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Lung Cancer Imaging: Screening Result and Nodule Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042460. [PMID: 35206646 PMCID: PMC8874950 DOI: 10.3390/ijerph19042460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 02/07/2023]
Abstract
Background: Lung cancer (LC) represents the main cause of cancer-related deaths worldwide, especially because the majority of patients present with an advanced stage of the disease at the time of diagnosis. This systematic review describes the evidence behind screening results and the current guidelines available to manage lung nodules. Methods: This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The following electronic databases were searched: PubMed, EMBASE, and the Web of Science. Results: Five studies were included in the systematic review. The study cohort included 46,364 patients, and, in this case series, LC was detected in 9028 patients. Among the patients with detected LC, 1261 died of lung cancer, 3153 died of other types of cancers and 4614 died of other causes. Conclusions: This systematic review validates the use of CT in LC screening follow-ups, and bids for future integration and implementation of nodule management protocols to improve LC screening, avoid missed cancers and to reduce the number of unnecessary investigations.
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Bartkowiak K, Casjens S, Andreas A, Ačkar L, Joosse SA, Raiko I, Brüning T, Geffken M, Peine S, Johnen G, Weber DG, Pantel K. Sensitive Blood-Based Detection of Asbestos-Associated Diseases Using Cysteine-Rich Angiogenic Inducer 61 as Circulating Protein Biomarker. Clin Chem 2020; 67:363-373. [PMID: 33336248 DOI: 10.1093/clinchem/hvaa232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Detection of asbestos-associated diseases like asbestosis or mesothelioma is still challenging. We sought to improve the diagnosis of benign asbestos-associated disease (BAAD) by detection of the protein cysteine-rich angiogenic inducer 61 (Cyr61) in human plasma. METHODS Plasma Cyr61 was quantified using an enzyme-linked immunosorbent assay. Plasma samples from males diagnosed with BAAD, but without a malignant disease (n = 101), and malignant mesothelioma (n = 21; 15 males, 6 females), as well as nonasbestos-exposed healthy control participants (n = 150; 58 males, 92 females) were analyzed. Clinical sensitivity and specificity of Cyr61 were determined by receiver operating characteristic analysis. RESULTS The median plasma Cyr61 concentration for healthy control participants was 0.27 ng/mL. Cytoplasmic Cyr61 in peripheral blood mononuclear cells from healthy control participants was evenly distributed, as detected by immunofluorescent staining. The increase in plasma Cyr61 concentrations in the BAAD study group was statistically significant compared to the healthy control participants (P < 0.0001). For the detection of BAAD vs male healthy control participants, clinical sensitivity was 88% and clinical specificity 95% with an area under the curve of 0.924 at maximal Youden Index. For a predefined clinical specificity of 100%, the clinical sensitivity was 76%. For male mesothelioma patients vs male healthy control participants, the clinical sensitivity at maximal Youden Index was 95% with a clinical specificity of 100% (area under the curve, 0.997) and for a predefined clinical specificity of 100%, the clinical sensitivity was 93%. CONCLUSIONS In our study, plasma Cyr61 protein concentrations showed to be a new biomarker for asbestos-associated diseases like BAAD and mesothelioma in men, which deserves further investigation in large-scale cohort studies.
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Affiliation(s)
- Kai Bartkowiak
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Antje Andreas
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucija Ačkar
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon A Joosse
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Irina Raiko
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Maria Geffken
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Daniel Gilbert Weber
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Klaus Pantel
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Sartorelli P, Indini S, Bianchi F, D'Alessandro M, Bergantini L, Cameli P, Mazzei MA, Scancarello G, Barabesi L, Bargagli E. Cytological analysis of bronchoalveolar lavage fluid in asbestos-exposed workers. LA MEDICINA DEL LAVORO 2020; 111:379-387. [PMID: 33124609 PMCID: PMC7809980 DOI: 10.23749/mdl.v111i5.9170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/24/2020] [Indexed: 11/17/2022]
Abstract
Background: Asbestos-related lung diseases are a group of heterogeneous disorders with different pathogenesis and prognosis. Very few studies investigated the BALF cell profile of asbestos exposed workers. The existence of a relationship between bronchoalveolar lavage fluid (BALF) cellular pattern and specific diagnosis and/or asbestos exposure biomarkers would allow the identification of effect biomarkers useful in the follow up of asbestos-exposed workers and in the diagnosis of asbestos-related diseases. Objectives: To assess BALF cell profile in formerly asbestos-exposed workers and its relationship with asbestos fibre (amphibole and chrysotile) and asbestos body (AB) concentrations. Methods: 113 male workers formerly exposed to asbestos underwent bronchoscopy with bronchoalveolar lavage and were retrospectively enrolled. 35 of them were affected by pleural plaques and 10 were affected by asbestosis. Pulmonary functional tests (PFT), BALF cellular pattern, BALF mineralogical analysis with asbestos fibres and AB counting were performed in each patient. A statistical analysis with a multivariate linear regression model was adopted. Results: From the statistical analysis of data a direct correlation between pack-years and BALF macrophages was found. Inversely correlation between pack-years and BALF lymphocytes was detected. There was not relationship among BALF cellular pattern, PFT values, specific diagnosis, BALF AB count or BALF asbestos fibre concentration. Discussion: BALF cellular pattern does not seem to be related to asbestos exposure biomarkers like AB and asbestos fibre concentration in BALF. Instead, smoke habit can induce an increase in BALF macrophages and a decrease of BALF lymphocytes count.
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Affiliation(s)
- Pietro Sartorelli
- Department of Medical Biotechnology, University of Siena, Unit of Occupational Health, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Sveva Indini
- Department of Medical Biotechnology, University of Siena, Unit of Occupational Health, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Francesco Bianchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Miriana D'Alessandro
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Laura Bergantini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Paolo Cameli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical Surgical and Neurological Sciences, University of Siena, Unit of Diagnostic Imaging, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
| | - Giuseppina Scancarello
- Unit of Occupational Hygiene and Toxicology, Laboratory of Public Health AUSL South-East Tuscany, Strada del Ruffolo 4, 53100 Siena, Italy.
| | - Lucio Barabesi
- Department of Economics and Statistics, University of Siena, Piazza San Francesco 7, 53100 Siena, Italy.
| | - Elena Bargagli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
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Mazzei MA, Sartorelli P, Bagnacci G, Gentili F, Sisinni AG, Fausto A, Mazzei FG, Volterrani L. Occupational Lung Diseases: Underreported Diagnosis in Radiological Practice. Semin Ultrasound CT MR 2018; 40:36-50. [PMID: 30686366 DOI: 10.1053/j.sult.2018.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Underreporting of occupational lung diseases is a widespread problem in clinical practice. In Europe there is not a common regulation even for the recognition of occupational cancers. Furthermore epidemiologic data on occupational interstitial lung diseases, in general, is limited by no standardized diagnostic criteria, varied physician awareness and training, limitations inherent to the various data sources, and the long latency period. Therefore, to optimize the management of the patient with occupational pathology, the collaboration and skills of the multidisciplinary at the service of the patient, play a fundamental role. In particular, radiologists should give substance to a clinical suspicion on an anamnestic basis and at the same time should recognize patterns of illness that can lead to the emergence of stories of misunderstood exposures. This article aims to provide an overview of the main occupational lung diseases with attention to diagnostic possibilities of the different imaging techniques. The issue of the radiological error is investigated, providing tools to minimize it in the daily practice.
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Affiliation(s)
- Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Pietro Sartorelli
- Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy; Department of Medical Biotechnology, Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Giulio Bagnacci
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy.
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Alfonso Fausto
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Luca Volterrani
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
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