenic, antimetastatic and apoptotic effects. The genotype and haplotype frequencies of three polymorphisms of VDR, i.e. TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232), were studied using PCR-RFLP in 137 patients with lung cancer and 156 controls. Differences were observed in genotype (P=0.024) and allele (P=0.011) frequencies of TaqI polymorphism due to the "T" allele. Furthermore, compared with the "tt" genotype, the odds ratio for the "TT" genotype increased 2.24 times (95%CI=1.05-4.77, P=0.037). Comparing cases and controls, smoking habit (P=0.012) and gender distribution (P=0.005) were found to increase the risk of lung cancer in patients with "TT" homozygotes, demonstrating the role of gene-environment interaction in lung cancer. In addition, when age and gender within the case group only were evaluated in relation to genotype, the adjusted odds ratios for the "TT" genotype increased 2.20 times (95%CI=1.01-4.78, P=0.047) for age and 2.24 times (95%CI=1.05-4.80, P=0.037) for gender. However, no differences were observed for the distribution of variant genotypes of the BsmI and ApaI polymorphisms (P>0.05). To evaluate the joint effects of these polymorphisms, haplotype analysis was performed which showed that the haplotype baT was associated with higher lung cancer risk compared with the most common haplotype BAt (P=0.026). This is perhaps the first study suggesting that TaqI polymorphism of the VDR gene might be a risk factor for lung cancer and that age, gender, and smoking habit could have an impact on lung cancer risk.
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