Tomasz Marjański

Medical University of Gdansk, Danzig, Pomeranian Voivodeship, Poland

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Publications (8)15.54 Total impact

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    ABSTRACT: ABSTRACT Purpose: Molecular features of non-small cell lung cancer (NSCLC) in never-smokers are not well recognized. We assessed the expression of genes potentially related to lung cancer etiology in smoking vs. never-smoking NSCLC patients. Methods: We assayed frozen tumor samples from surgically resected 31 never-smoking and 54 clinically pair-matched smoking NSCLC patients, and from corresponding normal lung tissue from 27 and 43 patients, respectively. Expression of 21 genes, including cell membrane kinases, sex hormone receptors, transcription factors, growth factors and others was assessed by reverse transcription - quantitative PCR. Results: Expression of 5 genes was significantly higher in tumors of non-smokers vs. smokers: CSF1R (p<0.0001), RRAD (p<0.0001), PR (p=0.0004), TGFBR2 (p=0.0027) and EPHB6 (p=0.0033). Expression of AKR1B10 (p<0.0001), CDKN2A (p<0.0001), CHRNA6 (p<0.0001), SOX9 (p<0.0001), survivin (p<0.0001) and ER2 (p=0.002) was significantly higher in tumors compared to normal lung tissue. Expression of AR (p<0.0001), EPHB6 (p<0.0001), PR (p<0.0001), TGFBR2 (p<0.0001), TGFBR3 (p<0.0001), ER1 (p=0.0006) and DLG1 (p=0.0016) was significantly lower in tumors than in normal lung tissue. Expression of IGF2 was higher in tumors than in healthy lung tissue in never-smokers (p=0.003), and expression of AHR (p<0.0001), CSF1R (p<0.0001) and RRAD (p<0.0001) was lower in tumors than in healthy lung tissue in smokers. Conclusion: Expression of several genes in NSCLC is strongly related to smoking history. Lower expression of PR and higher expression of ER2 in tumors suggests a possibility of hormonal therapeutic intervention in selected NSCLC patients. Distinct molecular features of NSCLC in never-smokers, e.g. CHRNA6 upregulation, may prompt new treatment strategies.
    Advances in Medical Sciences 01/2014; · 0.80 Impact Factor
  • Tomasz Marjanski, Adam Sternau, Robert Dziedzic
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    ABSTRACT: Bronchial stump fistula (BSF) is a known complication after lobectomy, although its incidence after lobe resection for non-small cell lung cancer usually does not exceed 2%. We present the case of a patient in whom a late BSF developed that led to a fatal pulmonary hemorrhage 4 weeks after right upper lobectomy and 4 hours after emergency readmission. Such a pulmonary hemorrhage could have been prevented by pulmonary artery embolization and intrapericardial pneumonectomy. The decision to perform pneumonectomy as a preventative procedure without overt clinical symptoms was a difficult decision to reach, particularly given the likelihood of being unnecessarily aggressive.
    The Annals of thoracic surgery 10/2013; 96(4):e95-e96. · 3.45 Impact Factor
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    ABSTRACT: Low-dose computed tomography (LDCT) screening improves lung cancer prognosis but also results in diagnostic work-up and surgical treatment in many individuals without cancer. Therefore, we analysed the procedures that screening participants underwent to better understand the extent of overdiagnosis. Between 2009 and 2011, 8649 healthy volunteers aged 50-75 years with a 20 pack-year smoking history underwent LDCT screening, of whom individuals with detected lung nodules had 2-years control. Participants with a nodule >10 mm in diameter or with suspected tumour morphology underwent diagnostic work-up: 283 (6%)/4694 (54%) screened participants had detected lung nodules. One hundred and four individuals underwent surgery, 27 underwent oncological treatment and 152 without a cancer diagnosis underwent further follow-up with LDCT. In 75% of participants accepted for diagnostic work-up and 25% of surgical patients, the procedures were unnecessary. In 70 (24.7%) participants, a specific diagnosis was obtained mainly due to the low efficacy of fine needle aspiration biopsy [sensitivity, 65.2%; negative predictive value (NPV), 95.9%] and bronchofiberoscopy (sensitivity, 71.4%; NPV, 50%) caused by overinterpretation of LDCT [positive predictive value (PPV), 2%]. Of 104 (36.7%) surgical patients, 43 (41.4%) had a preoperative cancer diagnosis, and 61 (58.6%) underwent surgery without pathological examination. In the latter group, intervention was justified in 35 (57.3%) patients. Complications occurred in 49 (17.3%) participants subjected to diagnostic work-up. In surgical patients, 67 (64.4%) malignant and 37 (35.6%) benign lesions were resected. In the latter group, intervention was justified in only 11 (29.7%) patients. No patient died because of diagnostic or treatment procedures during the study. The complication rate was 14.5% in the malignant and 10.8% in the benign groups. A neoplasm was found in 94 screening participants, of whom 67 (71.3%) underwent surgery; the remaining 27 (28.7%) patients were not surgical candidates. Adenocarcinoma accounted for 49/67 (73%) patients who underwent surgery for non-small-cell lung cancer (NSCLC); 56/67 (84%) patients had stage I NSCLC, and 26/67 (38%) underwent video-assisted thoracoscopic surgery lobectomy. Futile diagnostic work-ups and operations must be reduced before LDCT screening can be broadly used. Stage I adenocarcinoma dominated in the NSCLC patients who underwent surgery.
    Interactive Cardiovascular and Thoracic Surgery 09/2013; · 1.11 Impact Factor
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    ABSTRACT: There is increasing evidence that suggests that particular histopathologic types of non-small-cell lung cancer (NSCLC) display distinct molecular characteristics. We analyzed, in lung squamous cell carcinoma (SCC) and adenocarcinoma (AC), the expression of 8 genes that constitute 2 previously reported prognostic expression signatures in NSCLC. Fresh-frozen tumor and normal lung samples were obtained at surgery from 135 patients with stage I-III NSCLC (89 (65.9%) SCC, 46 (34.1%) AC). Expression of CSF1 (colony stimulating factor for macrophages), carbonic anhydrase 9 (CA9), epithelial growth factor receptor (EGFR), dual specificity phosphatase 6 (DUSP6), v-erb-b2 erythroblastic leukemia viral oncogene homolog 3 (ERBB3), monocyte to macrophage differentiation-associated (MMD), lymphocyte-specific protein tyrosine kinase (LCK) and signal transducer and activator of transcription 1 (STAT1) was assessed in SCC, AC, and in normal lung by quantitative reverse transcriptase - polymerase chain reaction (qRT-PCR). Metastasis-free survival was analyzed according to the median value of gene expression in the entire NSCLC cohort and separately in SCC and AC. Expression of CA9, CSF1, DUSP6, STAT1, and MMD differed between NSCLC and normal lung. EGFR was more abundant in SCC compared with AC, whereas the reverse was true for DUSP6 and ERBB3. A high expression of CSF1 correlated with shorter metastasis-free survival in the entire NSCLC group (P = .016) and in SCC (P = .049) and AC (P = .034) cohorts. Several genes considered prognostic in NSCLC showed significantly different expression in SCC and AC, and thus should be analyzed separately in these 2 subtypes for their prognostic significance. CSF1 is similarly expressed in SCC and AC, and portends a poor outcome in the entire group of patients with NSCLC, and in SCC and AC when considered separately.
    Clinical Lung Cancer 07/2013; · 2.04 Impact Factor
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    ABSTRACT: 1. Prolongation of the QT interval is associated with a risk of life-threatening cardiac arrhythmias. In the present study, we examined whether reversible blockade of preganglionic sympathetic fibres of the heart, achieved by thoracic epidural anaesthesia, affects cardiac repolarization and thus confers an anti-arrhythmic effect. 2. Fifty-two men, aged between 28 and 65 years, were included in the study: 28 were patients scheduled for thoracic epidural anaesthesia (Group T) and 24 were patients scheduled for lumbar epidural anaesthesia (Group L). Epidural blockade was achieved with 0.5% isobaric bupivacaine solution. Measurements were taken from electrocardiogram fragments obtained before epidural anaesthesia and after detection of blockade (T1 or T8 segment sensory block in Groups T and L, respectively). Correction of the QT interval was calculated using Bazett's formula (QTcb), Fridericia's correction (QTcf) and the Framingham formula (QTcF). Transmural dispersion of repolarization (TDR) was determined using the Tpeak--Tend time, where Tpeak is the peak of the T wave and Tend is the end of the T wave. 3. Significant shortening of the QTcb interval and TDR was detected after blockade in Group T. However, there were no changes in the ECG parameters in Group L. 4. In conclusion, reversible blockade of preganglionic sympathetic fibres to the heart, achieved by thoracic epidural anaesthesia, results in a reduction in QTcb, as well as the TDR. These changes may explain the anti-arrhythmic action seen with central blockade.
    Clinical and Experimental Pharmacology and Physiology 03/2009; 36(9):880 - 883. · 2.41 Impact Factor
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2007; 24:100-101.
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    ABSTRACT: To evaluate the results of thymectomy in myasthenia gravis we performed retrospective analysis of 82 consecutive patients in the mean age of 39 +/- 15 treated between 1991 and 2001. All patients underwent extended thymectomy by median sternotomy. Follow-up was assessed in 74 of 81(91.4%) patients, in the mean age of 39 +/- 15, discharged from the Department. Fifty three (71.6%) patients had symptoms of myasthenia gravis for less than 2 years. According to Osserman's classification 8 (10.8%) patients were assessed as class I, 32 (43.2%) as IIA 26 (35.2%) as IIB and 8 (10.8%) as IIC. In the postoperative period 8 (10.8%) patients had respiratory insufficiency, 5 (6.8%) were reoperated for bleeding. One patient died (1.4%) due to bilateral pneumonia and pulmonary insufficiency. After thymectomy the improvement of patient's clinical status was observed in 46 patients (86.4%) and complete remission was in 13 patients (17.6%). Prompt improvement after thymectomy (p = 0.008) and short duration of symptoms (p = 0.036) are positive predictive factors. Patients in class I had significantly better prognosis concerning complete remission (p = 0.036). Age, gender, histology of the thymus, and type of the thymoma had no influence on long time follow up. Extended thymectomy is a safe procedure leading to the improvement in majority of patients treated for myasthenia gravis.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2005; 18(103):41-4.
  • Endoscopy 46(S 01):E423. · 5.74 Impact Factor