Attenuation of oxidant / antioxidant imbalance during treatment of exacerbations of chronic obstructive pulmonary disease

protein components of the extracellular matrix, activate latent enzymes such as type IV colBackground – The peripheral blood concentrations of several proteases of the clotlagenase, and dissolve tumour associated fibrin clots. Circulating markers of the fibrinolysis ting system have been shown to predict survival in patients with malignancy. A system are raised in patients with lung cancer and they have been shown to correlate with study was undertaken to investigate the independent value of the plasma levels of tumour burden, clinical progression, and the response to chemotherapy. The aim of this the D-dimer degradation product of fibrin before treatment for predicting prognosis study was to investigate the independent value of the pretreated plasma levels of -dimer fibrin in patients with lung cancer. Methods – The study comprised 70 patients degradation products for predicting prognosis in patients with lung cancer. with lung cancer (49 non-small cell lung cancer and 21 small cell lung cancer). Plasma levels of D-dimer were measured using an enzyme immunoassay kit. MultiMethods variate statistical analysis was carried Seventy consecutive patients with lung cancer, out using the Cox’s proportional hazards of median age 65 years (range 20–83), admitted model. to the Mie University Hospital from July 1990 Results – The median value of the plasma to December 1991 took part in the study. There level of D-dimer differentiated two groups were 49 cases with non-small cell lung cancer of patients with different outcomes: a (non-SCLC) and 21 with small cell lung cancer group with a D-dimer level of <150 ng/ml (SCLC). Clinical staging was performed ac(low DD group) and those with D-dimer cording to the new international staging system. levels of [150 ng/ml (high DD group). Patients underwent curative surgery (n=20) Survival time was significantly better in or combination chemotherapy followed by patients in the low DD group than in those radiotherapy (n=50). Venous blood samples in the high DD group in all patients (hazwere taken 1–5 days (median two days) before ard ratio for high DD group=4.7; 95% starting any treatment and stored at −80°C confidence interval (CI) 1.8 to 11.7). The until needed. Plasma levels of -dimer were plasma levels of D-dimer predicted surdetermined using an enzyme immunoassay kit vival independently from the clinical stage (Dimertest, Agen, Mountain View, California, of disease, histological type, performance USA). -dimer levels were also measured in status, and tumour size (hazard ratio= blood samples from age matched healthy vo3.9; 95% CI 1.6 to 9.2). lunteers (n=40) and from patients with benign Conclusions – These results suggest that pulmonary disease (n=25). There was a history plasma levels of D-dimer might be useful of smoking in 50 patients with lung cancer, in for predicting the clinical outcome in 15 with benign disease, and in 10 healthy patients with lung cancer. However, fursubjects. The intra-assay and inter-assay prether prospective studies are needed in a cision of -dimer concentrations was 5.4% and The Third larger population to confirm these find9.5%, respectively. Written consent was obDepartment of ings. tained from all subjects and the investigation Internal Medicine, (Thorax 1997;52:563–565) Mie University School was carried out according to the conditions of of Medicine, the Helsinki declaration. 514 Edobashi,