News Tips From The American Thoracic Society Journals
For Immediate Release:
Contact: Christina Shepherd, ATS
212 315-6400
p21 PROTEIN MAY PREDICT DEGREE OF MALIGNANCY IN LUNG CANCER
Lung cancer has one of the worst prognostic outcomes of any human
malignancy. Only 30% of those with the disease are candidates for radical
lung surgery, with a scant 30% of patients who receive the operation
remaining disease free for five years. Better methods are urgently needed
to determine the profile of patients who can successfully undergo
potentially curative surgical resection. Writing in the February "American
Journal of Respiratory Cell and Molecular Biology," Antonio Giordano,
M.D., PhD, of the Jefferson Medical College, Philadelphia, along with 7
associates from Italy, assessed the expression of p21 protein in 60
surgically resected non-small-cell lung cancers. They found that the p21
protein was expressed in both normal and neoplastic tissue. Immunostaining
was considered positive for p21 expression in 80% (48) of the specimens.
p21 was considered to be overexpressed in slightly over 73% based on 5% of
the cells showing positive. They divided their specimens into two groups:
p21 detected in more than 5% of the cells (p21+) and the reamainder
(p21-). The mean survival time for the p21+ group was 36 months versus 13
months for the p21- group. The 5-year survival rate for p21+ lung cancer
patients was 38%, while for p21- it was 12%. The authors, who claim this
is the first report to show a relationship between p21 expression and lung
cancer, believe that the protein may play a predictive role in the clinical
behavior of the disease. They call for additional studies with larger
numbers of lung cancer patients to confirm their observations, including
research with small cell lung cancers.
STUDY QUESTIONS ADVANTAGE OF PEAK FLOW METER MONITORING IN THE SELF-MANAGEMENT OF ASTHMA
The results of a six-month prospective, randomized trial involving 92
patients have led Canadian investigators to question the advantage of peak
flow meter (PFM) monitoring as part of an action plan to aid asthmatics in
self-managing their disease. All of the asthmatic patients were given an
action plan to follow. Forty-four of the patients were assigned to the PFM
group and would seek care from health professionals when there would be
significant decreases in their peak expiratory flow. Forty-eight were
placed in a group who would seek help when their respective symptoms
increased. On a monthly basis, the researchers measured the patients'
breathing capacity, determined symptom scores, and assessed quality of
life, medication use, and health care utilization. In both groups, there
were significant improvements in breathing tests, symptom scores, and
quality of life. Investigators also saw a shift in medication dosage to
lower daily use of beta-agonists and to higher daily doses of inhaled
steroids. Adherence rates to the self-management plan for the PFM group
was 65% and 52% for those who acted when symptoms worsened. Consensus
recommendations and expert guidelines have advocated the use of peak flow
monitoring in the self-management of asthma, but after analyzing all of the
study outcomes, the researchers said that in this particular management
setting, the regular use of PFM did not demonstrate any advantage compared
with responding to increased symptoms. They study was reported in the
February issue of the "American Journal of Respiratory and Critical Care
Medicine."
For more information or for complete manuscripts, contact Christina
Shepherd at the American Thoracic Society. Phone: 212 315-6400. Fax:
212 315-6455.
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