BACKGROUND:Serum Procalcitonin (PCT) is a biomarker that is frequently used to diagnose an infection. In some cases of thoracic malignancy, procalcitonin level appears to increase. However, the role of procalcitonin to diagnose malignancy is not certain yet, and the causes have not been known.AIM:This study aimed to investigate procalcitonin levels in non-small cell lung cancer patients.METHODS:This was an observational study with a cross-sectional design. All lung cancer patients did not diagnose based on cytology/histopathology results with no evidence nor were signs and symptoms of infection recruited through consecutive sampling. The subtypes of lung cancer include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, staged III and IV. The procalcitonin levels were analysed from blood using immunofluorescent assay. Data were then analysed with the Chi-Square test by Epi Info™ 7 programs in which p-value < 0.05 was considered statistically significant.RESULTS:A total of 68 lung cancer patients fulfilled the criteria of this study, 55 men (80.9%) and 13 women (19.1%). The highest percentage of cytology/histopathology type found was adenocarcinoma (80.9%), and 60.3% of those were diagnosed in stage IV. An increased procalcitonin level (greater than 0.01 ng/mL) occurred in 80.9% of Non-Small Cell Lung Cancer (NSCLC) patients. It appears that the higher the stage of lung cancer, the lower procalcitonin levels would be, although it was not statistically significant. There was no association between lung cancer subtype with procalcitonin levels.CONCLUSION:An increased level of procalcitonin may be an indication not only for infection but also for Non-Small Cell Lung Cancer.

BACKGROUND:Lung cancer is the most frequently found cancer among men around the world and is is the main cause of cancer deaths. The occurrence of lung cancer is particularly associated with smoking habit around men, along with environmental tobacco smoke in the workplace. It is diagnosed in patients with the varied clinical and demographical profile.AIM:We aimed to determine the clinical profile of men with non-small cell lung cancer in Adam Malik Hospital Medan based on age, smoking habits, occupation, clinical symptoms, clinical stage, and type of lung cancer histopathologyMATERIAL AND METHODS:This is a descriptive study using medical record from 2012 to 2015 of all men with non-small cell lung cancer at Adam Malik Hospital Medan, IndonesiaRESULTS:Most men with lung cancer are aged 51-60 years old (43.5%) and work like entrepreneurs. More than 80% of men with lung cancer are heavy smokers. Adenocarcinoma is the most common type of lung cancer, and 2/3 of lung cancer patients are diagnosed at an advanced stage.CONCLUSION:Lung cancer occurs most often in active smokers in the age group above 50 years. The most dominant type of histopathology is adenocarcinoma and is frequently diagnosed in the late stages.

Orbital metastasis of lung adenocarcinoma is very rare. The incidence is only found to be approximately 7%–12% of lung cancer cases. The lack of knowledge about orbital metastasis results in misdiagnosis between malignant or benign lesion. This was a case of a 39-year-old woman complaining about a protruding left eye and a blind pain in the left eye characterized by hyperemesis eyeball. A CT scan of the orbital showed a soft tissue tumor in the fronto-naso-superomedial area of the left orbital with suspicion of infiltration of the medial rectus muscle, left bulbus oculi, lamina papyracea, and left frontal sinus wall which causes proptosis and soft tissue tumor in the left temporal region with suspicion of infiltration in the left sphenoid wing with an impression of metastasis. A Fine Needle Aspiration Biopsy (FNAB) in the temporal and intra-orbital region showed metastatic adenocarcinoma. Moreover, findings of the chest x-ray and chest CT scan concluded that there was a tumor in the left lung, and a bronchoscopy found adenocarcinoma as the biopsy results.

Background: Rat Sarcoma (RAS) protein encoded Guanosine Triphosphate (GTP-ase) activity, known as a switch of cell proliferation. The mutation of this protein alters the early stage of carcinogenesis and along with the interaction with other oncogene drivers and environmental factors affect the clinical characteristics and prognosis in cancer patients, particularly lung cancer. Objective: This study aims to determine the Kristen Rat Sarcoma (KRAS) mutation in lung cancer patients in North Sumatera and evaluate factors that might contribute in the development of lung cancer in the absence of KRAS mutation. Methods: This was a retrospective cohort study enrolled 44 subjects age > 18 year with the diagnosis of lung cancer. Histopathology preparation was obtained from surgery, bronchoscopy, and percutaneus needle biopsy then formed as paraffin-block. KRAS mutation was analyzed using Polymerase Chain Reaction (PCR) method with specific primer of exon 2 for evaluating the expression of RAS protein then continued with Sanger Sequencing Method at 12th and 13th codon. Results: The majority of subjects were male, age > 40 years old, bataknese, heavy smoker, with Adenocarcinoma. Almost all the subjects showed the expression of exon 2 of RAS protein in PCR examinations. However, Sequencing analysis using Bioedit Software, BLASTs and Finch T showed GGT GGC as protein base 219-224 which represented 12th and 13th Codon 12 and 13. The results interpreted there was no mutations of exon 2 of KRAS in North Sumatera Population. Conclusion: The absence of KRAS mutation in exon 2 in several ethnics in North Sumatera populations was not the main factors of lung cancer.

Background: Nicotine is metabolized to cotinine by cytochrome P450 enzyme, and this enzyme is involved in the activation of toxic and carcinogenic substances. The aim of this research was to assess the relationship between genetic polymorphism of CYP2A13 and lung cancer incidence in female passive smokers.Materials and methods: This research was a case-control study that involved 104 research subjects. Subjects were recruited through purposive sampling technique from 2 hospitals in Medan, North Sumatra, Indonesia. The case population consisted of female passive smokers with lung cancer and the control population consisted of female passive smokers without lung cancer. All research subjects underwent blood sampling for genomics DNA extraction and CYP2A13 genotyping by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Data was analyzed by conditional logistic regression by Epi Info 7.0 software.Results: Among 104 subjects, 26 (25%) individuals were heterozygous, 76 (73%) individuals were wild type, and 2 (2%) were mutant for the 257Cys allele. There was a significant correlation between CYP2A13 genotype and lung cancer incidence (p-value<0.05). Female passive smokers with CT genotype had 2.7 greater risk of developing lung cancer than those with CC genotype (wild type). The C allele had more frequency and 1.6 times higher risk of lung cancer compared to T allele with a wide confidence range (0.73–3.52).Conclusion: There was a significant correlation between CYP2A13 polymorphism and lung cancer incidence in female passive smokers.Keywords: polymorphism, CYP2A13, PCR-RFLP, female passive smoker, lung cancer