Lung cancer has been more frequently observed during the last 70 years.Many factors thought to be of pathogenic importance in the past are now considered to be totally unrelated or minimally related to cancer.The exposure to asbestosis, polycyclic aromatic hydrocarbons, nickel, arsenic, radon, and vinyl chloride are also responsible for carcinomas.But all of these factors become extremely unimportant when compared with the role played by smoking.Tobacco has a long history dating back to 600 A.D. It is known that Native Americans smoked tobacco for special religious and medical purposes.In 1964, the first report was published about the dangers of smoking and it was noticed that the nicotine and tar in cigarettes cause lung cancer.It is currently known that the smoke contains high levels of carcinogenic tobacco-specific nitrosamines.Therefore lung tumors that are histologically similar to the smoking-related lung cancers in humans do not develop in "non-smoker" animals.Most cases of lung cancer are most frequently diagnosed at an advanced stage where only limited number of treatment alternatives can be offered to these patients.The development of lung cancer involves multiple phases of tumorigenesis including interactions among genetic, epigenetic, and environmental factors with resultant dysregulation of key oncogenes and tumor suppressor genes ending in activation of cancer-related signaling pathways.For years, lung cancers have been classified as small cell and non-small cell lung cancers and this classification was satisfactory for treatment.The past decade has witnessed the discovery of multiple molecules that are effective in the development of lung cancer which are more commonly detected in adenocarcinomas.Therefore in histopathological examination, special aim is placed on discriminating adenocarcinomas from the other lung cancers so as to effectively select tumors for targeted molecular testing.Current review summarizes the histopathological features of lung cancers according to the 2015 World Health Organization (WHO) classification of lung cancer and attempts to focus on further understanding of the molecular abnormalities underlying lung cancer development and progression.

Objective: Insulin- like growth factor-1 (1GF-1) regulates a number of cellular functions such as proliferation and differentiation. On the other hand, insulin-like growth factor binding protein-3 (IGFBP-3) is a putative tumor suppressor and inhibits the proliferative activity of IGF-1. Therefore most studies report that IGF-1 and IGFBP-3 may promote and inhibit rumor growth, respectively. In this study we aimed to evaluate the importance of IGF-1 and IGFBP-3 in advanced stage non-small cell lung cancer (NSCLC) and to find out whether they contribute to clinical evaluations. Material and Methods: We measured the pretreatment serum levels of IGF-1 and IGFBP-3 in 80 men between July 2007 and June 2008 by chemiluminescent immunometric assay. Serum samples were obtained from 50 patients with inoperable advanced stage NSCLC at Dr. Suat Seren Pulmonary Diseases Hospital and 30 healthy controls at Izmir Tepecik Research Hospital, All 80 men had a smoking history of minimum 20 pack/years. Results: Contrary to the results of many reports, the serum IGF-1 levels were lower in the patients and the difference between the groups reached a statistical significance (p=0.025). IGF-1/IGFBP-3 ratio was also significantly lower in lung cancer patients (p=0.016). The histological subtype of rumor was correlated with IGF-1 level (p=0.005). Conclusion: Our result showed that serum level of IGF-1/IGFBPs may be useful markers for diagnosing and identifying tumor subtypes in NSCLC. In addition, IGF-1 and IGFBP-3 levels in serum might serve a clinical significance in patients with advanced stage NSCLC. However, further studies comprising more cases are needed to investigate the clinical significance of IGF-1 and IGFBP-3 in NSCLC.

OBJECTIVES To evaluate patients with multiple primary tumors (MPTs) from the data of Izmir Cancer Registry (ICR) in Izmir Ataturk Research and Training Hospital (IAEAH) and to compare them with single tumor (ST). METHODS 572 multiple primary tumors ( MPTs) (286 patients) out of 2 0.895 tumors recorded during the period of 1993-2005 by office of ICR located in IAEAH were analyzed. Double tumors (DTs) were analyzed. Chi-square test and Independent Samples t-test were performed by SPSS 10.0. RESULTS Of patients with MPTs 53.2% had synchronous whereas 43.1% had metachronous. The mean age were 55.81±15.4 years for ST group; 61.49±13.32 for DT group (p

OBJECTIVESTo evaluate patients with multiple primary tumors (MPTs) from the data of Izmir Cancer Registry (ICR) in Izmir Atatiirk Research and Training Hospital (IAEAH) and to compare them with single tumor (ST).METHODS572 multiple primary tumors (MPTs) (286 patients) out of 2 0.895 tumors recorded during the period of 1993-2005 by office of ICR located in IAEAH were analyzed. Double tumors (DTs) were analyzed. Chi-square test and Independent Samples t-test were performed by SPSS 10.0.RESULTSOf patients with MPTs 53.2% had synchronous whereas 43.1% had metachronous. The mean age were 55.81 +/- 15.4 years for ST group; 61.49 +/- 13.32 for DT group (p<0.001). Urogenital tumors (30.9%) and skin tumors (17.1%) in DTs group were higher than ST group statistically. The mean interval of DT was 44.4 +/- 30.82 (38.99-49.77) months.CONCLUSIONField cancerization, theory of a common clonal origin or screening effect may account for the relatively frequent association of urogenital tumors.

The use of a relatively nontoxic tyrosine kinase receptor inhibitor, imatinib mesylate (IM) (STI-571), has increasingly become a valuable therapeutic alternative in some KIT (CD117)-overexpressing neoplasms potentially because of the presence of KIT-activating mutations. As the treatment eligibility for this drug hinges on CD117 expression, KIT immunostaining has recently been widely examined in various different tumors. We examined CD117 expression in pediatric embryonal rhabdomyosarcomas (RMSs) to identify its eventual prognostic impact and to evaluate its effect on tumorigenesis. This study included two spindle cell (leiomyomatous) variants, two botryoid variants, and 21 conventional embryonal RMSs. Sections from paraffin-embedded tumor samples were immunostained by a standard SABC technique using c-kit polyclonal antibody with antigen retrieval. In all the series, the percentage of CD117 positivity was 12%. Staining was strong in two of two spindle cell variants, in zero of two botryoid variants, and in one of 21 conventional embryonal RMSs. In Spearman's correlation analysis, there was statistical relationship between the presence of CD117 expression and the histological subtype of RMS. Kaplan-Meier analysis revealed no prognostic significance of CD117 expression for survival. The present study demonstrated a very limited expression of CD117 in pediatric embryonal RMS other than in the spindle cell variant. This finding suggested that the stem cell factor/c-kit pathway may be implicated in the tumorigenesis of spindle cell RMSs. Therefore, the mutation of c-kit gene must be prospectively examined in larger series of RMSs. If it can be verified that tissue expression of CD117 reflects the mutation of c-kit gene, IM can be considered a targeted therapy for CD117-expressing RMSs, particularly the spindle cell variant.

OBJECTIVE:To evaluate the efficacy of curative and palliative radiotherapy in inoperable advanced non-small cell lung cancer (NSCLC) patients with a performance status (PS) equal or greater than 2, and to compare the therapy effect on survival with or without metastatic disease. METHODS:From January 1998 through December 2004, 797 patients with inoperable stage III and IV NSCLC were treated with radiotherapy alone because of older age, cardiovascular disease, insufficient respiratory reserve or general frailty. Radical radiotherapy, consisting of approximately 60 Gy, given in 30 fractions was performed in 363 (45.5 %) of these patients. The other 434 patients (54.5%) were treated with palliative dose radiotherapy. Conventional follow-up of the patients was conducted at Izmir Oncology Center. All results were evaluated statistically. RESULTS:Seven hundred and sixty-three patients (95.7%) were male. The mean age was 61.02 years (+/- 9.678), ranging from 30-88 years. The prominent histology was squamous cell carcinoma (70.7%). Sixty-five patients (8.2%) have been staged IIIA, 419 (52.6%) IIIB, and 313 (39.3%) IV. The median follow up of patients was 274.19 days. One-year survival rate was 37%, and 2-year survival rate was 11% in the radical radiotherapy group, while these rates were 20% and 5% in the others. CONCLUSION:Although radical thoracic radiotherapy for metastatic NSCLC has not been adopted universally, this study shows that curative radiotherapy for the primary tumor provides additional survival benefit in patients with metastatic disease compared with palliative radiotherapy. This result raises the question of whether treatment with radical radiotherapy alone might be the most beneficial and cost-effective treatment of advanced stage NSCLC.

Background/aims We studied the tissue expression of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg), as well as the presence of CD57 (+) lymphocytes in liver biopsies of 73 chronic hepatitis B pediatric patients. Twenty-seven of them had a malignant disease, either leukemia or solid tumor. We investigated the differences between the oncological and non-oncological patient groups. Methods Liver biopsy specimens were examined for HBsAg, HBcAg and CD57 antigens immunohistochemically. Liver damage was measured according to the Knodell scoring system and all findings were assessed by Pearson correlation statistical analysis. Results Forty-three cases (58.9%) had minimal hepatitis, 27 cases (37%) had mild and three cases (4.1%) had moderate hepatitis. Fibrosis was shown in four cases (5.5%). For histological activity index (HAI), there was no statistical difference between the two groups. HBcAg and HBsAg expression rates were 69.9% and 90.4%, respectively. CD57 (+) lymphocytes were found in 32 cases (43.8%). HBcAg expression was higher in oncological patients. There was a positive correlation between HAI and percentage of CD57 (+) cells. However, HBsAg expression showed a negative correlation with HAI. The number of CD57 (+) cells was lower than expected. Conclusion These results suggest that determination of nuclear HBcAg expression would be more useful in the follow-up of oncological patients with chronic hepatitis B.