Viviane De Maertelaer

Pulmonary Emphysema: Size Distribution of Emphysematous Spaces on Multidetector CT Images—Comparison with Macroscopic and Microscopic Morphometry

PURPOSEnTo test the hypothesis that the frequency-size distribution of low-attenuation areas could be a parameter to quantify pulmonary emphysema.nnnMATERIALS AND METHODSnEthics committee approval and written informed consent were obtained. Multidetector computed tomographic (CT) scans were performed with simultaneous acquisition of four 1-mm sections of the whole chest in 80 patients (57 men, 23 women; age range, 38-79 years) who were referred for surgical resection of lung cancer. From the raw data, 1.25-mm-thick sections were reconstructed at 10-mm intervals. The relative area of lung with attenuation coefficients lower than -960 HU (RA(960)) and the 1st percentile of the distribution of attenuation coefficients were calculated. The cumulative frequency-size distributions of the RA(960) and the 1st percentile, when represented on a log-log plot, followed linear relationships. The slopes of these lines (D(960) and D(p1)) were compared with areas found macroscopically to have emphysema and with two different microscopic measurements assessed on resected specimens. Spearman correlation coefficients of each CT index with macroscopic and microscopic measurements were calculated.nnnRESULTSnThe RA(960) and the 1st percentile showed statistically significant correlations with macroscopic and microscopic indexes (P < .001), whereas D(960) and D(p1) did not (P > or = .165).nnnCONCLUSIONnThe RA(960) and the 1st percentile reflect the extent of emphysema as compared to macroscopic and microscopic measurements, while D(960) and D(p1) do not.

Increased expression of high but not low molecular weight heat shock proteins in resectable lung carcinoma

Strong expression of high-molecular-weight (HMW) heat-shock proteins (HSP) by lung carcinoma has been documented using immunohistochemistry. Far less is known about the expression of low-molecular-weight (LMW) HSP in lung cancer. We compared the quantitative expression of HMW (HSP-60, HSP-70) and LMW (HSP-27, ubiquitin) HSP in tumor and non-tumor lung tissue obtained from 47 patients undergoing surgical resection of lung carcinoma. HSP levels were determined in cell lysates from tissue samples by ELISA using streptavidin-biotin technology. Results were normalized to total protein content measured by spectrophotometry. Compared to disease-free lung tissue, tumor tissue samples showed higher levels of both HSP-60 (median value: 227 pg versus 96 pg per mg protein (P<0.001 by Wilcoxon Rank test for paired data) and HSP-70 (median value: 525 ng versus 401 ng per mg protein (P=0.01 by Wilcoxon Rank test for paired data). Tumor and tumor-free tissues show similar levels of ubiquitin and HSP-27. Neither the survival rate nor the histologic type and extent of cancer are correlated with the observed differences in HSP-60 and HSP-70 expression (P>0.1 by one way analysis of variance for repeated measures with one between subject factor). Our data confirm, on a quantitative basis, the increased expression of HSP-60 and HSP-70 in non-small-cell lung carcinoma. However, no prognostic value was found to be associated with this over-expression. In contrast, LMW stress proteins such as ubiquitin and HSP-27, although implicated in cellular processes potentially related to malignant transformation, show no increased expression in lung carcinoma.