671 672

181

PRYs1c1Ans pBoQyxsIS OF SURVIVAL Ill rmn SULL CFU L4luG CUKx [USCLC]: colparisan with prognostic factors. N F livers [On behalf of the Tboracic Group of the Yorkshire Regional Cancer Gqanisation] Leeds, UK.

hessaent of prqaosis underpins mnagesent of NXLC, but no CoDparisons exist between physician’s opinions, progaostic factor [PF] sodels, and actual survival. 289 cmsecutive unselected patients aasaged as EUC by four physicians aad two oacoloqists uere prospectively studied. At presentation we recorded anthroposetry, WliO activity scare, cell type, 8 blood values, disease extent by 14 variables, aad the severity of 12 symptom The physicians pre- treatmest progsosis [aostbs] was subseqaently cwpared with PF mills and actual survival [?able]. The ilhtrated rode1 uses activity score, anorexia and lymphocyte couat.

8 survivors at: 3 no 12 No

1. All patiats 13 2. Node1

Good prqacsis 88 Nod proqsosis 13 Poor progAs 54

3. opinion: will survive 80 Opinion: will not survive 25

80

46 2a 16 50 21

Conclrian: The physicians’ proqaosis was better than the models at 3 aostbs aad equal at 1 year aad was lore optimistic than reality. The hypothesis that PF aodels can be used to refine clinical opinions now requires testiaq.

673 674

Clinical features of cavitary lung cancers. N.Suzuki, K.Yamanaka, S.Ohno, J.Kobayashi, and S.Kitamura. Department of Pulmonary Medicine,

Jichi Medical School, Tochigi, Japan. We studied the clinical features of cavitary lung

cancers. Cavitation was observed in 66 cases out of 863 patients with lung cancers(7.6%) admitted to Jichi Medical School from 1974 to 1990. The incidence of cavitary formation was from the bottom of 0% in small cell carcinomas(0/144) to the top of 14% in epidermoid carcinomas(41/297). In non-cavitary lung cancers, metastasis was found in 49%(391/798) of all, 31%(81/256) of epidermoid carcinomas, 57%(191/337) of adenocarcinomas, 58%(83/144) of small cell carcinomas, 61%(20/33) of large cell carcinomas, and 57%(16/28) of other undifferentiated carcinomas. In cavitary lung cancers, metastasis was seen in 23%(15/66) of all, 26%(11/42) of epidermoid carcinomas, 21%(4/19) of adenocarcinomas, 0%(0/3) of large cell carcinomas, and 0%(0/2) of other carcinomas. Compared with non- cavitary lung cancers, the incidence of hematogenous metastasis was significantly decreased in cavitary lung cancers(p 0.01) and especially cavitary adeno- carcinomas(p 0.05). Six patients with cavitary lung cancers died of massive hemoptysis. On X-ray findings, all of them showed thick irregular walls with central cavitation, and the walls became thinner before their episodes of hemoptysis. Above results may suggest that cavitary lung cancers cause hematogenous metastasis less frequently and that it might be possible to predict massive hemoptysis from X-ray findings.

USEFULNESS OF ENDOTOXIN ASSAY IN INFECTIONS ACCOMPANIED WITH PRIMARY LUNG CANCER. Y.Shibuya, N.Suziki.A.Hoshi.Y.Sugiyama and S.Kitamura.

Department of Pulmonary Medicine,Jichi Medical School, Tochigi,JAPAN.

As developing methods of the assay for endotoxin, various clinical applications are possible.In order to evaluate the usefulness of endotoxin assay in infecti- ons accompanied with primary lung cancer particularly in the case of fungal infections,we measured serum endotoxin concentrations of 55 patients suffering from primary lung cancer.Patients were assayed for the titer of the test specific to endotoxin(Endospecy,cut off level:3.0pg/ml)and activity of the conventional limulus test(Toxicolor,cut off level:7.0pg/ml).Classi- fication of the diseases and the levels of Toxicolor were following:primary lung cancer without any infec- tions were 3.3&3.lpg/ml(mean#.D.,n=3l),primary lung cancer associated with fungal infections were 35.7*28. 4(n=8),primary lung cancer associated with bacterial infections were ll.u10.7(n=14),prinary lung cancer associated with radiation pneumonitis were 47.0f25.3 (n=3).Candida albicans and Candida glabrata were Isola- ted from 3 cases.In these cases the levels of Toxicolor were 89.M26.2.Levels of Endospecy were normal in any cases.In our data,Toxicolor levels of fungal infect- tions were significantly high* then those of Endospecy level particularly in the case of candidemia.The high Toxicolor levels with normal Endospecy levels may sug- gest fungal infections except the cases such as radia- tion pneumonitis.

Peripheral blood YE; T cells in lung cancer and infectious pulmonary diseases

Masami Ito, Naoyoshi Kojiro, Toshiyuki Ikeda, Takashi Ito, Junichi Funada, and Tatsuo Kokubu (Dept. of Internal Med., Kinki Central Hospital, Hyogo, Japan)

Most peripheral T cells express the ab T-cell antigen receptor (TcR). Normally, however, there is a small population of peripheral T cells bearing the y6 TCR. Recently, increased attention has focused on the role of y6 T cells in the defense against invading microor- ganisms and tumor cells. The present study was designed to evaluate the levels of y& T cells in lung cancer and infectious pulmonary diseases. Peripheral blood samples were obtained from patients with lung cancer (n=20), tuberculosis (n=17), bacterial pneumo- nia (n=13), chronic lower respiratory tract infection (n=13), and normal controls with (n=18) or without (n=21) old tuberculous lesion. Peripheral blood YS T cells were measured by the immunofluorescence assay using PE-conjugated anti-CD3 and FITC-conjugated anti- TCRAi mAbs. The results showed that only patients with tuberculosis had significantly increased propor- tions of y6 T cells as compared to patients with lung cancer, nontuberculous infection, and controls with or without old tuberculous lesion. In conclusion, the increased proportions of peripheral blood y6 T cells in tuberculosis could be related to T-cell activation by Mycobacterium tuberculosis, although it remains to be investigated which components of mycobacteria are the major ligands for y& T cells.