Aberrant p16 promoter hypermethylation in bronchial mucosae as a biomarker for the early detection of lung cancer.
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Biomedical subjects
Publications and source records attributed to Guang-shun Xie.
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OBJECTIVE: To investigate the clinical features and diagnostic procedures for diffuse panbronchiolitis in Chinese patients. METHODS: With literature review, the clinical features and diagnostic procedures of diffusely panbronchiolitis in a series of 9 patients with histopathological confirmation were retrospectively described and discussed. RESULTS: Of the 9 cases, 8 had persistent cough, sputum production and exertion dyspnea, 7 had chronic sinusitis, 9 had centrilobular micronodules on chest CT, 7 had coarse crackles, 4 had FEV(1)/FVC < 70%, 5 had PaO(2) < 80 mm Hg and 1 had titer of cold hemagglutinin > or = 1:64. According to the Japanese revised clinical diagnostic criteria for diffuse panbronchiolitis, definite diagnosis could be made in 4 cases, probable in 3 and excluded in 2 cases, respectively, but it was clinically diagnosed or suspected only in 2 cases before clinicopathological confirmation, the remaining 7 cases were missed or mistaken for other diseases. Of the 9 cases, 8 had received transbronchial biopsy and all showed non-specific inflammation, which was in agreement with but nondiagnostic for diffuse panbronchiolitis. CONCLUSIONS: Most cases of diffuse panbronchiolitis can be clinically diagnosed or suggested according to the clinical diagnostic criteria, proposed solely by Japanese experts which should be further validated in non-Japanese populations. If difficulty in diagnosis arises, the diagnosis of diffuse panbronchiolitis should be based on its clinicopathological features and exclusion of other mimicking diseases. Of note, few cases can be confirmed by transbronchial biopsy, and in this case, surgical lung biopsy should be considered.
BACKGROUND: Diffuse panbronchiolitis (DPB) was originally and is still primarily reported in Japan, rarely in other countries. As macrolide therapy is effective for this disease with once dismal prognosis, familiarity with its clinical features is urgently needed, especially for clinicians outside Japan. The objectives of this study were to investigate the clinical features of DPB in a Chinese population and propose diagnostic procedures that will lead to increased awareness of this treatable disease among clinicians, ultimately allowing for more rapid diagnosis. METHODS: After a literature review, the clinical features of DPB were histopathologically confirmed in a series of 9 cases either by open lung biopsy or video-assisted thoracic surgical biopsy, resulting in the largest series of confirmed DPB cases in a non-Japanese population. Here, the cases are retrospectively described and diagnostic procedures are discussed. RESULTS: Persistent cough, sputum, and exertion dyspnea occurred in 89% of patients, a history of or current chronic sinusitis in 78%, centrilobular micronodules appearing on chest CT scans in 100%, coarse crackles in 78%, FEV1/FVC < 70% in 44%, PaO2 < 80 mmHg in 56%, and titer of cold hemagglutinin > or = 1:64 in 11%. According to its clinical diagnostic criteria, diagnosis was definitive in 44%, suggested in 33%, and excluded in 23% at the time of diagnosis. However, DPB was clinically considered before confirmation in only 22% of patients, with the remaining 78% of cases missed or mistaken for other diseases. Of the 9 cases, 8 received transbronchial biopsies before confirmation of the diagnosis, but all showed non-specific inflammation. CONCLUSIONS: Although its clinical features may vary with disease course and ethnic populations, most cases of DPB can be diagnosed or suggested according to clinical diagnostic criteria. However, underdiagnosis as a result of unfamiliarity with its clinical features and diagnostic criteria prevails. If difficulty in diagnosis arises, the diagnosis should be based on clinicopathological features and the exclusion of other diseases. Few cases can be confirmed by transbronchial biopsies; in these cases, either an open-lung biopsy or a video-assisted thoracic surgical lung biopsy should be recommended.
BACKGROUND: Recent studies suggest that circulating DNA may be a potential tumor marker for lung cancer, but most of these studies are conducted between healthy controls and lung cancer patients, with few or no benign lung disease patients included. The objective of this study was to evaluate the performance of plasma DNA quantification in discriminating lung cancer from the healthy and benign lung disease. METHODS: Plasma DNA was extracted with a QIAamp DNA Blood Midi kit and quantified by a PicoGreen dsDNA quantitation kit in 44 healthy individuals, 36 benign lung disease patients and 67 lung cancer patients. Discrimination power was evaluated by the receiver operating characteristic curve. RESULTS: Plasma DNA values were significantly increased in lung cancer patients, especially in those with metastases, and in benign lung disease patients compared with that in the healthy individuals (P < 0.001, respectively). The values in lung cancer patients were significantly increased compared with that in the benign lung disease patients (P < 0.001). The area under the curve was 0.96 [95% confidence interval (CI) 0.92 - 0.99] for the healthy versus lung cancer, 0.73 (95% CI 0.64 - 0.83) for lung cancer versus benign lung disease, and 0.86 (95% CI 0.80 - 0.91) for lung cancer versus the healthy and benign lung disease. CONCLUSIONS: Plasma DNA quantification has a strong power to discriminate lung cancer from the healthy and from the healthy and benign lung disease, less power to discriminate lung cancer from benign lung disease. Plasma DNA quantification may be useful as a screening tool for lung cancer.