Background/aim: Significant advances have been achieved in immunotherapy for the treatment of lung cancer. It is known that tumor cells and cells in the tumor microenvironment express high amounts of programmed cell death ligand 1 (PD-L1). These PD-L1s interact with programmed cell death protein 1 (PD-1), causing immunosuppression. The aim of our study is to examine the correlation between the serum sPD-1 and sPD-L1 levels and clinicopathological characteristics in patients with nonsmall cell lung cancer. We also compared our results with the healthy population (control group). Materials and methods: Thirthy-seven nonsmall cell lung cancer (NSCLC) patients who were operated in our clinic were included in our study. The control group included fifteen healthy patients. The sPD-1 and sPD-L1 levels were measured in serum samples by using the ELISA method. Results: The preoperative sPD-1 and sPD-L1 levels were significantly higher in the study group compared to the control group (44.12 ± 22.25 pg/mL vs. 18.54 ± 6.56 pg/mL; p = 0.001 and 26.15 ± 18.03 pg/mL vs. 10.29 ± 3.08 pg/mL; p = 0.001, respectively). There was a statistically significant decline in serum sPD-1 and sPD-L1 levels at the preoperative and postoperative 1st, 7th, and 30th days following surgical resection (44.12 ± 22.25 pg/mL, 37.86 ± 18.02 pg/mL, 36.33 ± 18.36 pg/mL, 34.14 ± 13.71 pg/mL; p = 0.007 and 26.15 ± 18.03 pg/mL, 20.60 ± 15.50 pg/mL, 18.31 ± 14.04 pg/mL, 13.64 ± 10.60 pg/mL; p = 0.001, respectively).There was a positive correlation between the preoperative and postoperative 30th day serum sPD-1 levels and the tumor size (p = 0.031, r = 0.352; p = 0.024, r = 0.371; respectively). We also found a positive correlation between the preoperative and postoperative 30th day serum sPD-L1 levels and pleural invasion (p = 0.001, p = 0.001; respectively), and the N category (p = 0.015, p = 0.013; respectively). Conclusion: We think that sPD-1 and sPD-L1 levels may be used as a potential biomarker for lung cancer screening, prediction of the stage, and besides to detect recurrences and/or metastases following resection in NSCLC following validation with multicenter and larger-scale prospective trials.

Postoperative complications following thoracic procedures are a major cause of morbidity and mortality. Alveolar air leaks and/or bronchopleural fistulas are associated with increased risk of infection, prolonged chest tube, and hospital stay duration and therefore generate economical concern for health care providers. A variety of surgical sealants or adhesives have been introduced to overcome this complication. Since intraoperative BioGlue® application can also cause an inflammatory reaction and mimic tumor recurrence on FDG PET-CT, in the present study we aimed to investigate its potential role in false-positive PET-CT results in patients operated for NSCLC. Data of six patients who underwent resection for primary NSCLC at our institution (Department of Thoracic Surgery, Hacettepe University Medical Faculty) between January 2015 and December 2018 and had false positivity, due to BioGlue® application, at the bronchial stump in follow-up FDG PET-CT were retrospectively analyzed from a prospectively collected database. One of the 6 patients was female and 5 were male. The mean age was 68 years (range, 56-79 years). The average time interval between operation and postoperative FDG-PET imaging was 4.3 months (range, 4-6 months). Follow-up FDG-PET imaging SUVmax values ranged between 3.0 and 9.0 (median: 5.33). All patients have been evaluated by FDG-PET scan following the detection of soft tissue densities at the surgical site suspicious for recurrence at their follow-up chest CT scans. Four patients underwent a bronchoscopic examination, bronchial stumps were examined and multiple biopsies were taken from suspicious nodules or tissues and sent for pathologic examination. Histopathological results revealed inflammation which is compatible with foreign body granuloma, without any suspicion for malignancy, in all cases. Two patients were solely followed-up and subsequent FDG-PET imaging after 3 months revealed complete resolution of FDG uptake. To avoid unnecessary biopsies or surgical procedures, the possibility of false-positive results due to surgical adhesive product use should be taken into account while interpreting follow-up FDG-PET imaging results and the operative reports should be written in detail, describing which surgical materials used and their exact application sites.

Introduction: Postoperative pneumonia is one of the most common and serious complications of surgery. Patients undergoing major pulmonary surgery for lung cancer are at high risk for postoperative pulmonary infections. The aim of this study was to evaluate the feasibility of using preoperative...

Background/aim: No reliable, easily measurable biomarker currently exists for the screening or prognosis of lung cancer. The present study evaluates the potential utility of vascular endothelial growth factor (VEGF) and endocan, which can be readily measured in blood samples, as biomarkers for screening and prognostic assessment in lung cancer. Materials and methods: Included in the study were 38 patients with early-stage non-small cell lung cancer (NSCLC) and 29 controls. All patients underwent surgical intervention and were monitored for 1 month postoperatively. Serum VEGF and endocan levels were measured preoperatively and postoperatively. Clinical characteristics, laboratory data, and histopathological findings were recorded for all participants. Results: The preoperative VEGF levels of the patients were significantly higher than those of the controls (p = 0.001), while postoperative VEGF levels decreased significantly following surgery (p < 0.001). The endocan levels of the patients and controls were similar preoperatively. Additionally, endocan levels were significantly increased after the surgery in the patient group (p < 0.001). A comparison of VEGF and endocan levels according to TNM staging and tumor histopathology revealed no significant differences. Conclusion: VEGF can serve as a potential biomarker for screening and prognostic assessment in early-stage NSCLC. In contrast, endocan did not demonstrate utility for such clinical purposes. VEGF may also be considered for the evaluation of treatment efficacy following surgical intervention.

Aim: COVID-19 (coronavirus disease 2019) pneumonia is a serious condition with high mortality and morbidity. Tools are needed for effective diagnosis and better prediction of prognosis in the course of this disease. This study aimed to compare the effectiveness of the MuLBSTA (Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension and Age) score with blood parameters, SOFA (Sequential Organ Failure Assessment), and APACHE II (Acute Physiology and Chronic Health Evaluation II) scores, and to investigate its significance in predicting 28-day mortality in patients diagnosed with COVID-19 and followed up in the intensive care unit (ICU). Material and Method: This study included 312 patients admitted to ICU for COVID-19 infection. SOFA, MuLBSTA and APACHE-II scores of patients were estimated at ICU admission. Demographic data and laboratory results of patients were retrospectively reviewed. Results: Of the 312 patients included in the study, 58.7% (n=183) were male and 41.3% (n=129) were female. The AUC value was 0.863 for the SOFA score and 0.843 for the MuLBSTA score. The MuLBSTA score was positively correlated with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), while it was negatively correlated with the lymphocyte-to-monocyte ratio (LMR). Patients were divided into two groups as high-risk and low-risk, considering a cut-off value of 12 for the MuLBTSA score. The survival time of patients with a high-risk MuLBTSA score was 12±0.78 days, while the survival time of patients with a low MuLBTSA score was 22.8±1.3 days. Conclusion: The combined use of the MuLSBTA score, SOFA score, and NLR after ICU admission for COVID-19 pneumonia will be more effective in predicting mortality.

Lung cancers associated with cystic airspaces (LCCAs) are a rare and relatively novel concept analyzed in various case reports and retrospective studies. In this review, it was our aim to investigate the morphologic, imaging, and clinicopathologic characteristics of this entity, as well as its natural course in light of the current literature. Literature search including the years 2000-2022 was conducted in PubMed. We analyzed the definition, morphological classification, pathogenesis and histopathology, imaging and clinical features, differential diagnosis and natural course and prognosis of LCCAs. LCCAs are increasingly being identified as missed or delayed diagnoses in lung cancer screening programs. Early recognition and intervention of this entity when cyst wall thickening or solid components appear can potentially improve outcomes. Nevertheless, the prognosis and survival of these patients are still poorly understood due to limited data, and further research is needed to better understand the behavior of these lesions and propose management guidelines.