Yotanna Dalavanga

Soluble adhesion molecules E-cadherin, intercellular adhesion molecule-1, and E-selectin as lung cancer biomarkers.

BACKGROUND Altered levels of circulating adhesion molecules found in several carcinomas, including lung cancer, reflect local loss of diffusion barriers and tumor volume and can be potentially used as biomarkers. In the present study, we investigated the role of soluble E-cadherin (sE-cad), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E-selectin (sE-sel) as biomarkers in lung cancer. METHODS Sixty-two patients with recently diagnosed lung cancer, 42 with small cell lung cancer (SCLC), and 20 with non-small cell lung cancer (NSCLC), as well as 29 healthy volunteers were enrolled. Blood samples were collected at the time of diagnosis and measurement of soluble adhesion molecules in the serum samples was performed by enzyme-linked immunoassay using monoclonal antibodies against E-cadherin, E-selectin, and ICAM-1. RESULTS Serum levels of sE-cad, sE-sel, and sICAM-1 in both SCLC and NSCLC were significantly elevated compared with control subjects (P < .001). In addition, patients with SCLC or NSCLC with distant metastasis had a marked increase of sE-Cad (P < .001), but no such correlation with sE-sel and sICAM-1 was found. CONCLUSIONS Our findings suggest that sE-cad, sE-sel, and sICAM-1 have an adjunctive diagnostic role in lung cancer. Furthermore, sE-cad may also have a prognostic role and could be a useful biomarker in the prediction of lung cancer outcome.

Malignant mesothelioma in Metsovo, Greece, from domestic use of asbestos: 30 years later

To the Editors: Malignant mesothelioma (MM) is a devastating disease, almost exclusively due to inhalation of asbestos fibres, and with higher risk for amphiboles [1]. Mediterranean regions, such as Turkey, Cyprus and Corsica, and others, such as New Caledonia [2], have experienced epidemics of MM as a result of nonoccupational, “domestic” exposure to tremolite asbestos and fibrous erionite [3]. In 1987, we reported on the very high incidence, 300 times higher than expected, of MM in the area of Metsovo, a complex of small villages in the prefecture of Ioannina in north-west Greece [4]. This, in conjunction with the previously noted very frequent pleural calcifications among Metsovites [5], led to the discovery of the culprit, a tremolite asbestos-containing whitewash (“luto” in the local dialect) [6]. The material was used by practically all households until 1940–1950. After that, it was gradually substituted by modern materials that did not contain asbestos. In 1980, luto was used by only 18% of builders and by 1990 it had been abandoned altogether (fig. 1) [7]. In 1996, we reported that the incidence of MM in the period 1985–1994 declined to one-third compared with the period 1980–1984, and we attributed the reduction to the abandonment of the use of luto. As a result, we concluded that the “Metsovo mesothelioma epidemic” would decline by 2020–2030 [8]. Figure 1– Percentage of Metsovo (Greece) households using luto from 1940–1990 (•) and the decline in Metsovo malignant mesothelioma (MM) cases between 1980 and 2009 in 5-yr (white bars) and 10-yr intervals (grey bars). In the …

Evidence Suggesting the End of Universal Domestic Asbestos Exposure in Metsovo, NW Greece

Background: Inhabitants of Metsovo, NW Greece, had been domestically exposed to asbestos from a gradually abandoned whitewash (“luto”) that resulted in a declining epidemic of malignant mesothelioma. Objectives: We aimed to evaluate whether other sources of asbestos exposure exist following “luto” abandonment. Methods: Chest computed tomography (CT) and bronchoalveolar lavage (BAL) were used to evaluate residual asbestos exposure in younger Metsovites through the identification of pleural calcifications and asbestos bodies, respectively. In order to provide a historical universally exposed group for comparison, we used the accumulated chest CTs and chest roentgenograms of our previous studies, performed in Metsovites with confirmed exposure but negative chest roentgenogram. As an additional external comparison group, we also assessed CT scans and chest roentgenograms of Metsovites being older than our target group obtained from the records of the Radiology Department between 2009 and 2011. In order to be able to compare our BAL findings, we sought historical controls among BAL studies performed in Metsovites with known exposure to “luto,” in the 1980s-1990s, mainly to evaluate alveolitis. Those belonging to individuals of the same age range were used for further comparison. Results: Twenty-two Metsovites born between 1960 and 1980 consented to undergo a chest CT scan, while another 14 CTs were retrieved from the records of the Radiology Department (among 86 of all ages), thus increasing the number of individuals studied to 36. Five of the 36 Metsovites studied were former “luto” users for a short period of time. Minimal pleural calcifications were present in 2 of them, while all chest CTs of nonusers were negative. All 8 BAL studies were negative for asbestos bodies. Conclusion: “Luto” use seems to have been the only source of considerable asbestos exposure in Metsovo.