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and benefit of metformin in nondiabetic patients is unclear and needs to be studied further.” In a separate study, researchers in Japan associated metformin with lower incidence of lung cancer and mortality from overall cancer. Hiroshi Noto, M.D., Ph.D., with Tokyo Medical and Dental University, said this study confirms the beneficial link between metformin and NSCLC but that long-term randomized prospective trials are needed to confirm this potential benefit. “Nonetheless, their study should provide clinicians with an additional incentive to pay integrated clinical attention and elucidate the complex interactions between metformin and cancer,” he said. In another Roswell Park Cancer Institute study, researchers are investigating a new method using reverse transcription–PCR to classify NSCLC. This method measures miR-205 (microRNA 205) in relation to RNU6B and miR-21. According to their study, this technique increases classification accuracy to as high as 95%. With small biopsy samples, the accuracy of such classification using routine histological examination is approximately 85%. Dhillon, who was also involved in this study, said that routine use of this technique has been limited by the need to use samples with at least 50% tumor content. To overcome this, the researchers used laser microdissection, which allowed them to use small biopsy samples. Dhillon said the study validates using miR-205 level for accurate histological classification in NSCLC. According to a study from Japan, positive pleural lavage cytology (PLC) findings may help predict lung cancer prognosis. (PLC is the microscopic study of cells obtained from saline instilled into and retrieved from the chest during surgery for NSCLC, and a positive finding means that cancer cells were detected.) Masatoshi Kakihana, M.D., from Tokyo Medical University, explained that between 1995 and 2008, 1,965 patients with NSCLC and no pleural effusion underwent lung resection, and 812 consecutive patients underwent PLC immediately after thoracotomy before any manipulation of the lung. PLC was regarded as positive or negative, and the researchers used multivariate analysis to evaluate how 15 clinicopathological variables affected survival. Researchers identified positive PLC findings in 55 patients (6.8%), and adenocarcinoma occurred more often in those with positive findings than in those with negative findings. Females had a better prognosis than males, and N2 and N3 lymph node infiltrations were associated with worse survival. Positive PLC findings were statistically significantly associated with poorer survival in patients with stage II disease; also, patients with stage III NSCLC with negative PLC findings and those with positive adjusted stage III PLC findings had similar survival. The researchers also said that all patients with positive findings relapsed within 5 years. CHEST 2013 will be held October 26–31, 2013, in Chicago. None of the researchers mentioned disclosed any commercial financial interest supporting their research.

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