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Background: A study was undertaken to evaluate the usefulness of telomerase activity assay in transthoracic fine needle biopsy (TFNB) aspirates collected from peripheral tumours of the lung in predicting the malignant aetiology of lung infiltrations. Methods: 100 patients with a peripheral infiltration of the lung underwent TFNB of the focal lesion. The aspirates were subjected to standard cytological evaluation. Telomerase activity in the specimens was determined with the PCR-ELISA PLUS method. The sensitivity, specificity, accuracy and predictive value of TFNB were calculated for cytological examination of aspirates alone and cytological examination with additional telomerase activity assessment. Results: Lung cancer was newly diagnosed in 84 subjects and benign peripheral lesions were found in 16. During the first TFNB, lung cancer was identified in 56 cases of cancer (66.7%) while increased telomerase activity was found in 61 cancer aspirates (72.6%). No subject with a benign infiltration had a false positive result from cytological examination, but in one case (6.25%) increased telomerase activity was observed. The diagnostic sensitivity, accuracy and negative predictive value of the combination of cytological examination and telomerase activity assay in TFNB specimens were significantly higher than for cytological examination alone (89.3% vs 66.7%, p = 0.0004; 90% vs 72%, p = 0.001; 62.5% vs 36.4%, p = 0.039), but a combination of the two examinations was associated with a lower specificity of TFNB (96.9% vs 100%, p = 0.002). Conclusion: Detection of telomerase activity in aspirates taken during TFNB of a peripheral lung infiltration should be considered as an indication of the risk of malignancy in cases with false negative cytological results.

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in Poland and worldwide. Cost-of-illness studies (analysing total, direct and indirect costs) are studies aimed to determine the economic burden of a disease. Acute exacerbations and hospitalisation are the major cost drivers in COPD. The aim of the study was to estimate the direct costs of COPD treatment in the setting of specialist outpatient care from the societal perspective. Material and methods: Chronic obstructive pulmonary disease costs were estimated from a compilation of data: medical records of patients managed at 8 specialist outpatient clinics and 5 teaching hospitals in Poland between 2007 and 2008. The direct costs, resulting from chronic treatment and treatment of acute exacerbations in the outpatient setting, were calculated using the bottom-up approach on the basis of data collected by pulmonary specialists at outpatient clinics. The mean cost of acute exacerbation managed in the inpatient setting was derived from a multicentre Polish study in which five clinical centres participated. Results: The total cost per patient per year was 4027.82 zlotys (1007 euro) and included the cost of chronic treatment in the amount of 2423.57 zlotys (606 euro) plus the cost of treatment of an acute exacerbation in the outpatient setting in the amount of 421.16 zlotys (105 euro) plus the cost of treatment of an acute exacerbation in the inpatient setting in the amount of 1183.09 zlotys (296 euro). Conclusions: Treatment of COPD in poses a considerable economic burden on the Polish society.

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