Mehmet Zeki Gunluoglu

Background: The ability to predict the survival of patients with non-small cell lung cancer (NSCLC) can provide a basis for individualized treatment and follow-up. Determination of positron emission tomography/computed tomography (PET/CT) parameters, i.e., maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), may improve predictions of survival for NSCLC patients. Objectives: To determine the relationship between the PET/CT-derived parameters SUVmax, SUVmean, MTV, and TLG and survival in NSCLC patients. Patients and Methods: Patients with NSCLC diagnosed at our clinic between January 2019 and October 2020 were evaluated retrospectively using data obtained from the electronic database. The study population consisted of 132 patients over 18 years of age who had a PET/CT scan before receiving any treatment for NSCLC. During their initial PET/CT evaluation, SUVmax, SUVmean, MTV, and TLG were calculated. Correlations between the variables were analyzed using Spearman’s correlation test, and the associations of the variables with patient survival were determined using the Cox proportional hazards regression model. Results: The overall 2-year survival rate of the patients was 36.6%. In the univariate analysis, MTV and TLG, but not SUVmax or SUVmean, were significantly associated with survival (P = 0.8, P = 0.003, and P = 0.045, respectively). In the multivariate analysis, MTV was related to a higher risk of death in patients with adenocarcinoma, lymph node involvement, or distant metastasis. By contrast, TLG was associated with a lower risk of death in patients with adenocarcinoma (ACA) or distant metastasis. Conclusion: Among the parameters obtained in PET/CT studies, SUVmax and SUVmean were not related to the survival of patients with NSCLC. However, MTV was associated with a higher risk of death, while TLG was associated with a lower risk of death in patients with adenocarcinoma or distant metastasis. Further studies with larger samples are needed to validate these results.

Background/aim: LUNGBANK was established as a pioneering biorepository dedicated to lung cancer. Designed for streamlined biospecimens handling, it employs high-volume technologies to secure high-quality samples. Fortified with robust data management, LUNGBANK efficiently integrates diverse datasets. This strategic infrastructure positions LUNGBANK as more than a biospecimens repository; it operates as a sophisticated platform for advanced lung cancer research, amplifying the potential for meaningful discoveries.Materials and methods: LUNGBANK is intricately designed to streamline the collection, transfer, storage, and processing of biospecimens, employing high-volume technologies to ensure the acquisition of high-quality biological specimens. The system is fortified with robust data management protocols, facilitating efficient integration of diverse datasets. This strategic infrastructure ensures that LUNGBANK not only serves as a repository of biospecimens but also operates as a sophisticated platform for advanced lung cancer research.Results: LUNGBANK plays an essential role in furnishing a rich collection of biospecimens essential for unraveling the molecules and mechanisms linked to lung cancer. Rigorous standard operating procedures guided the meticulous collection of biospecimens, subjecting them to stringent quality control measures before inclusion in the study. Moreover, LUNGBANK has proven valuable in the establishment of patient-derived systems. The incorporation of cutting-edge technologies guarantees the acquisition of top-tier data, thereby amplifying the likelihood of substantial breakthroughs in both contemporary translational research and traditional histological evaluations.Conclusion: The establishment of LUNGBANK marks a significant stride towards addressing the pressing need for effective diagnostic and therapeutic systems in lung cancer research. By facilitating the collection and analysis of high-quality biospecimens, LUNGBANK serves as a valuable resource for unraveling the molecular intricacies of lung cancer initiation and progression. This comprehensive system not only supports Project LUNGMARK but also contributes to the broader landscape of personalized medicine, tailoring interventions to the specific needs of lung cancer patients.

Background: Group 2 innate lymphoid cells (ILC2) can be activated by interleukin (IL)-33 or IL-25. IL-25-activated ILC2 cells help protect the host against helminth infection while exacerbating allergic-like inflammation and tissue damage in the lung. In the context of cancer, IL-33-activated ILC2 cells were found to bear anti-tumoral functions in lung cancer while IL-25-activated ILC2 cells promoted tumorigenesis in colorectal cancer. The role of IL-25-activated ILC2 cells in lung cancer remains to be addressed.Methods: We examined the overall survival of human non-small cell lung cancer (NSCLC) patients according to IL25 expression as well as the distribution of ILC2 cells and regulatory T cells (Tregs) in various NSCLC patient tissues and peripheral blood (PB) of healthy donors (HDs). We analyzed the effect of adoptive transfer of IL-25-activated ILC2 cells on tumor growth, metastasis and survival in a heterotopic murine model of lung cancer.Results: We report that human NSCLC patients with high IL-25 expression have reduced overall survival. Moreover, NSCLC patients bear increased frequencies of ILC2s compared to HDs. Frequencies of Tregs were also increased in NSCLC patients, concomitantly with ILC2s. In mice bearing heterotopic lung cancer, adoptive transfer of IL-25-activated ILC2s led to increased tumor growth, increased metastasis and reduced survival. The frequencies of monocytic myeloid-derived suppressor cells (M-MDSCs) were found to be increased in the tumors of mice that received ILC2s as compared to controls.Conclusion: Overall, our results indicate that the IL-25/ILC2 axis promotes lung cancer potentially by recruiting immune-suppressive cells to the tumors both in humans and in mice, and that it may therefore represent a suitable novel target for NSCLC immunotherapeutic development.

It is now clear that group 2 innate lymphoid cells (ILC2) play crucial and sometimes opposing roles in the lung, such as restoring barrier function and integrity after viral infections or, on the contrary, exacerbating inflammation and tissue damage in allergic asthma. However, their role in lung cancer is still unclear. Here, we report that human non-small cell lung cancer patients bear increased frequencies of ILC2s in tumors, normal lung tissue and peripheral blood (PB) as compared to PB from healthy donors (HDs). Frequencies of Foxp3 ⁺ regulatory T cells were also increased in NSCLC patients, concomitantly with ILC2s. In mice bearing heterotopic lung cancer, adoptive transfer of ILC2s led to increased tumor growth and reduced survival. The frequencies of monocytic myeloid-derived suppressor cells (M-MDSCs) were found to be increased in the tumors of mice that received ILC2s as compared to controls. Overall, our results indicate that ILC2 cells play a pro-tumoral role in lung cancer potentially by recruiting immune-suppressive cells to the tumors.

Rapid developments and increasing technological knowledge have changed perspectives on ultrasonography. Previously, ultrasonography was used to evaluate chest wall pathologies, to distinguish between pleural effusion and consolidation, to evacuate pleural effusion, or to evaluate diaphragm movement. Today, it is also used in a wide range of pleural and parenchymal diseases. Ultrasonography is not just used in the emergency department and the intensive care units. It is also utilized in many clinical branches dealing with the respiratory system—due to its ease of use, fast access, price advantage, non-radiation exposure, higher diagnostic sensitivity, and specificity in many clinical situations—and has become a part of the examination. In this review, we have assessed not just transthoracic ultrasonography but also more focal and targeted sonographic applications, such as the endobronchial ultrasound and esophageal ultrasound.

Aims. We investigated the histopathological features of solitary pulmonary necrotic nodules (NNs) of undetermined cause. We combined our findings with those obtained using other methods to determine how well the etiological factors were explained. Methods. We screened patients who underwent surgery to treat solitary pulmonary granulomatous and nongranulomatous NNs of undetermined cause. The NN sizes and features of both the NNs and adjacent parenchyma were evaluated. Histochemical analyses included Ehrlich–Ziehl–Neelsen (EZN), Grocott, and Gram staining. Polymerase chain reaction (PCR) was used to detect tuberculous and nontuberculous mycobacteria, panfungal DNA, Nocardia, Francisella tularensis types A and B, and actinomycetes. Results. The NNs were granulomatous in 78.9% and nongranulomatous in 21% of the 114 patients included. EZN staining or PCR was positive for Mycobacterium in 53.5% of all NNs: 62.2% of granulomatous and 20.8% of nongranulomatous NNs. We found a weak but significant correlation between granulomatous NNs and Bacillus positivity and a significant correlation between granulomas surrounding the NNs and the presence of multiple necroses. The NN etiology was determined via histopathological, histochemical, and PCR analyses in 57% of patients but remained undetermined in 42.9%. Conclusion. The causes of both granulomatous and nongranulomatous NNs can be determined by pathological examination. Granulomatous necrosis and granulomas in the adjacent parenchyma are important for differential diagnosis. When both features are present, they strongly support a diagnosis of tuberculosis, even in the absence of bacilli.

Objective and aim Ischemia-modified albumin (IMA) is a newly recognized marker of chronic inflammation used to evaluate oxidative stress status in patients with various diseases. We explored the possible relationship between IMA levels and obstructive sleep apnea (OSA). Methods In this retrospective study, 169 of 216 sequential patients being evaluated for suspicion of OSAS met inclusion criteria. Polysomnography confirmed OSA in 86 patients (51%) while 81 patients (49%) without OSA were categorized as control subjects. All study participants were tested for blood IMA level, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) level, and red blood cell distribution width (RDW). Results The serum IMA level was significantly higher in patients with OSAS than controls (p = 0.008). The serum IMA level increased significantly as OSAS severity increased (r = 0.50, p < 0.001) and was positively correlated with the AHI (r = 0.41, p < 0.001), CRP level (r = 0.31, p = 0.004), body mass index (r = 0.24, p = 0.022), RDW (r = 0.31, p = 0.03), oxygen desaturation index (ODI) (r = 0.22, p = 0.02), and negatively correlated with the hemoglobin concentration (r = − 0.28, p = 0.04) and minimum hemoglobin oxygen saturation (SpO2) (r = − 0.25, p = 0.02). Receiver operator curve (ROC) analysis showed that the optimal serum IMA, CRP, RDW, and NLR values were not different for predicting OSAS diagnosis (areas under the curves (AUC) = 0.62, 0.59, 0.60, and 0.43, respectively). However, the serum IMA level was superior in reflecting OSAS severity (AUC = 0.78) compared to CRP, RDW, and NLR values (AUC = 0.61, 0.53, and 0.51, respectively) (all p < 0.001). Conclusion Like other markers of inflammation, blood IMA levels were significantly elevated in patients with OSA. However, blood IMA level was a better predictor of disease severity than the other markers.

Purpose The purpose of this study was to evaluate the following parameters after complete resection in established lung cancer patients: the frequency of bronchial stump recurrence (BSR), the effect of the distance between the tumor and bronchial resection margin (DBTM) on BSR, the survival of patients with BSR, and the effect of the DBTM on survival. Patients and Methods We retrospectively evaluated 553 consecutive lung cancer patients who underwent complete lung resection. The patients were classified as DBTM:10mm (group 1), 11 to 20mm (group 2), and>20mm (group 3). Results We found BSR in eight (1.5%) patients. Six patients were in group 1, and two were in group 2. The difference was found to be statistically significant ( p =0004; groups 1 vs. 3). In multivariable analysis, we observed a trend toward significance for the effect of a DBTM on BSR development ( p =0.1). The DBTM did not significantly affect survival ( p =0.61). The survival of patients who developed BSR was significantly poor compared with those who did not develop BSR ( p =0.001). Conclusion BSR can develop even after complete resection of lung cancer. The DBTM is associated with BSR risk, and the survival of patients who develop BSR is poor.