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Han L, Yao Z, Xie L, Li D, Wang C, Yang Y, Yang J, Huang Z, Li K, Zhang Y, Ye L, Tan Z, Liu Y, Chen Q, Wang T, Yang Z. Transcriptome Sequencing reveals the expressed profiles of mRNA and ncRNAs and regulate network via ceRNA mediated molecular mechanism of lung adenocarcinoma bone metastasis in Xuanwei. Transl Cancer Res 2021; 10:73-87. [PMID: 35116241 PMCID: PMC8799022 DOI: 10.21037/tcr-20-2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/20/2020] [Indexed: 12/25/2022]
Abstract
Background The most ordinary subtype of lung cancer is lung adenocarcinoma (LuAC), which is characterized by strong metastatic ability. And LuAC rates in Xuanwei leads to the poor prognosis and high death rate. In this study, we systematically explored the molecular mechanism of LuAC bone metastasis in Xuanwei by transcriptome sequencing. Methods RNA Sequencing was conducted to explore the noncoding RNAs (ncRNAs) expression profiles in primary LuAC and LuAC bone metastasis. We identified differentially expressed mRNAs (DEmRNAs), miRNAs (DEmiRNAs), lncRNAs (DElncRNAs) and circRNAs (DEcircRNAs). Bioinformatics analyses the possible relationships and functions of the LuAC bone metastasis-related competing endogenous RNA (ceRNA). And qRT-PCR was performed to evaluate the expression of these differently expressed genes in serum. Results A total of 2,141 DEmRNAs, 43 DEmiRNAs, 136 DElncRNAs and 706 DEcircRNAs were identified in the Xuanwei patients with primary LuAC vs. LuAC bone metastasis, respectively. The circRNA/miRNA/mRNA and lncRNA/miRNA/mRNA networks of LuAC in Xuanwei with bone metastasis were built, and the gene expression mechanisms regulated by ncRNAs were unveiled via the ceRNA regulatory networks. We observe that lncRNA (ADAMTS9-AS2, TEX41, DLEU2, LINC00152)-miR-223-3p-SCARB1 and hsa_circ_0000053-miR-196a-5p/miR-196b-5p-HOXA5 ceRNA networks might play an important role in bone metastasis of Xuanwei LuAC. Conclusions We comprehensively identified ceRNA regulatory networks of LuAC in Xuanwei with bone metastasis as well as revealed the contribution of different ncRNAs expression profiles. Our data demonstrate the association between mRNAs and ncRNAs in the metastasis mechanism of LuAC in Xuanwei with bone metastasis.
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Affiliation(s)
- Lei Han
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zhihong Yao
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Lin Xie
- Department of Medical Oncology, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Dongqi Li
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Cao Wang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Yihao Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Jifei Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zeyong Huang
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Kecheng Li
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Ya Zhang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Lijuan Ye
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zunxian Tan
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Yan Liu
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Qiuyun Chen
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Tiying Wang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zuozhang Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
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Decision-making factors for best supportive care alone and prognostic factors after best supportive care in non-small cell lung cancer patients. Sci Rep 2019; 9:19872. [PMID: 31882700 PMCID: PMC6934749 DOI: 10.1038/s41598-019-56431-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/10/2019] [Indexed: 12/20/2022] Open
Abstract
Among patients with non-small cell lung cancer (NSCLC), best supportive care (BSC) is well-known to improve patient's quality of life and prolong survival. This study aimed to clarify (1) the decision-making factors of BSC alone and (2) the prognostic factors after selection of no further anticancer therapies. We retrospectively reviewed the clinical data of patients with NSCLC between November 2004 and February 2014, who received BSC as only therapy and BSC after completion of anticancer therapies. One hundred eighteen patients received BSC alone. Among 860 patients treated with anticancer therapies, 236 were selected as control group, 160 of whom received BSC after anticancer therapy. The significant reasons for receiving BSC alone were: comorbidities of dementia, poor Eastern Cooperative Oncology Group performance status (ECOG-PS), patients' wishes, pulmonary comorbidities, wild type epidermal growth factor receptor (EGFR), relevant social background and psychiatric comorbidities. Poor prognostic factors at the start of BSC were poor ECOG-PS, presence of disseminated intravascular coagulation (DIC), and history of anticancer therapy. NSCLC patients with comorbidities, wild type EGFR, and relevant social background factors tended to receive BSC alone. Post-cancer therapy NSCLC patients and those with DIC and declining ECOG-PS have a shorter survival period from the start of BSC.
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Ji X, Ji Y, Wang W, Xu X. Forkhead box N1 inhibits the progression of non-small cell lung cancer and serves as a tumor suppressor. Oncol Lett 2018; 15:7221-7230. [PMID: 29725441 DOI: 10.3892/ol.2018.8210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 11/10/2017] [Indexed: 12/19/2022] Open
Abstract
Forkhead box N1 (FOXN1) belongs to the FOX family of transcription factors, which comprises a diverse group of winged-helix proteins. FOXN1 is a ubiquitously expressed member that has been implicated in the embryo development, metabolism, aging and cancer. However, little is known regarding the role of FOXN1 in non-small cell lung cancer (NSCLC). The aim of the study was to investigate the function of FOXN1 in NSCLC and examine the relevant mechanism. In the present study, using reverse transcription-quantitative polymerase chain reaction, western blotting, transwell assay, MTT assay, luciferase report assy, it was identified that knockdown of FOXN1 increased the proliferation of A549 and H1299 cells, while overexpression of FOXN1 evidently suppressed the cell growth. A Transwell assay was used to determine the relative cell invasion ability, and it was observed that the invading cells were markedly decreased in the FOXN1 overexpression groups; by contrast, reduced expression of FOXN1 demonstrated the potential to promote cell invasion. Furthermore, lower expression of FOXN1 was observed in NSCLC tissues and cell lines as compared with the adjacent non-tumor tissues or human bronchial epithelial cells, respectively. A higher level of FOXN1 was associated with a better prognosis of NSCLC patients. Quantitative chromatin immunoprecipitation analysis and luciferase reporter gene assays revealed that enhancer of zeste homolog 2 (EZH2) and β-catenin were two target genes of FOXN1. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis indicated that FOXN1 suppressed the expression levels of these target genes at the transcriptional level. In conclusion, the present study demonstrated that FOXN1 served major roles in NSCLC proliferation and invasion by directly repressing EZH2 and β-catenin, which suggested that FOXN1 may function as a tumor suppressor in NSCLC.
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Affiliation(s)
- Xiaojian Ji
- Emergency Department, The People's Hospital of Guizhou Province, Guiyang, Guizhou 550002, P.R. China
| | - Yan Ji
- Department of Hematology and Oncology, Regions Hospital, St. Paul, MN 55101, USA
| | - Wenqing Wang
- Emergency Department, The People's Hospital of Guizhou Province, Guiyang, Guizhou 550002, P.R. China
| | - Xinmei Xu
- Emergency Department, The People's Hospital of Guizhou Province, Guiyang, Guizhou 550002, P.R. China
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Abdel-Rahman O. Validation of the prognostic value of new sub-stages within the AJCC 8th edition of non-small cell lung cancer. Clin Transl Oncol 2017; 19:1414-1420. [DOI: 10.1007/s12094-017-1673-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/05/2017] [Indexed: 12/25/2022]
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Jia M, Xu Y, Zhu M, Wang M, Sun M, Qian J, Chang J, Wei Q. The P38α rs3804451 Variant Predicts Chemotherapy Response and Survival of Patients with Non-Small Cell Lung Cancer Treated with Platinum-Based Chemotherapy. Transl Oncol 2016; 9:531-539. [PMID: 27835790 PMCID: PMC5109261 DOI: 10.1016/j.tranon.2016.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 01/01/2023] Open
Abstract
The JNK and P38α pathways play an important role in the sensitivity and outcomes of chemotherapy. We hypothesize that functional single nucleotide polymorphisms (SNPs) of genes of these pathways modulate outcomes of patients with advanced non-small cell lung cancer (NSCLC) treated with first-line platinum-based chemotherapy (PBC). We selectively genotyped 11 independent, potentially functional SNPs of 9 genes in the JNK and P38α pathways first in a discovery group of 355 patients with advanced NSCLC treated with PBC, and we evaluated their associations with progression-free survival (PFS) and overall survival (OS) by Cox proportional hazards regression analysis. Then, resultant significant SNPs were further validated in a replication group of 355 patients. In both discovery and validation groups as well as their combined analysis, the MAPK14 rs3804451GA/AA genotypes showed a strong association with a reduced PFS (adjusted hazards ratio [HR]=1.39; 95% confidence interval [CI]=1.16-1.66; P=.0003) and OS (adjusted HR=1.41; 95% CI=1.11-1.80; P=.005) compared with the wild-type GG genotype. In contrast, patients with or without the MAPK14 rs3804451A allele had no significant difference in OS in response to tyrosine-kinase inhibitor treatment (adjusted HR=0.86; 95% CI=0.56-1.33; P=.505). The present study provides evidence that the MAPK14 rs3804451 G>A variant may modulate survival outcomes in patients with advanced NSCLC treated with PBC. Larger studies of additional patient populations are needed to validate our findings.
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Affiliation(s)
- Ming Jia
- Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China.
| | - Yuan Xu
- Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China.
| | - Meiling Zhu
- Department of Oncology, Xinhua Hospital affiliated to Shanghai Jiaotong University, School of Medicine, No. 1665, Kong Jiang Road, Shanghai, 200092, China.
| | - Mengyun Wang
- Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China.
| | - Menghong Sun
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China; Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai, 200032, China.
| | - Ji Qian
- State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Fudan Taizhou Institute of Health Sciences, Fudan University, Shanghai, 200032, China.
| | - Jianhua Chang
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China; Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai, 200032, China.
| | - Qingyi Wei
- Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui, Shanghai, 200032, China; Duke Cancer Institute, Duke University Medical Center, and Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA.
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Yoshiya T, Mimae T, Tsutani Y, Tsubokawa N, Sasada S, Miyata Y, Kushitani K, Takeshima Y, Murakami S, Ito H, Nakayama H, Okada M. Prognostic Role of Subtype Classification in Small-Sized Pathologic N0 Invasive Lung Adenocarcinoma. Ann Thorac Surg 2016; 102:1668-1673. [DOI: 10.1016/j.athoracsur.2016.04.087] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/24/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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Detterbeck FC, Chansky K, Groome P, Bolejack V, Crowley J, Shemanski L, Kennedy C, Krasnik M, Peake M, Rami-Porta R. The IASLC Lung Cancer Staging Project: Methodology and Validation Used in the Development of Proposals for Revision of the Stage Classification of NSCLC in the Forthcoming (Eighth) Edition of the TNM Classification of Lung Cancer. J Thorac Oncol 2016; 11:1433-46. [PMID: 27448762 DOI: 10.1016/j.jtho.2016.06.028] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Stage classification provides a consistent language to describe the anatomic extent of disease and is therefore a critical tool in caring for patients. The Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer developed proposals for revision of the classification of lung cancer for the eighth edition of the tumor, node, and metastasis (TNM) classification, which takes effect in 2017. METHODS An international database of 94,708 patients with lung cancer diagnosed in 1999-2010 was assembled. This article describes the process and statistical methods used to refine the lung cancer stage classification. RESULTS Extensive analysis allowed definition of tumor, node, and metastasis categories and stage groupings that demonstrated consistent discrimination overall and within multiple different patient cohorts (e.g., clinical or pathologic stage, R0 or R-any resection status, geographic region). Additional analyses provided evidence of applicability over time, across a spectrum of geographic regions, histologic types, evaluative approaches, and follow-up intervals. CONCLUSIONS An extensive analysis has produced stage classification proposals for lung cancer with a robust degree of discriminatory consistency and general applicability. Nevertheless, external validation is encouraged to identify areas of strength and weakness; a sound validation should have discriminatory ability and be based on an independent data set of adequate size and sufficient follow-up with enough patients for each subgroup.
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Affiliation(s)
| | - Kari Chansky
- Cancer Research And Biostatistics, Seattle, Washington
| | - Patti Groome
- Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | | | - John Crowley
- Cancer Research And Biostatistics, Seattle, Washington
| | | | - Catherine Kennedy
- University of Sydney, Strathfield Private Hospital Campus, Strathfield, New South Wales, Australia
| | - Mark Krasnik
- Gentofte University Hospital, Copenhagen, Denmark
| | | | - Ramón Rami-Porta
- Thoracic Surgery Service, Hospital Universitari Mutua Terrassa and Centros de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Lung Cancer Group, Terrassa, Barcelona, Spain
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Rami-Porta R, Asamura H, Goldstraw P. Predicting the prognosis of lung cancer: the evolution of tumor, node and metastasis in the molecular age-challenges and opportunities. Transl Lung Cancer Res 2015; 4:415-23. [PMID: 26380182 DOI: 10.3978/j.issn.2218-6751.2015.07.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/15/2015] [Indexed: 12/25/2022]
Abstract
The tumor, node and metastasis (TNM) classification of malignant tumors was proposed by Pierre Denoit in the mid-20(th) century to code the anatomic extent of tumors. Soon after, it was accepted by the Union for International Cancer Control and by the American Joint Committee on Cancer, and published in their respective staging manuals. Till 2002, the revisions of the TNM classification were based on the analyses of a database that included over 5,000 patients, and that was managed by Clifton Mountain. These patients originated from North America and almost all of them had undergone surgical treatment. To overcome these limitations, the International Association for the Study of Lung Cancer proposed the creation of an international database of lung cancer patients treated with a wider range of therapeutic modalities. The changes introduced in the 7(th) edition of the TNM classification of lung cancer, published in 2009, derived from the analysis of an international retrospective database of 81,495 patients. The revisions for the 8(th) edition, to be published in 2016, will be based on a new retrospective and prospective international database of 77,156 patients, and will mainly concern tumor size, extrathoracic metastatic disease, and stage grouping. These revisions will improve our capacity to indicate prognosis and will make the TNM classification more robust. In the future the TNM classification will be combined with non-anatomic parameters to define prognostic groups to further refine personalized prognosis.
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Affiliation(s)
- Ramón Rami-Porta
- 1 Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain ; 2 Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan ; 3 Academic Department of Thoracic Surgery, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK
| | - Hisao Asamura
- 1 Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain ; 2 Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan ; 3 Academic Department of Thoracic Surgery, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK
| | - Peter Goldstraw
- 1 Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain ; 2 Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan ; 3 Academic Department of Thoracic Surgery, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK
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Weissferdt A, Moran CA. Reclassification of early stage pulmonary adenocarcinoma and its consequences. J Thorac Dis 2014; 6:S581-8. [PMID: 25349709 DOI: 10.3978/j.issn.2072-1439.2014.07.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/28/2014] [Indexed: 01/15/2023]
Abstract
The classification of pulmonary adenocarcinoma has recently undergone several proposed changes. Among these, the most striking pertains to the discontinuation of the term "bronchioloalveolar carcinoma (BAC)" and its replacement by the terms "adenocarcinoma in situ (AIS)" or "minimally invasive adenocarcinoma (MIA)" for small solitary adenocarcinomas with either pure bronchiolalveolar growth or predominant bronchioloalveolar growth and ≤5 mm invasion, respectively, in resection specimens. The recommendation for these new concepts was based on discussion and review of the literature by a panel of experts from multiple disciplines. However, the results of a recent study investigating the topic of early stage adenocarcinoma (pT1N0M0) which was based on an actual series of cases, have raised questions as to the concept, validity and justification of such new terminology and have reinforced the need to evaluate actual cases that meet the newly proposed definitions and compare them in terms of patient outcome. This is even more important when proposing terminology that implies benign behavior and that could result in a false sense of security putting patients at risk for suboptimal treatment approaches. The controversies surrounding these issues are the subject of this work.
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Affiliation(s)
| | - Cesar A Moran
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
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Prediction for prognosis of resected pT1a-1bN0M0 adenocarcinoma based on tumor size and histological status: relationship of TNM and IASLC/ATS/ERS classifications. Lung Cancer 2014; 85:270-5. [PMID: 24976332 DOI: 10.1016/j.lungcan.2014.05.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/11/2014] [Accepted: 05/13/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to estimate the relationship between 7th TNM classification and IASLC/ATS/ERS classification with regard to tumor size and pathological status and to determine the utility of these classifications for predicting prognosis in resected node-negative adenocarcinoma with tumor size ≤2.0 cm and >2.0-3.0 cm. MATERIALS AND METHODS We reviewed 321 pN0M0 lung adenocarcinoma cases resected at Hiroshima University Hospital from January 1991 to December 2010. Histological differences between T1a and T1b based on the IASLC/ATS/ERS classification were estimated and followed by evaluation of overall survival (OS) and recurrence-free interval (RFI) based on differences in tumor size and histological features. RESULTS We found 188 cases of pT1a-1bN0M0 (135 T1a, 53 T1b). Pathological T1a tumors included significantly more adenocarcinoma in situ (AIS) cases and minimally invasive adenocarcinoma (MIA) cases than T1b tumors (60.7% vs 18.8%, respectively; p<0.0001), while more invasive adenocarcinoma cases were included in pT1b. By considering the two classifications simultaneously, the 5-year OS rates of T1a AIS/MIA, T1b AIS/MIA, T1a invasive adenocarcinoma, and T1b invasive adenocarcinoma were 97.5%, 87.5%, 95.8%, and 86.8%, respectively. The 5-year RFIs of T1a AIS/MIA, T1b AIS/MIA, T1a invasive adenocarcinoma, and T1b invasive adenocarcinoma were 100%, 100%, 91.3%, and 72.5%, respectively. T1a AIS/MIA and T1b AIS/MIA could be separated as good prognostic cases with a 100% RFI. Multivariate analysis indicated that only T1b invasive adenocarcinoma was an independent factor for predicting recurrence (p=0.001). CONCLUSION Compared to a single classification, combining TNM and IASLC/ATS/ERS classifications could provide more detail information concerning disease recurrence. AIS and MIA should be handled equally, regardless of tumor size, because their non-/less invasive status is more useful for predicting prognosis than their tumor size classification. In contrast, the T descriptors based on TNM classification are important for predicting prognosis in invasive adenocarcinoma.
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West H. Management of Multifocal Bronchioloalveolar Carcinoma (BAC). Lung Cancer 2014. [DOI: 10.1002/9781118468791.ch9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Weissferdt A, Kalhor N, Marom EM, Benveniste MF, Godoy MC, Correa AM, Swisher SG, Moran CA. Early-stage pulmonary adenocarcinoma (T1N0M0): a clinical, radiological, surgical, and pathological correlation of 104 cases. The MD Anderson Cancer Center Experience. Mod Pathol 2013; 26:1065-75. [PMID: 23542459 DOI: 10.1038/modpathol.2013.33] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 01/01/2013] [Accepted: 01/02/2013] [Indexed: 11/10/2022]
Abstract
The recent proposal for histological subtyping of pulmonary adenocarcinoma by predominant pattern and introduction of the terms adenocarcinoma in situ and minimally invasive adenocarcinoma to replace the term bronchioloalveolar carcinoma by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society has led us to conduct a study of 104 patients with early-stage primary pulmonary adenocarcinoma (T1N0M0), with a view to histological subtype as defined by the new proposal and clinical outcome. None of the clinical parameters of our patient population (type of surgery, age, gender, tumor size, and comorbidities) showed any statistically significant correlation with outcome, except for associated malignancies, which not surprisingly appeared to have a negative impact on survival. In addition, statistical analyses of the histological characteristics to include tumor differentiation and the percentage of a lepidic or bronchioloalveolar component did not show any statistically significant values in terms of survival. Our results failed to show any statistically significant difference of survival between those T1N0M0 adenocarcinomas with a lepidic component and those without, thus questioning the use of terms such as in situ or minimally invasive adenocarcinoma. On the basis of our results, we consider that the outcome for patients with T1N0M0 disease is still best determined by appropriate staging rather than by changes in the pathology nomenclature of adenocarcinoma.
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Affiliation(s)
- Annikka Weissferdt
- Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
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Sakurai H, Asamura H, Miyaoka E, Yoshino I, Fujii Y, Nakanishi Y, Eguchi K, Mori M, Sawabata N, Okumura M, Yokoi K. Differences in the prognosis of resected lung adenocarcinoma according to the histological subtype: a retrospective analysis of Japanese lung cancer registry data. Eur J Cardiothorac Surg 2013; 45:100-7. [PMID: 23729748 DOI: 10.1093/ejcts/ezt284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study intended to assess the clinicopathological features of the histological subtypes of adenocarcinoma of the lung in a large registry population. METHODS The Japanese Joint Committee of Lung Cancer Registry performed a nationwide retrospective registry study on the prognosis and clinicopathological profiles of 11 663 patients who underwent resection for primary lung neoplasm in 2004. The registry data of 7921 (62.5%) patients with adenocarcinoma were analysed regarding the prognosis and clinicopathological features according to the histological subtype of adenocarcinoma. The histological subtypes were defined according to the 1999 World Health Organization classification (third edition), where bronchioloalveolar carcinoma (BAC) is defined as adenocarcinoma with a pure bronchioloalveolar growth pattern without invasion. RESULTS The distribution of the histological subtype was acinar in 471 patients (7.5%), papillary in 2004 (32.2%), BAC in 1385 (22.3%), solid adenocarcinoma with mucin in 103 (1.7%) and adenocarcinoma with mixed subtypes (AMS) in 2257 (36.3%). The 5-year overall survival rates according to histological subtype were 63.4% for acinar, 72.9% for papillary, 90.3% for BAC, 54.4% for solid adenocarcinoma with mucin and 73.7% for AMS. While the survival rate in patients with BAC was significantly better than those for the other histological subtypes, acinar and solid adenocarcinoma with mucin had significantly worse prognoses than the other histological subtypes. The histological subtype was an independent predictor of survival in a multivariate analysis (P < 0.001). Regarding BAC, the pathological stage included not only Stage IA/IB (n = 1275; 92.1%), but also Stage II-IV (n = 110; 7.9%). One hundred twenty-five patients (9.0%) with BAC had recurrence, including both local and distant recurrence. CONCLUSIONS The histological subtype in adenocarcinoma significantly correlated with the prognosis. In BACs with recurrence or pathological stage II-IV, these tumours might have been classified as invasive adenocarcinoma rather than as BAC. The need for the rigorous pathological evaluation of adenocarcinomas that are considered to be a preinvasive or minimally invasive tumour should be addressed in the new lung adenocarcinoma classification to be proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society.
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Affiliation(s)
- Hiroyuki Sakurai
- Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
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Situ DR, Dartevelle P, Chevalier TL, Zhang LJ. The Sino-French 2012 Conference in Thoracic Oncology: an international academic platform for in-depth exchange on comprehensive research. CHINESE JOURNAL OF CANCER 2013; 32:53-8. [PMID: 23327797 PMCID: PMC3845613 DOI: 10.5732/cjc.012.10321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Sino-French 2012 Conference in Thoracic Oncology, held November 17–18, 2012, was hosted by the Department of Thoracic Surgery at Sun Yat-sen University Cancer Center and organized in collaboration with two prestigious French hospitals: Institute Gustave Roussy and Marie Lannelongue Hospital. The conference was established by leading experts from China and France to serve as an international academic platform for sharing novel findings in basic research and valuable clinical practice experiences. Hot topics including innovation in surgical techniques, diagnosis and staging of early-stage lung cancer, minimally invasive surgery, multidisciplinary treatment of lung cancer, and progress in radiotherapy for lung cancer were explored. Highlights of the conference presentations are summarized in this report.
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Affiliation(s)
- Dong-Rong Situ
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China
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Abstract
OBJECTIVE In 2009, a new TNM staging system was published by the International Union Against Cancer and the American Joint Committee on Cancer. The new edition will encompass non-small cell lung cancer, small cell lung cancer, and bronchopulmonary carcinoids. This article will review many important changes that have been made in the revised staging system. CONCLUSION It is important that radiologists learn the new system and understand the reasons for the changes to provide more accurate clinical staging.
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Ignatius Ou SH, Zell JA. The applicability of the proposed IASLC staging revisions to small cell lung cancer (SCLC) with comparison to the current UICC 6th TNM Edition. J Thorac Oncol 2009; 4:300-10. [PMID: 19156001 DOI: 10.1097/jto.0b013e318194a355] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND We examined the impact of the proposed Internal Association for the Study of Lung Cancer (IASLC) tumor, node, metastasis (TNM) and stage grouping revisions on staging and survival outcome of small cell lung cancer (SCLC). METHODS A total of 10,660 SCLC patients from the California Cancer Registry between 1991 to 2005 with complete TNM staging were identified and reclassified according to the IASLC proposed TNM revisions and new stage groupings. Surveillance Epidemiology and End Results extent of disease codes were used to identify various T4 and M descriptors. Cox proportional hazards regression was used to identify prognostic factors. RESULTS Survival was correlated with the current UICC6 and IASLC proposed T descriptors. Patients without mediastinal lymph node involvement (N 0-1) had superior survival compared to patients with mediastinal lymph node involvement (N 2-3). The IASLC proposed stage grouping results in better separation of survival curves among early stage SCLC than the current Union Internationale Centre le Cancer (UICC) 6 stage groupings by both univariate and multivariate analyses. Pleural effusion (IASLC M1a) in SCLC had survival similar to other IASLC M1a categories (pericardial effusion, contralateral intrapulmonary metastasis) by pairwise hazard ratio comparisons. CONCLUSIONS The IASLC proposed TNM staging changes result in better separation of stage-specific SCLC survival curves than the current UICC6 staging system. The new IASLC M1a descriptors (pleural effusion, pericardial effusion, and contralateral/bilateral intrapulmonary metastasis) adequately prognosticate SCLC patients as having metastatic disease.
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Affiliation(s)
- Sai-Hong Ignatius Ou
- Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California Irvine Medical Center, Orange, CA 92868-3298, USA.
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Cheung WY, Hwang DM, Chung TB, Johnston MR, Leighl NB. Initial treatment strategies and outcomes for multifocal bronchioloalveolar carcinoma. Clin Lung Cancer 2009; 10:187-92. [PMID: 19443339 DOI: 10.3816/clc.2009.n.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Bronchioloalveolar carcinoma (BAC) commonly presents as multifocal disease. Management of multifocal BAC remains controversial and may include surgical resection, systemic therapy, surveillance, or a combination of these strategies. Knowledge of current practice patterns and outcomes could help to inform future research. MATERIALS AND METHODS Medical records of patients with BAC were retrospectively reviewed, and regression analyses were conducted to correlate demographic parameters, disease characteristics, and treatment modality with clinical outcomes. RESULTS Of the 109 cases identified, 85 patients were eligible for study, 26% with unifocal and 74% with multifocal BAC. Median age at diagnosis was 65 years; the majority of the patients were female (64%), were non-Asian (82%), and had a smoking history (66%). In the subset with multifocal BAC, 24% of the cases were confined to one lobe, 76% affected multiple lobes, and 40% involved both lungs. The primary treatment modality for multifocal disease included surgical resection (78%), systemic therapy (14%), and observation (8%). In multivariate analyses, extensive disease (> or = 3 lobes involved) and medical oncology assessment predicted treatment with systemic therapy (odds ratio [OR], 8.68; P = .03 and OR, 1.68; P < .01, respectively). The presence of extensive disease and the receipt of systemic therapy were associated with higher likelihood of disease progression (hazard ratio [HR], 8.62; P = .02 and HR, 8.46; P = .02, respectively). CONCLUSION Initial treatment choices and referral patterns for multifocal BAC were diverse and influenced by clinical selection, whereby patients with extensive disease were more likely to discuss and receive systemic therapy. Surgery and surveillance were reasonable treatment options for selected patients. The precise roles of the various treatment strategies for multifocal BAC require further evaluation.
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Affiliation(s)
- Winson Y Cheung
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario
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Carvalho L, Cardoso E, Nunes H, Baptista V, Gomes A, Couceiro P. [The IASLC lung cancer staging project. Comparing the current 6(th) TNM edition with the proposed 7(th) edition]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2009; 15:67-76. [PMID: 19145388 DOI: 10.1016/s0873-2159(15)30110-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The future 7th edition of TNM classification for lung cancer will be published in 2009 and comprises the IASLC recommendations for TNM parameters. The general staging of lung cancer includes the new parameters: reclassification of tumours larger than 7 cm from T2 to T3; extra tumoral nodules will change their category to T3, T4 and M1 when in the same, ipsilateral or contralateral lobe, respectively; pleural effusion will be M1a. With these alterations, cases staged as IB - T2b N0 M0 will be IIA, cases staged IIB - T2a N1 M0 will be IIA and cases IIIB- T4 N0- -1 M0 will be IIIA. The 7(th) TNM edition recommendations were applied to 203 broncho -pulmonary carcinomas, concerning epidermoid carcinomas (83) and adenocarcinomas (120) registered in the archive of the Serviço de Anatomia Patológica of the Hospitais da Universidade de Coimbra - Portugal, previously submitted to surgical resection and lymph node excision. The following alterations will be kept as the application of the future 7(th) TNM edition: 20 cases in stage IB will move to stage IIA (17) and stage IIB (3); 18 cases will change from stage IIB to stage IIA (17) and 1 case to stage IIIA; 2 cases from stage IIIB will move to stage IV; 6 cases in stage IV will move to stage IIIA (5) and 1 case to stage IIIB. In this translational adaptation from 6th to 7th TNM staging, 51 out of the 203 analysed cases change their staging, corresponding to 25.1%.
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Rami Porta R. Nueva clasificación TNM del cáncer de pulmón. Arch Bronconeumol 2009; 45:159-61. [DOI: 10.1016/j.arbres.2008.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Accepted: 09/30/2008] [Indexed: 11/24/2022]
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Targeted therapies in bronchioloalveolar carcinoma. Target Oncol 2008. [DOI: 10.1007/s11523-008-0088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Validation Study of the Proposed IASLC Staging Revisions of the T4 and M Non-small Cell Lung Cancer Descriptors Using Data from 23,583 Patients in the California Cancer Registry. J Thorac Oncol 2008; 3:216-27. [DOI: 10.1097/jto.0b013e318164545d] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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