RESUMEN
This paper examines how European banks adjusted their lending subsequent to the release of the countercyclical capital buffers (CCyB) during the COVID-19 pandemic. At its onset in 2020Q1, being exposed to a higher ex-ante countercyclical capital buffer led to a reduction in banks' lending. Yet the relief of the CCyBs removed this negative effect from 2020Q2 onwards. We find that the reduction in CCyBs led to a significant relative increase in the average bank's lending by about 5.6 percentage points of their total assets. This increase happened mainly in retail mortgage loans and was stronger for poorly-capitalized banks. These results imply that the release of the CCyBs was effective in promoting bank lending during the pandemic.
RESUMEN
During the pandemic, households accumulated savings in their deposit accounts as a result of a reduction in their spending, which occurred due to the restrictions on their mobility. This led to a significant increase in bank deposits for banks located in counties with a larger reduction in spending. Banks, in turn, used these additional funds to issue more real estate loans. This implies that policies that might affect household spending would lead to changes in the volume of deposits in the banking system, which have consequences on banks' loan supply.
RESUMEN
This paper examines how European banks adjusted lending at the onset of the pandemic depending on their local exposure to the COVID-19 outbreak and capitalization. Using a bank-level COVID-19 exposure measure, we show that higher exposure to COVID-19 led to a relative increase in worse-capitalized banks' loans whereas their better-capitalized peers decreased their lending more. At the same time, only better-capitalized banks experienced a significantly larger increase in their delinquent and restructured loans. These findings are in line with the zombie lending literature that banks with low capital have an incentive to issue more loans during contraction times to help their weaker borrowers so that they can avoid loan loss recognition and write-offs on their capital.
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Anticuerpos Monoclonales/administración & dosificación , Antirreumáticos/administración & dosificación , Artritis Reumatoide/tratamiento farmacológico , Fármacos Gastrointestinales/administración & dosificación , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Espondiloartropatías/tratamiento farmacológico , HumanosRESUMEN
BACKGROUND: Infliximab is typically administered intravenously via 2- to 3-h duration infusions. Infusions are time-consuming and costly. Shorter duration infusions are administered at some centres. Limited safety data are available on shorter duration infusions. AIM: To determine risk of infusion reaction associated with standard 2- to 3-h infusions vs. rapid infusions in patients receiving infliximab therapy for inflammatory bowel disease (IBD), rheumatoid arthritis, spondylarthopathy and psoriatic disease. METHODS: MEDLINE, Embase, and Web of Science were searched. Inclusion required human subjects, documentation of number of standard and rapid infliximab infusions and number of incident infusion reactions. Studies of overlapping populations were excluded. Three reviewers independently extracted data. Study quality was assessed. Relative risk (RR) was pooled using random effects models. RESULTS: We identified 10 studies comprising 13 147 standard 2- to 3-h and 8497 ≤ 1-h infliximab infusions. Nine studies reported the risk of infusion reaction in standard vs. 1-h infusions, demonstrating decreased RR of infusion reaction with 1-h vs. standard infusions (0.9% vs. 2.2% of infusions; RR = 0.48, P = 0.009). Seven studies limited to IBD also demonstrated decreased risk of reaction (RR = 0.49, P = 0.002). Other comparisons demonstrated no difference in RR of reaction, including concomitant medication use (P = 0.30) or analysis limited to high and medium quality studies (P = 0.07). CONCLUSIONS: Rapid infliximab infusions of ≤1-h duration are not associated with increased risk of infusion reaction when compared to standard 2- to 3-h infusions in selected patients who previously tolerated three to four standard infusions. One-hour infusions will conserve health care resources and may lead to improved adherence and quality of life in patients receiving infliximab.
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Anticuerpos Monoclonales/administración & dosificación , Antirreumáticos/administración & dosificación , Artritis Reumatoide/tratamiento farmacológico , Fármacos Gastrointestinales/administración & dosificación , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Espondiloartropatías/tratamiento farmacológico , Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Relación Dosis-Respuesta a Droga , Fármacos Gastrointestinales/efectos adversos , Humanos , Infliximab , Infusiones Intravenosas/métodos , Calidad de Vida , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
Patients with non-small cell lung cancer (NSCLC) frequently suffer from stage IV disease at the time of presentation. Survival of these patients is disadvantageous although they may benefit from chemotherapy. The main purpose of this investigation was to evaluate the prognostic relevance of the metastatic localisation in unselected patients. The second purpose was to evaluate the impact of clinical characteristics on the kind of decision-making in patients with stage IV NSCLC in an epidemiological manner.[nl]Clinical data as well as survival of 336 patients with stage IV NSCLC were analysed. The recruitment period was 3? years, mean follow-up was 24 months. This investigation was part of the HALLUCA studies which were sponsored by the German Ministry of Health.[nl]Localisation-dependent median and 1-year survivals were significantly different and varied between 2.2 months and 4.7â% (liver metastases) and 11.0 months and 44.5â% (lung metastases). The different survival remained significant in the multivariate analyses with age, performance status, treatment and histology as co variables. The chemotherapy rate of all patients with stage IV NSCLC was 39â%. Patients with liver, bone and multiple metastases received less often chemotherapy compared to patients with other metastases although the performance status was not different to the other groups.[nl]Although there are some limitations in this investigation, these epidemiological data demonstrate the prognostic heterogeneity of stage IV NSCLC patients which should be considered for stratification in controlled clinical trials. Regional treatment decision-making is different from guidelines and controlled clinical trials. Further regionally orientated trials are necessary to improve the transformation from clinical trials to regional medical care.
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Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/secundario , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Femenino , Alemania/epidemiología , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Masculino , Prevalencia , Pronóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Análisis de Supervivencia , Tasa de SupervivenciaRESUMEN
OBJECTIVES: This retrospective study evaluates the probability of survival in patients who had undergone resection for non-small cell lung cancer (NSCLC) and in whom residual disease at the resection margins was found. METHODS: During a period of 6 years, 596 patients with NSCLC were operated upon with curative intention. Residual disease at the resection margin was divided into microscopic (R1) and macroscopic (R2). RESULTS: Twenty-six patients (4.4%) showed R1 and 12 (2%) R2 residual disease. An extrabronchial (thoracic wall, vessels) R1 situation was found in five patients and a bronchial R1 infiltration in 21 cases. The bronchial resection margin was subject to peribronchial infiltration in most cases (16/21). A total of 17/21 (65%) patients with bronchial infiltration had N2 disease. Thirty day lethality was 3.8% in the R1 group. Fifteen patients had postoperative irradiation. The 5-year survival rate for patients with R1 resection was 14%. The differences in survival between patients with extrabronchial vs. bronchial infiltration and N0/N1 vs. N2 were significant using univariate analysis. Adjuvant radiation did not result (especially in N2 disease) in a survival benefit. Among 12 patients with macroscopic residual disease (R2), 3/12 (25%) died within the first 30 days after the operation, and none of the R2 patients survived the first year after the operation. CONCLUSIONS: Patients with an R1 situation have a survival rate of 14% comparable to curative resected patients (RO) in stage III. Adjuvant radiation had no clear effect on survival. Patients with macroscopic tumor (R2) should receive palliative treatment after the operation depending on their condition.
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Adenocarcinoma/cirugía , Carcinoma Adenoescamoso/terapia , Carcinoma de Células Grandes/terapia , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Carcinoma de Células Escamosas/cirugía , Neoplasias Pulmonares/cirugía , Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidad , Bronquios/patología , Bronquios/cirugía , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/mortalidad , Carcinoma de Células Grandes/diagnóstico , Carcinoma de Células Grandes/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/mortalidad , Secciones por Congelación , Alemania/epidemiología , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidad , Ganglios Linfáticos/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasia Residual , Pronóstico , Radioterapia Adyuvante , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia , Procedimientos Quirúrgicos Torácicos , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: Iatrogenic tracheobronchial ruptures are seldom but severe complications after intubation or bronchoscopy. Therefore, we evaluated the reasons, the subsequent therapy and the outcome of patients with tracheal rupture, who were admitted to our hospital. METHODS: In a retrospective study we examined 19 patients (15 women, four men; 43-87 years) treated for acute tracheobronchial lesions. Eleven (58%) patients had a tracheobronchial rupture by single-lumen tube, four (21%) by double-lumen tube and two patients (10%) by tracheal cannula. A total of 47% of whom were carried out under emergency conditions. Two patients had a rupture due to a stiff bronchoscopy. Mean symptoms were mediastinal and subcutaneous emphysema. Two emergency collar incisions had been done. RESULTS: The localization of ruptures was in all cases in the paries membranaceus, length: 1-7 cm (mean: 4.8 cm). The interval between the onset of symptoms and the diagnose differed widely (up to 72 h), nine (47%) diagnoses were made during intubation/bronchoscopy. One patient, with a small tear (1 cm) was treated conservatively with fibrin-glue. The other 18 patients had surgical repair through a thoracotomy. The postoperative mortality was determined with 42%, which was not dependent on the rupture but basically by the underlying diseases requiring intubation. CONCLUSIONS: Iatrogenic tracheal rupture is a dangerous complication with potentially high postoperative mortality, mostly influenced by the underlying disease. Early surgical repair must be the preferred treatment.
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Bronquios/lesiones , Enfermedad Iatrogénica , Rotura/etiología , Tráquea/lesiones , Adulto , Anciano , Anciano de 80 o más Años , Bronquios/cirugía , Broncoscopía/efectos adversos , Femenino , Estudios de Seguimiento , Alemania/epidemiología , Humanos , Enfermedad Iatrogénica/epidemiología , Intubación Intratraqueal/efectos adversos , Masculino , Persona de Mediana Edad , Radiografía , Reoperación , Estudios Retrospectivos , Factores de Riesgo , Rotura/cirugía , Toracotomía , Tráquea/diagnóstico por imagen , Tráquea/cirugía , Traqueostomía/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: The aim of our study was to examine the significance of tumour DNA-content and proliferation in lung cancer. METHODS: The DNA content and S-phase fraction (SPF) was determined by flow cytometry in 125 resected tumours of patients with non-small cell lung cancer. In 40 cases we compared the SPF with immunohistochemical staining of the Ki-67 protein using MIB-1 antibody. RESULTS: DNA aneuploidy was detected in 84.8% (106/125). Cell cycle analysis for the determination of proliferation activity was only possible in 69 (55.2%) cases. An SPF of 0-8% as a sign of low proliferation was found in 27 specimens. In advanced tumours at stage III and IV the proportion of tumours with SPF 9-16% was significantly (p<0.05) increased as compared to tumours at stage I and II. There was a significant correlation (p=0.012, ascent: 0.045) between SPF and MIB-1. Patients with aneuploid tumours had a relative risk of 1.4 to die earlier than patients with diploid tumours. Patients with SPF of 9-16% in the tumour tended to decreased survival (5-year survival rate: 29%) in correlation to patients with a percentage of SPF 0-8% (5-year survival rate: 38%, p=0.5). These differences were significant (p=0.048) in patients with adenocarcinomas only. In the multivariate COX-regression model age (p=0.03) and stage (p=0.0001) were significant prognostic factors, ploidy state (p=0.33) was of no prognostic significance. CONCLUSIONS: Flow cytometry seems to be a useful method for understanding the clinical behaviour of lung cancer. Especially the SPF in adenocarcinomas may be used as a prognostic indicator.
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Carcinoma de Pulmón de Células no Pequeñas/genética , ADN de Neoplasias/análisis , Antígeno Ki-67/análisis , Neoplasias Pulmonares/genética , Análisis de Varianza , Aneuploidia , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Ciclo Celular , Citometría de Flujo , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Persona de Mediana Edad , Tasa de SupervivenciaRESUMEN
The cleavage of the donor substrate d-xylulose 5-phosphate by wild-type and H263A mutant yeast transketolase was studied using enzyme kinetics and circular dichroism spectroscopy. The enzymes are able to catalyze the cleavage of donor substrates, the first half-reaction, even in the absence of any acceptor substrate yielding d-glyceraldehyde 3-phosphate as measured in the coupled optical test according to Kochetov (Kochetov, G. A. (1982) Methods Enzymol. 90, 209-223) and compared with the H263A variant. Overall, the H263A mutant enzyme is less active than the wild-type. However, an increase in the rate constant of the release of the enzyme-bound glycolyl moiety was observed and related to a stabilization of the "active glycolaldehyde" (alpha-carbanion) by histidine 263. Chemically synthesized dl-(alpha,beta-dihydroxyethyl)thiamin diphosphate is bound to wild-type transketolase with an apparent K(D) of 4.3 +/- 0.8 microm (racemate) calculated from titration experiments using circular dichroism spectroscopy. Both enantiomers are cleaved by the enzyme at different rates. In contrast to the enzyme-generated alpha-carbanion of (alpha,beta-dihydroxyethyl)thiamin diphosphate formed by decarboxylation of hydroxylactylthiamin diphosphate after incubation of transketolase with beta-hydroxypyruvate, the synthesized dl-(alpha,beta-dihydroxyethyl)thiamin diphosphate did not work as donor substrate when erythrose 4-phosphate is used as acceptor substrate in the coupled enzymatic test according to Sprenger (Sprenger, G. A., Schörken, U., Sprenger, G., and Sahm, H. (1995) Eur. J. Biochem. 230, 525-532).
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Saccharomyces cerevisiae/enzimología , Transcetolasa/química , Transcetolasa/metabolismo , Sustitución de Aminoácidos , Dicroismo Circular , Fructosafosfatos/metabolismo , Variación Genética , Histidina , Cinética , Estructura Molecular , Pentosafosfatos/metabolismo , Conformación Proteica , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Estereoisomerismo , Especificidad por Sustrato , Tiamina Pirofosfato/análogos & derivados , Tiamina Pirofosfato/química , Tiamina Pirofosfato/metabolismoRESUMEN
This study reports on the results of a checkup carried out on 38 patients subjected to an extended cancer aftercare examination at least 6 months after pneumectomy because of bronchial carcinoma, 12 of these patients receiving adjuvant chemotherapy and/or radiotherapy. Lung function data determined by body plethysmography were measured, as well as the quality of life, using the Karnofsky and Spitzer indices as well as QLQ-C30 of the EORTC. In addition, anamnestic data and postoperative ECG and blood gas analysis results were recorded. The most important findings concern restricted lung function due to pneumectomy, an IVC decrease by 33.3%, a drop in FEV1 by 27.3% and a reduction of the total lung capacity (TLC) by 14%. Moreover, a distinctly increased right heart load was seen in 23.4% of all patients. The quality of life tests revealed a slightly reduced quality of life in the external assessment indices according to Karnofsky (86 +/- 11%) and Spitzer (8.6 +/- 1.2). Self-assessment by QLQ-C30 of the EORTC, however, evidenced a clear reduction of the global quality of life (54.2 +/- 15.6) and role function, a moderate decrease of physical, emotional, cognitive and social functioning as well as a greatly increased incidence of the symptoms fatigue, dyspnea, sleep disturbances and pain after surgery. Adjuvant therapy applied in 12 patients had no significant influence, neither on lung function parameters nor on the quality of life. A more advanced tumour stage or a relapse, however, will adversely affect the quality of life.
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Neoplasias Pulmonares/cirugía , Recurrencia Local de Neoplasia/cirugía , Neumonectomía/métodos , Complicaciones Posoperatorias/etiología , Calidad de Vida , Adulto , Cuidados Posteriores , Anciano , Quimioterapia Adyuvante , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/radioterapia , Mediciones del Volumen Pulmonar , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/radioterapia , Estadificación de Neoplasias , Radioterapia Adyuvante , Factores SexualesRESUMEN
The knowledge of anatomical lymphatic drainage pathways between lung and mediastinum and metastatic spread patterns of lung cancer forms the basis for the modern TNM classification for the staging of lung cancer. Clinical and anatomical studies divided pulmonary nodes into intrapulmonary and bronchopulmonary, the latter distinguished into lobar and hilar nodes. Mediastinal nodes are grouped into anterior prevascular, tracheobronchial, paratracheal and posterior nodes. The different pathways of lymphatic drainage of the lungs to the mediastinal lymph nodes are presented with the consequent surgical implications.
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Pulmón/anatomía & histología , Ganglios Linfáticos/anatomía & histología , Linfa/fisiología , Mediastino/anatomía & histología , HumanosRESUMEN
Staging of lung cancer needs an accurate diagnostic programme resulting in therapeutic and prognostic consequences. A modern, articulate flow-chart is presented and discussed. As a result, the rate of exploratory thoracotomy was reduced from 15.1% in 1988 to 2.1% in 1997 and the rate of resectability raised up to 30%. Preoperative over-staging was found in about 25% and the same value for understaging. Looking to the N-values, there was concordance of clinical and postoperative data in 61.9% of cases.
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Neoplasias Pulmonares/patología , Alemania , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Neoplasias Pulmonares/diagnóstico por imagen , Metástasis Linfática , Mediastinoscopía , Estadificación de Neoplasias , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
Activation of the coenzyme ThDP was studied by measuring the kinetics of deprotonation at the C2 carbon of thiamin diphosphate in the enzymes pyruvate decarboxylase, transketolase, pyruvate dehydrogenase complex, pyruvate oxidase, in site-specific mutant enzymes and in enzyme complexes containing coenzyme analogues by proton/deuterium exchange detected by 1H-NMR spectroscopy. The respective deprotonation rate constant is above the catalytic constant in all enzymes investigated. The fast deprotonation requires the presence of an activator in pyruvate decarboxylase from yeast, showing the allosteric regulation of this enzyme to be accomplished by an increase in the C2-H dissociation rate of the enzyme-bound thiamin diphosphate. The data of the thiamin diphosphate analogues and of the mutant enzymes show the N1' atom and the 4'-NH2 group to be essential for the activation of the coenzyme and a conserved glutamate involved in the proton abstraction mechanism of the enzyme-bound thiamin diphosphate.
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Piruvato Descarboxilasa/metabolismo , Complejo Piruvato Deshidrogenasa/metabolismo , Piruvato Oxidasa/metabolismo , Tiamina Pirofosfato/metabolismo , Transcetolasa/metabolismo , Regulación Alostérica , Escherichia coli/enzimología , Cinética , Lactobacillus/enzimología , Resonancia Magnética Nuclear Biomolecular , Levaduras/enzimologíaRESUMEN
Ab initio calculations on the HF-SCF 6-31g* level were performed on tautomers as well as protonated and deprotonated species of thiamin. Aspects of the proton relay function of the 4'-aminopyrimidine ring in the thiamin catalysis were studied on model systems. The acidity of the 4'-amino group increases in the N1' and N3' protonated thiamin systems. Starting from the 4'N deprotonated thiamin, the calculated reaction coordinate of the ylide formation suggests the cocatalytic function of the 4'-amino/imino group. Some structural, energetic, and electronic properties of the model systems are discussed with respect to key steps in the catalytic mechanism.
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Pirimidinas/química , Tiamina Pirofosfato/química , Gases , Isomerismo , Modelos Moleculares , Estructura Molecular , Protones , Termodinámica , Tiamina/químicaRESUMEN
Although not seldom as a palliative procedure, the preferred treatment of locally recurrent breast cancer or chest wall involvement by metastases is full-thickness chest wall resection. For closure and coverage of the defect various techniques are described. Autoplastic reconstruction is indicated for smaller defects, while larger defects usually require alloplastic materials, especially in case of chest instability after resection. We report the case of a 55-year-old female who developed a locally recurrent breast cancer with infiltration of the sternum 4 years after left sided ablation. En bloc resection of the chest wall including the complete sternum was followed by replacement with a computer-aided custom made polyethylene sternal prosthesis. With this procedure we stabilized the chest wall with protection of the underlying organs, avoided prolonged postoperative ventilation and achieved a satisfying cosmetic result.
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Neoplasias Óseas/cirugía , Sustitutos de Huesos , Polietilenos , Implantación de Prótesis/instrumentación , Esternón , Materiales Biocompatibles , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/patología , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/secundario , Neoplasias de la Mama/cirugía , Femenino , Humanos , Espectroscopía de Resonancia Magnética , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Diseño de Prótesis , Esternón/diagnóstico por imagen , Esternón/patología , Esternón/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Primary liposarcomas of the mediastinum are rare neoplasms comprising less than 1% of mediastinal tumors. While in early stages often asymptomatic they may grow to an enormous size and then exhibit various clinical symptoms mimicking lung or heart disease by compression of adjacent intrathoracic organs. Intention of surgical treatment is to relieve the symptoms and to establish the histological diagnosis. Surgery alone may be curative in some cases. The role of additional radio- and chemotherapy remains questionable. We report two cases of primary mediastinal liposarcomas that were treated surgically in our institution.
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Liposarcoma/cirugía , Neoplasias del Mediastino/cirugía , Anciano , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Humanos , Liposarcoma/diagnóstico , Liposarcoma/patología , Masculino , Neoplasias del Mediastino/diagnóstico , Neoplasias del Mediastino/patología , Mediastino/patología , Mediastino/cirugía , Microscopía Electrónica , Persona de Mediana EdadRESUMEN
Between 1975-1996, 39 patients underwent resection of pulmonary metastases from renal cell carcinoma. Multivariate analysis (COX model) for survival of preoperative risk factors showed that time of diagnosis (syn-/metachronous) of the metastases (p = 0.05) and the number of metastases (p = 0.01) were of prognostic significance. It is concluded that metastasectomy in patients with not more than six metachronous metastases after renal cell carcinoma has significant benefit and in cases of synchronous metastases or more than 6 pulmonary metastases indication for resection should be restricted.
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Carcinoma de Células Renales/secundario , Neoplasias Renales/cirugía , Neoplasias Pulmonares/secundario , Neumonectomía , Adulto , Anciano , Carcinoma de Células Renales/mortalidad , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Análisis de SupervivenciaRESUMEN
BACKGROUND: The study of the nature of tumor-infiltrating lymphocytes (TIL) may provide insight into the complex issue of tumor-host interactions. METHODS: Cytofluorometric analysis was performed to characterize the phenotypic profiles of TIL from non-small-cell lung cancers (NSCLC) and pulmonal metastases of different primary locations. An extensive panel of antibodies was used specific to different activation-associated molecules on T cells. In 10 patients, findings on the T cell phenotype of TIL were compared with the findings in peripheral blood lymphocytes (PBL) from the same patients. Furthermore, we investigated whether the measurement of the TIL phenotype might serve as a prognostic parameter correlating with survival of patients with NSCLC. RESULTS: In contrast to PBL, T cells infiltrating lung tumors expressed significantly higher amounts of various activation antigens. However, the immunophenotype of TIL hardly differed among different histological subtypes and pulmonal metastases. Addressing the prognostic value of the lymphocytic composition of TIL, we found no significant difference in the survival of NSCLC with high or low percentages of T and natural killer cells, whereas high percentages of B cells were associated with increased survival (p = 0.05). Patients with high percentages of CD13+ tumor-infiltrating T cells had significantly poorer prognosis according to Cox's multivariate analysis. CONCLUSION: Our results indicate that different tumor histologies within the lung are characterized by a 'similar' T cell phenotype, at least with respect to the surface molecules studied by us. The measurement of the expression of activation-associated markers on T cells may have prognostic value in the pathological evaluation of NSCLC.