New prognostic factor of lung cancer are being intensively studied currently. A small number of studies compare the importance of molecular makers with so far known functional and clinical prognostic factors. Purpose of this study was to find out whetherp16(ink4) expression is more superior prognostic factor in survival rates in non-small lung cancer (NSCLC) patients than spirometry tests. 100 NSCLC patients (50 squamous and 50 adenocarcinoma) with IIIB and IVA stage and 80 healthy individuals were included. p16(ink4) was immunohistochemicaly detected on formalin-fixed tissues. We measured s pirometry tests : vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in first second (FEV1), Tiffeneau index (FEV1/FVC ratio) and forced expiratory flow 25% to 75%. 2-year progression-free survival (PFS) and overall survival (OS) were observed. Low p16(ink4) expression and impared spirometry parameters correlated with worse 2-year survival outcomes, in both adenocarcinoma and squamous carcinoma. In squamous carcinoma p16(ink4) expression was an independent negative prognostic marker. Severe impairments of spirometry tests had similar prognostic value as low p16(ink4) expression in both NSCLC subtypes. In contrast to p16 (ink4) as a negative molecular prognostic factor, spirometry testings are widely achievable and affordable and could be serviceable prognostic marker in NSCLC patients in advanced NSCLC. Further studies including all clinical stages of NSCLC are needed.

Growing body of evidence suggests that molecular markers are an important prognostic marker for non-small lung cancer (NSCLC). Using targeted therapy based on these markers leads to improved outcomes in lung adenocarcinoma. However, progress of targeted therapy in squamous lung cancer is still modest. p16(ink) protein acts as tumor suppressor and vascular endothelial growth factor (VEGF) promotes tumor angiogenesis. Purpose of this study was to evaluate the difference in p16(ink4) and VEGF expression between squamous and adenocarcinoma of the lung; to evaluate the relationship of p16(ink4) and VEGF expression to survival outcomes in NSCLC patients, and the difference of their prognostic values between squamous and adenocarcinoma subtypes. 100 NSCLC patients (50 squamous and 50 adenocarcinoma) and 80 healthy individuals were included. p16(ink4) and VEGF proteins were immunohistochemicaly detected on formalin-fixed tissues. One- and 2-year progression-free survival (PFS) and overall survival (OS) were observed. p16(ink4) expression was significantly lower in squamous type compared to adenocarcinoma. In both squamous and adenocarcinoma, high VEGF expression correlated with worse 1-year PFS and OS, but only with worse 2-year PFS. Low p16(ink4) expression correlated with worse 1- and 2-year PFS, as well as OS, in both NSCLC subtypes. In squamous lung cancer p16(ink4) expression was an independent negative prognostic marker. Our study confirms the difference of p16(ink4) protein expression in squamous and adenocarcinoma of the lung. Besides anti-VEGF therapy, the regulation of p16(ink4) expression could have a therapeutic potential in NSCLC, especially in squamous lung cancer.

Angiogenesis is a critical event in the development, progression, and spread of various human cancers, including lung cancer. Molecular mechanisms that underlie the complex regulation of angiogenic processes are poorly understood. However, an increasing body of evidence indicates miRNAs as important regulators of tumor angiogenesis. Forceps biopsies were collected from tumor tissue, surrounding tissue, and non-tumor tissue from 50 NSCLC patients. Lung tissue samples from individuals with no clinical evidence of a cancerous disease served as controls. Immunohistochemical staining for Factor VIII was used to evaluate microvessel density (MVD). TaqMan® primer-probe sets were used in quantitative real-time RT-PCR reactions to determine expression levels of let-7b, miR-126, miR-9, and miR-19a. We demonstrated significantly higher MVD and decreased expression levels of let-7b and miR-126 in tumor tissue and surrounding tissue in comparison to corresponding non-tumor tissue or lung tissue from the control group. In addition, no differences in MVD and expression levels of both miRNAs between tumor tissue and surrounding tissue from NSCLC patients were observed. Low expression of both miRNAs correlated with high MVD and worse progression-free survival and overall survival. These observations strongly suggest similar molecular alternations within tumor tissue and surrounding tissue that comprise a specific microenvironment. Low expression of let-7b and miR-126 seems to have a possible anti-angiogenic role in lung tumor tissue and significantly correlates with worse survival outcomes for lung cancer patients. Moreover, the regulation of let-7b and miR-126 expression could have therapeutic potential because it could reduce tumor angiogenesis and therefore suppress tumor growth in lung cancer patients.

Objective: The primary goal of this study was to determine the difference of abundance of CD4+, CD8+ and CD56+ bronchoalveolar fluid’s lymphocytes and their subpopulations between cancerous lung and healthy lung from the same patient. Methods: Mini-bronchoalveolar lavage was taken from 55 patients from lung with cancer and healthy lung. After laboratory processing and addition of CD4, CD8, CD27, CD28 and CD56 antibody, the material was analyzed by flow cytometer. Results from lung with cancer were compared to the ones from the healthy lung. The examined patients were the test and the control group at the same time. Results: CD27+28+ forms of CD4+ and CD8+ lymphocytes are more activated in the cancerous lung compared to healthy lung, while the CD27-28- forms are less activated in diseased lung. CD4+ forms of CD56+ lymphocytes are more activated in cancerous lung compared to the health lung, while the CD8+ forms are less activated in diseased lung. Conclusion: Immature helper and cytotoxic T lymphocyte response, as well as regulatory NK and NKT cell response are more activated in cancerous lung compared to the health lung of the same patient.

Lymphangioma is a malformation composed of a mass of dilated lymph vessels typically found in the cervical region in children. Mediastinal lymphangioma is a rare condition and accounts for 0.01% to 4.5% of all mediastinal tumors. Only 4 cases of mediastinal lymphangioma involving the heart and great vessels in adults have been described in the available literature. Extremely rarely, lymphangiomas occur as a generalized lymphangiomatosis. We present a case of a woman who coughed up small amounts of fresh blood during 6 months and showed signs of cardiac failure. Several years previously, the patient underwent surgical removal of cystic lymphangiomas from the left ovary, both fallopian tubes and small intestine. A chest radiograph showed an 8-cm round shadow located in the middle lobe. A computerized tomography (CT) scan of the chest with contrast verified the existence of a cyst in the anterior mediastinum. The radiologist suggested that the cyst could have originated in the pericardium. One small cyst also appeared in the projection of the left cardiophrenic sinus. A CT scan with contrast of the patient’s abdomen showed multiple cystic formations in the liver, spleen, kidneys, and left parapelvic region. A fine-needle biopsy of the mediastinal tumor verified the cystic lymphangioma, which was then completely removed surgically. A pathohistological examination confirmed the existence of cystic lymphangioma. The patient was discharged after a period of recovery.

Early detection and treatment of preneoplastic lesions represents an obvious option to reduce morbidity and mortality from lung malignancies. Until now, radiological detection, sputum cytology, and autofluorescence have shown limited effectiveness as screening methods. Novel technologies such as Narrow Band Imaging (NBI) are showing promising results, but new studies are still needed to evaluate their use as screening methods. Together with early detection, adequate methods of lesion treatment, such as argon plasma coagulation, are needed. This case report concerns a 45-year-old man who was referred for bronchoscopy after his annual checkup. Using NBI technology, a preneoplastic lesion was identified, and treated using argon plasma coagulation. Our experience has shown us that both NBI screening and argon plasma coagulation are very promising, easily implemented, methods.