Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2008
[Reversal of digital clubbing in surgically treated lung cancer patients].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Moreira José da Silva, Hass Marlene, Moreira Ana Luiza Schneider, Fleck James de Freitas, Camargo José de Jesus Peixoto
Аннотация
OBJECTIVE: To objectively evaluate the reversal of digital clubbing (DC) in a series of surgically treated lung cancer patients, and to review the literature on the subject.
METHODS: Sixty-one patients with non-small cell lung cancer--40 with and 21 without DC--were treated by pulmonary resection. Eleven (18%) received additional postoperative radiation therapy. Preoperatively, as well as on postoperative days 7, 18, and 90, the hyponychial angle (HA) and the distal phalangeal depth/interphalangeal depth (DPD/IPD) ratio were determined on profile shadow projections of the index fingers. A review of the literature on reversal of DC (1954-2007) was also performed.
RESULTS: From the preoperative period to postoperative day 90, HA decreased from 200.5 +/- 5.0 masculine to 193.3 +/- 6.8 masculine (p < 0.001), and the DPD/IPD ratio decreased from 1.014 +/- 0.051 mm to 0.956 +/- 0.045 mm (p < 0.001) in the group of 40 patients with DC. The HA and the DPD/IPD ratio decreased in 33 (82.5%) but remained the same in 7 (1.7%), 6 with unfavorable evolution. In the 21 patients without DC, HA (184.5 +/- 5.5 masculine) and the DPD/IPD ratio (0.937 +/- 0.046 mm) remained unchanged after surgery. In the literature (1954-2007), we found 52 cases, 5 of which were lung cancer cases, in which reversal of DC, observed in several clinical conditions, was explicitly reported.
CONCLUSION: In most lung cancer patients, DC resolves after effective surgical treatment of the tumor, as can occur in patients with other conditions.
METHODS: Sixty-one patients with non-small cell lung cancer--40 with and 21 without DC--were treated by pulmonary resection. Eleven (18%) received additional postoperative radiation therapy. Preoperatively, as well as on postoperative days 7, 18, and 90, the hyponychial angle (HA) and the distal phalangeal depth/interphalangeal depth (DPD/IPD) ratio were determined on profile shadow projections of the index fingers. A review of the literature on reversal of DC (1954-2007) was also performed.
RESULTS: From the preoperative period to postoperative day 90, HA decreased from 200.5 +/- 5.0 masculine to 193.3 +/- 6.8 masculine (p < 0.001), and the DPD/IPD ratio decreased from 1.014 +/- 0.051 mm to 0.956 +/- 0.045 mm (p < 0.001) in the group of 40 patients with DC. The HA and the DPD/IPD ratio decreased in 33 (82.5%) but remained the same in 7 (1.7%), 6 with unfavorable evolution. In the 21 patients without DC, HA (184.5 +/- 5.5 masculine) and the DPD/IPD ratio (0.937 +/- 0.046 mm) remained unchanged after surgery. In the literature (1954-2007), we found 52 cases, 5 of which were lung cancer cases, in which reversal of DC, observed in several clinical conditions, was explicitly reported.
CONCLUSION: In most lung cancer patients, DC resolves after effective surgical treatment of the tumor, as can occur in patients with other conditions.