Although impressive differences in median, 3-year, and 4-year survival were observed, they were not statistically significant, except for stage I and II disease.

The NVB-DDP combination increased objective response rates and time to progression in comparison with NVB alone, but did not influence the survival of patients. The activity of NVB in the treatment of advanced NSCLC was confirmed.

Previous studies have suggested the utility of D-Dimer ELISA assays in eliminating a diagnosis of pulmonary embolism (PE). Our objectives were to evaluate the performance of a new, rapid, quantitative, and automated Liatest D-Dimer Assay in patients with suspected PE. Three hundred eighty-six consecutive patients referred to our institution between March 1992 and December 1996 for clinically suspected PE, with recent clinical signs not exceeding 1 wk, were included in this study. Diagnosis of PE was based on clinical evaluation, radionuclide lung imaging, lower limb examination, and, when required, pulmonary angiography. D-Dimer performances, for both Liatest D-Dimer and standard D-Dimer ELISA (Asserachrom DDi), assays, were assessed at the end of the study. Among the 386 patients tested, 146 (37.8%) were classified as PE-positive. Liatest D-Dimer assay had a 100% sensitivity (95% confidence interval, 97 to 100%) and a negative predictive value of 100% (95% confidence interval, 94 to 100%). A normal result, below the cutoff of 500 ng/ml, occurred in 83 of the 386 (21%) patients. There was a strong agreement between Liatest D-Dimer and Asserachrom DDi analyses. These findings suggest that this rapid, quantitative, and automated D-Dimer assay provides a useful diagnostic tool for the clinician with regard to exclusion of PE.

Several studies have evaluated D-dimer, a fragment that is specific for the degradation of fibrin, 1 in patients with clinically suspected d e e p v e n o u s thrombosis (DVT).2 Because of their long half-lives, D-dimers provide a better choice than markers with shorter half-lives (thrombin-antithrombin complexes and prothrombin fragments 1 + 2) in evaluating the DVTs. Two D-dimer techniques are currently available: an e n z y m e l i n k e d -i m m u n o s o r b e n t assay (ELISA) or a latex agglutination assay. In preliminary studies, the ELISA assay has been reported to have very high sensitivity and moderate specificity. ELISA is the more widely used method. However, because it is time consuming, it is not well adapted for emergency testing; in addition, ELISA formatting is not usually suitable for individual testing. Studies involving latex testing for the measurement of Ddimer have frequently reported insufficient sensitivity for the exclusion of DVT. The purpose of the present study was to determine the performance of a new, quantitative and automated rapid D-dimer assay in the diagnosis of s u s p e c t e d DVT in a cohort of patients in whom symptoms had developed within 7 days before admission to the hospital. METHODS PatientsData for all patients with a possible diagnosis of DVT w h o were a d m i t t e d to the D e p a r t m e n t of Pneumology and Internal Medicine were collected prospectively on a register from March 1992 to June 1995. Recent clinical symptoms of DVT (onset less than 7 days) had to be present. The clinical suspicion of DVT occurred before hospitalization, so patients were referred for diagnosis, or during the first clinical 748

Treatment proposals and administered therapy differed according to age.