Wojciech Dyszkiewicz

PURPOSE: The aim of the project was to apply ultra-high-performance liquid chromatography-quadrupole-Orbitrap-high-resolution mass spectrometry for serum metabolite profiling of non-small-cell lung cancer (NSCLC). This Orbitrap-based methodology has been applied for a study of NSCLC potential markers for the first time. METHODS: After extraction using protein precipitation, sera were separated on the ACE Excel 2 C18-PFP (100 × 2.1 mm, 2.0 µm) column using gradient elution and analyzed within the range of 70-1000 m/z. Only patients with early stage disease (stages IA-IIB) were included in the study, providing opportunity to find biomarkers for early lung cancer detection. The resulting metabolite profiles were subjected to univariate and multivariate statistical tests. RESULTS: 36 features were found significantly changed between NSCLC group and controls after FDR adjustment and 19 were identified using various metabolite databases (in-house library, HMDB, mzCloud). The study revealed a number of NSCLC biomarker candidates which belong to such compound classes as acylcarnitines, organic acids, and amino acids. Multivariate ROC curve built using 12 identified metabolites was characterized by AUC = 0.836 (0.722-0.946). There were no significant differences in the serum metabolite profiles between two most common histological types of lung cancer-adenocarcinoma and squamous cell carcinoma. CONCLUSIONS: Through identification of novel potential tumor markers, Orbitrap-based global metabolic profiling is a useful strategy in cancer research. Our study can accelerate development of new diagnostic and therapeutic strategies in NSCLC. The metabolites involved in discrimination between NSCLC patients and the control subjects should be further explored using a targeted approach.

OBJECTIVE: The aim of this study was to determine which of the clinical parameters are the most valuable in predicting postoperative atrial fibrillation after lung surgery. MATERIALS AND METHODS: Retrospective analysis was carried out on 298 patients after pulmonary resection necessitated mainly by lung cancer. The following parameters were investigated: age and sex, disturbances of cardiac rhythm, history of ischemic heart disease, diabetes and atherosclerosis, NYHA classification and type of surgical procedure. In addition, the duration of surgery, variations in oxygen saturation, changes in systemic blood pressure and heart-rate were noted intraoperatively. Statistical analysis was performed using Fisher's exact test. RESULTS AND CONCLUSIONS: Atrial fibrillation occurred in 25 cases (8.4%) and more frequently after pneumonectomy (24%). Other factors contributing to atrial fibrillation after lung surgery were: history of ischemic heart disease, congestive heart failure, intraoperative cardiac arrest and the need for rethoracotomy.

OBJECTIVE: The aim of this study was to analyze the early and long-term results of simultaneous surgical treatment of both coronary heart disease (CHD) and lung cancer. METHODS: Twenty-five patients with the diagnoses of both non-small cell lung cancer (NSCLC) and unstable angina were operated on between 2001 and 2006 in the Department of Cardiothoracic Surgery at the University of Medical Sciences in Poznań, Poland. Myocardial revascularization was performed simultaneously with the lung resection. The mean patient age was 63 years. The majority (18 patients) were male and the stage of lung cancer was predominantly AJCC II. Most of the patients were classified as stage II or III CCS and the predominant pathology was a two-vessel disease. Fifteen lobectomies, six pneumonectomies and four wedge resections were performed together with the aortocoronary graft implantation (mean: 1.9 graft per patient). RESULTS: There were no postoperative deaths or perioperative myocardial infarctions (MI). The most frequent complications were as follows: atrial fibrillation (24%), atelectasis (12%) and residual pneumothorax (12%). All the patients were followed up for 8-60 months. Within this period, eight patients (32%) died, mostly due to the cancer relapse. The local recurrence of lung cancer and distant metastases were the only factors statistically influencing the late survival. No patient in the entire follow-up period had a MI. In three patients, the symptoms of recurrent angina occurred and one of them underwent a coronary stent implantation. CONCLUSIONS: Simultaneous off-pump myocardial revascularization and lung resection is a safe and effective treatment when unstable CHD and lung cancer coexist. In selected patients, this combined procedure may be an alternative to the two-stage approach, surgical or non-surgical (cardiologic) interventions preceding the pulmonary resection. The only statistically significant factor having an impact on long-term survival is the recurrence of the cancer.