To assess whether intake of selected foods and food groups and adherence to a Mediterranean diet are associated with lung cancer risk in heavy smokers.
In the context of a lung cancer screening ...programme, we invited asymptomatic volunteers, aged 50 years or more, current smokers or recent quitters, who had smoked at least 20 pack-years, to undergo annual low-dose computed tomography. We assessed participants' diet at baseline using a self-administered food frequency questionnaire and calculated their average daily food intake using an ad hoc computer program and determined their alternate Mediterranean diet (aMED) score. We used Cox proportional hazards regression to assess the association between selected food items, beverages and the aMED score and lung cancer risk.
During a mean screening period of 5.7 years, 178 of 4336 participants were diagnosed with lung cancer. At multivariable analysis, red meat consumption was associated with an increased risk of lung cancer hazard ratio (HR) Q4 versus Q1, 1.73; 95% confidence interval (CI) 1.15–2.61; P-value for trend 0.002, while tea consumption (HR for one or more cup/day versus none, 0.56; 95% CI 0.31–0.99; P-value for trend 0.04) and adherence to a Mediterranean diet (HR for aMED≥8 versus ≤1, 0.10; 95% CI 0.01–0.77) were significantly associated with reduced lung cancer risk.
Among heavy smokers, high red meat consumption and low adherence to a Mediterranean diet are associated with increased risk of lung cancer.
Cancer affects a significant percentage of people, and early detection techniques are important for prompt and effective treatment. The use of microwave frequencies to achieve non-invasive and ...non-destructive cancer detections is currently under investigation by several research groups. In this frequency range, the dielectric properties of the biological tissue determine the interactions of the tissue with electromagnetic fields. Knowledge of the dielectric properties of both the normal and the malignant human tissues is therefore a fundamental starting point. A dielectric spectroscopy system, based on the use of a reflectometry setup, was used to perform an extensive experimental campaign on fresh surgical specimens. The measurement system allowed achieving a broadband dielectric characterisation of biological tissues up to 50 GHz, thus including millmetre-wave (mm-wave) frequencies. In the case of breast tissues, the results showed that the malignant and normal tissues exhibit significantly different complex dielectric permittivities of up to 50 GHz, due to their respective high and low water content. This permittivity difference is well detectable, and this paves the way to new screening methods based on mm-wave imaging systems.
Abstract Introduction It is unclear how long low-dose computed tomographic (LDCT) screening should continue in populations at high risk of lung cancer. We assessed outcomes and the predictive ability ...of the COSMOS prediction model in volunteers screened for 10 years. Materials and methods Smokers and former smokers (>20 pack-years), >50 years, were enrolled over one year (2000–2001), receiving annual LDCT for 10 years. The frequency of screening-detected lung cancers was compared with COSMOS and Bach risk model estimates. Results Among 1035 recruited volunteers (71% men, mean age 58 years) compliance was 65% at study end. Seventy-one (6.95%) lung cancers were diagnosed, 12 at baseline. Disease stage was: IA in 48 (66.6%); IB in 6; IIA in 5; IIB in 2; IIIA in 5; IIIB in 1; IV in 5; and limited small cell cancer in 3. Five- and ten-year survival were 64% and 57%, respectively, 84% and 65% for stage I. Ten (12.1%) received surgery for a benign lesion. The number of lung cancers detected during the first two screening rounds was close to that predicted by the COSMOS model, while the Bach model accurately predicted frequency from the third year on. Conclusions Neither cancer frequency nor proportion at stage I decreased over 10 years, indicating that screening should not be discontinued. Most cancers were early stage, and overall survival was high. Only a limited number of invasive procedures for benign disease were performed. The Bach model – designed to predict symptomatic cancers – accurately predicted cancer frequency from the third year, suggesting that overdiagnosis is a minor problem in lung cancer screening. The COSMOS model – designed to estimate screening-detected lung cancers – accurately predicted cancer frequency at baseline and second screening round.
Currently, the acquisition of tissue from metastatic deposits is not recommended as a routine practice. Our aim was to evaluate the discordance rate of estrogen receptor (ER), progesterone receptor ...(PgR), and human epidermal growth factor receptor 2 (HER2) receptor status between primary tumor and liver metastases and its potential impact on treatment choice.
We retrospectively analyzed a database including 1250 ultrasound-guided liver biopsies carried out at the European Institute of Oncology from August 1999 to March 2009. ER, PgR, and HER2 status were determined by immunohistochemistry and/or FISH. Differences between proportions were evaluated using Fisher’s exact test.
We identified 255 consecutive patients with matched primary and liver tissue samples. Changes in ER status were observed in 37 of 255 patients (14.5%). Changes in PgR status were observed in 124 of 255 patients (48.6%). Changes in HER2 status were observed in 24 of 172 assessable patients (13.9%). We observed a discordance in receptor status (ER, PgR, and HER2) between primary tumor and liver metastases, which led to change in therapy for 31 of 255 of patients (12.1%).
Biopsy of metastases for reassessment of biological features should be considered in all patients, when safe and easy to carry out, since it is likely to impact treatment choice.
Robust technique and accurate data analysis are required for reliable computed tomography perfusion (CTp) imaging. Multislice CT is required for high temporal resolution scanning; 16-slice (or ...64-slice) scanners are preferred for adequate volume coverage. After tumour localization, the volume of CTp imaging has to be positioned to include the maximum visible area of the tumour and an adequate arterial vessel. Dynamic scans at high temporal resolution (at least 1-s gantry rotation time) are performed to visualize the first pass of contrast agent within the tumour; repeated scans with low temporal resolution can be planned for late enhancement assessment. A short bolus of conventional iodinated contrast agent, preferably with high iodine concentration, is power injected at a high flow rate (>4 ml/s) in the antecubital vein. The breath-hold technique is required for CTp imaging of the chest and upper abdomen to avoid respiratory motion; free breathing is adequate for CTp imaging of the head, neck and pelvis. Using dedicated software, a region of interest (ROI) has to be placed in an adequate artery (as arterial input) to obtain density-time curves; according to different kinetic models, colour maps of different CTp parameters are generated and generally overlaid on CT images. Additional ROIs can be positioned in the tumour, and in all other parts of the CTp volume, to obtain the values of the CTp parameters within the ROI.
This presentation discusses the optimum magnetic resonance imaging (MRI) sequence for lung cancer assessment in a clinical setting, and the sensitivity and specificity of MRI (alone and in ...combination with diffusion-weighted imaging (DWI)-MR) compared with those of computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (PET) for lung cancer staging. The role of perfusion studies (by CT or MRI), of DWI-MRI, blood oxygenation level dependent sequences and PET in defining the aggressiveness of lung tumours and in evaluating the response to radiochemotherapy is also discussed.
We evaluated the long-term outcomes of a randomized, double-blind, placebo-controlled phase IIb trial of inhaled budesonide in 202 current and former smokers with persistent CT-detected lung nodules. ...Budesonide significantly decreased the size of non-solid nodules after 5 years. This is of potential importance since some of these nodules may progress slowly to adenocarcinoma.
A previously carried out randomized phase IIb, placebo-controlled trial of 1 year of inhaled budesonide, which was nested in a lung cancer screening study, showed that non-solid and partially solid lung nodules detected by low-dose computed tomography (LDCT), and not immediately suspicious for lung cancer, tended to regress. Because some of these nodules may be slow-growing adenocarcinoma precursors, we evaluated long-term outcomes (after stopping the 1-year intervention) by annual LDCT.
We analyzed the evolution of target and non-target trial nodules detected by LDCT in the budesonide and placebo arms up to 5 years after randomization. The numbers and characteristics of lung cancers diagnosed during follow-up were also analyzed.
The mean maximum diameter of non-solid nodules reduced significantly (from 5.03mm at baseline to 2.61mm after 5 years) in the budesonide arm; there was no significant size change in the placebo arm. The mean diameter of partially solid lesions also decreased significantly, but only by 0.69 mm. The size of solid nodules did not change. Neither the number of new lesions nor the number of lung cancers differed in the two arms.
Inhaled budesonide given for 1 year significantly decreased the size of non-solid nodules detected by screening LDCT after 5 years. This is of potential importance since some of these nodules may progress slowly to adenocarcinoma. However, further studies are required to assess clinical implications.
NCT01540552.
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