The aim of this study was to assess the diagnostic yield of the tumour markers carcinoembryonic antigen, carbohydrate antigen 15-3, carbohydrate antigen 19-9 and carbohydrate antigen 125, in serum and bronchoalveolar lavage fluid in a group of patients with bronchogenic carcinoma. Serum and bronchoalveolar lavage fluid samples were collected in a group of 90 patients with benign or malignant pulmonary diseases. After appropriate processing, tumour markers were determined by enzyme immunoassay. The diagnostic yields (sensitivity, specificity and predictive values) in each environment (serum and bronchoalveolar lavage fluid) were obtained by using ''Receivers operating characteristic'' curve. Determined individually, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125, showed the greatest diagnostic accuracy in bronchoalveolar lavage fluid. Carbohydrate antigen 15-3 did so in serum. Carcinoembryonic antigen was the most relevant marker in bronchoalveolar lavage fluid. For the factors evaluated in this study, determination of carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125 in bronchoalveolar lavage fluid were clinically more useful markers in comparison with serum, although the latter may also be helpful in certain situations. Although there is no specific tumour marker for lung cancer, the combination of several can be used to diagnose most patients with lung cancer and also to rule out false positive and negative cases.

It is noteworthy that the dehydro-Ala residue adopts an extended conformation that is different than those observed in dehydro-Phe, dehydro-Leu, and dehydro-Abu. The peptide N-Boc-L-Phe-dehydro-Ala-OCH3 (C18H24N2O5) was synthesized by the usual workup procedure and finally by converting N-Boc-L-Phe-L-Ser-OCH3 to N-Boc-L-Phe-dehydro-Ala- OCH3. It was crystallized from its solution in a methanol-water mixture at room temperature. The crystals belong to the monoclonic space group P2(1), with a = 9.577(1) A, b = 5.195(3) A, c = 19.563(3) A, beta = 94.67(5) degrees, V = 970.1(6) A3, Z = 2, dm = 1.201(5) Mg m-3, dc = 1.197(5) Mg m-3. The structure was determined using direct method procedures. It was refined by a full-matrix least-squares procedure to an R value of 0.048 for 1370 observed reflections. The C2 alpha-C2 beta distance is 1.327(8) A, while the bond angles N2-C2 alpha-C2' and C1'-N2-C2 alpha are 109.8(5) degrees and 127.8(5) degrees, respectively. The backbone adopts a nonspecific conformation with dehydro-Ala in a fully extended conformation with the following torsion angles: theta 1 = 175.2(4) degrees, omega 0 = 170.2(4) degrees, phi 1 = 135.8(5) degrees, psi 1 = -22.6(6) degrees, omega 1 = 168.5(5) degrees, phi 2 = -170.3(5) degrees, psi 2T = -178.6(5) degrees, theta T = 178.4(7) degrees. The rigid planar and trans conformation of dehydro-Ala forces Phe to adopt a strained conformation. The Boc group has a trans-trans conformation.(ABSTRACT TRUNCATED AT 250 WORDS)

Background and Aims:Chronic obstructive pulmonary disease (COPD) is thought to have increased association with metabolic syndrome (MS) which represents a cluster of factors that increase the risk of cardiovascular diseases and diabetes mellitus. However, the extent of association of COPD with MS and its individual components are still an unsettled issue, and it is likely to vary from population to population. Under the above context, this study was undertaken to investigate the association of MS and its components with COPD.Materials and Methods:With a cross-sectional analytic design, 77 COPD and an equal number of non-COPD (apparently healthy) participants were studied purposively. The two groups were found to be matched by age, sex, and monthly income groups. The data of COPD patients and non-COPD participants were collected from a tertiary level hospital in Kolkata and a locality of Greater Kolkata, respectively. They were interviewed, and the frequencies of MS were assessed using 3 criteria (National Cholesterol Education Program-Third Adult Treatment Panel [NCEP ATP III], modified NCEP ATP III, and International Diabetic Federation [IDF]). Anthropometric measurements were taken, and fasting blood sample was collected to test the fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein (HDL) of respondents. Logistic regression was applied to estimate the odds ratio (OR).Results:Among the COPD subjects, 44%, 46%, and 31% had coexisting MS as defined by NCEP ATP III, modified NCEP ATP III, and IDF criteria, respectively. The corresponding percentages in the non-COPD groups were 31%, 38%, and 32%. On multivariate analysis, a significant association of MS (P < 0.015) with COPD was found only when the NCEP ATP III criteria were used. The (mean ± standard deviation) FBG concentration among COPD and non-COPD groups was 130 ± 65 mg/dl and 97 ± 26 mg/dl, which was significantly different (P < 0.001). The difference in systolic blood pressure (SBP) (P < 0.063) and HDL level (P < 0.058) lied just outside the statistical significance among COPD and non-COPD groups. Gender, exercise habit, family history of hypertension, and smoking habits were important confounders for the association of COPD with individual MS components. Using NCEP ATP III criteria, female gender (OR = 3.48), COPD groups (OR = 3.05), and family history of hypertension (OR = 3.31) were found as determinants (P < 0.05) of MS. Using modified NCEP ATP III criteria, female (OR = 3.66) and family history of hypertension (OR = 3.84) were found as determinants (P < 0.05) of MS.Conclusions:COPD is associated with MS only when the NCEP ATP III is used for the diagnosis of MS. No association can be revealed on using the IDF criteria for MS. Body mass index (BMI), and waist circumference does not seem to be appropriate measures for assessing the presence of MS among COPD patients. Among the components of MS BMI, SBP, FBG, TG, and HDL are significantly associated with COPD.