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Terao A, Ninomiya H, Takeuchi K. Prognostic value of large amino acid transporter type 1 (LAT1) expression in pulmonary adenocarcinoma: A tissue microarray study. Cancer Treat Res Commun 2024; 39:100814. [PMID: 38677033 DOI: 10.1016/j.ctarc.2024.100814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Large amino acid transporter type 1 (LAT1) provides cancer cells with essential amino acids for both protein synthesis and cell growth and may predict patient prognosis. Additionally, LAT1 inhibition can be a therapeutic target. This study aimed to examine the prognostic significance of LAT1 expression in lung cancer, paying special attention to adenocarcinoma subtypes. METHODS Tissue microarrays (TMA) of 1,560 total cores obtained from surgically resected lung cancer specimens between 1995 and 2008 at our hospital were used. Overall, 795 cases of adenocarcinoma were identified, and 717 underwent further evaluation. Immunohistochemical staining of whole slides and TMA cores were assessed to set H-score cutoff value.. Immunohistochemical expression of LAT1 was examined based on the subtypes of adenocarcinoma. Statistical analyses explored the prognostic significance of LAT1. RESULTS Adenocarcinoma accounted for 71.8% of all cases (n = 795), and 216 cases (27.1%) expressed LAT1. The 795 cases were categorized into five subtypes: lepidic (n = 29, 3.6%), papillary (n = 601, 75.6%), acinar (n = 58, 7.3%), and solid (n = 9, 1.1%); 717 of the 795 cases were further assessed according to the exclusion criteria. The LAT1-positive ratio increased as the architectural grade increased. Notably, in papillary adenocarcinoma, the LAT1-positive group had significantly lower overall survival compared to the negative group (10-year survival: 45.6% vs. 60.8%, p < 0.001). CONCLUSION LAT1 expression was higher in high-grade subtypes of pulmonary adenocarcinoma. Moreover, LAT1 expression is useful for predicting prognosis, particularly in papillary adenocarcinoma, facilitating prognostic stratification of papillary adenocarcinoma.
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Affiliation(s)
| | - Hironori Ninomiya
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Japan; Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan.
| | - Kengo Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Japan; Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan
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Iwai M, Yokota E, Ishida Y, Yukawa T, Naomoto Y, Monobe Y, Haisa M, Takigawa N, Fukazawa T, Yamatsuji T. Establishment and characterization of novel high mucus-producing lung tumoroids derived from a patient with pulmonary solid adenocarcinoma. Hum Cell 2024:10.1007/s13577-024-01060-3. [PMID: 38632190 DOI: 10.1007/s13577-024-01060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024]
Abstract
Among mucus-producing lung cancers, invasive mucinous adenocarcinoma of the lung is a rare and unique subtype of pulmonary adenocarcinoma. Notably, mucus production may also be observed in the five subtypes of adenocarcinoma grouped under the higher-level diagnosis of Invasive Non-mucinous Adenocarcinomas (NMA). Overlapping pathologic features in mucus-producing tumors can cause diagnostic confusion with significant clinical consequences. In this study, we established lung tumoroids, PDT-LUAD#99, from a patient with NMA and mucus production. The tumoroids were derived from the malignant pleural effusion of a patient with lung cancer and have been successfully developed for long-term culture (> 11 months). Karyotyping by fluorescence in situ hybridization using an alpha-satellite probe showed that tumoroids harbored aneuploid karyotypes. Subcutaneous inoculation of PDT-LUAD#99 lung tumoroids into immunodeficient mice resulted in tumor formation, suggesting that the tumoroids were derived from cancer. Xenografts from PDT-LUAD#99 lung tumoroids reproduced the solid adenocarcinoma with mucin production that was observed in the patient's metastatic lymph nodes. Immunoblot analysis showed MUC5AC secretion into the culture supernatant of PDT-LUAD#99 lung tumoroids, which in contradistinction was barely detected in the culture supernatants of NCI-A549 and NCI-H2122 pulmonary adenocarcinoma cells known for their mucin-producing abilities. Here, we established a novel high-mucus-producing lung tumoroids from a solid adenocarcinoma. This preclinical model may be useful for elucidating the pathogenesis of mucus-producing lung cancer.
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Affiliation(s)
- Miki Iwai
- General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan
| | - Etsuko Yokota
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Yuta Ishida
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Takuro Yukawa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Yoshio Naomoto
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | | | - Minoru Haisa
- Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of Medical Care Work, Kawasaki College of Health Professions, Okayama, Japan
- Kawasaki Geriatric Medical Center, Okayama, Japan
| | - Nagio Takigawa
- General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Takuya Fukazawa
- General Medical Center Research Unit, Kawasaki Medical School, Okayama, Japan.
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan.
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
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Wu G, Chen Q, Lv D, Lin L, Huang J. Pulmonary Adenocarcinoma Patient with Complex Mutations on EGFR Benefits from Furmonertinib after Acquiring Gefitinib Resistance: A Case Report. Recent Pat Anticancer Drug Discov 2024; 19:247-252. [PMID: 38214361 DOI: 10.2174/1574892818666230316145232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/20/2022] [Accepted: 01/27/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Although epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been proven a long-lasting treatment effect in pulmonary adenocarcinoma, most patients still progressed within one year due to the acquired resistance. Complex mutations of rare rare sites after acquiring resistance are rarely reported in pulmonary adenocarcinoma. CASE PRESENTATION A 62-year-old woman was diagnosed with pulmonary adenocarcinoma with stage IV. Genetic testing at the initial treatment showed EGFR L858R positive. After being treated with gefitinib, persistent 2 years disease progression occurred due to drug resistance. The genetic testing showed that EGFR L858R was eliminated, while a rare rare complex mutation of L861Q/G719X appeared. After 160 mg furmonertinib was treated for 1 month, the primary tumor regressed and the intracranial lesions disappeared. The patient has achieved progression-free survival (PFS) for more than 20 months. CONCLUSION Pulmonary adenocarcinoma with rare rare complex mutations in EGFR induced by gefitinib resistance and disease progression might benefit from furmonertinib treatment.
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Affiliation(s)
- Guixian Wu
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, Zhejiang Province, 318050, China
| | - Qian Chen
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, Zhejiang Province, 318050, China
| | - Dongqing Lv
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang Province, 317000, China
| | - Ling Lin
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang Province, 317000, China
| | - Jing Huang
- Department of Respiratory and Critical Care Medicine, Taizhou Hospital Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, Zhejiang Province, 318050, China
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Tan Y, Huang YH, Xue JW, Zhang R, Liu R, Wang Y, Feng ZB. Clinicopathological features and prognostic significance of pulmonary adenocarcinoma with signet ring cell components: meta-analysis and SEER analysis. Clin Exp Med 2023; 23:4341-4354. [PMID: 37779169 DOI: 10.1007/s10238-023-01200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Abstract
Pulmonary adenocarcinoma is a common type of lung cancer that has been on the rise in recent years. Signet ring cell components (SRCC) can be present in various patterns of pulmonary adenocarcinoma, including papillary, acinar, and solid patterns. "Signet ring cell carcinoma" is a distinct subtype in the 2014 WHO classification of lung neoplasms, subsequent WHO classifications in 2015 and 2021 have deemed signet ring cells as accompanying morphological features with no clinical significance. The prognostic and clinical implications of SRCC in pulmonary adenocarcinoma remain controversial. Therefore, we conducted a meta-analysis to investigate the clinicopathological features and prognostic factors of SRCC in pulmonary adenocarcinoma. We conducted a comprehensive search in PubMed, EMBASE, and Web of Science to identify studies that examined the clinicopathological features and prognostic implications of pulmonary adenocarcinoma with SRCC. We used both fixed- and random-effects models to analyze the data and calculate the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (CIs). Additionally, we explored the prognostic significance of SRCC in pulmonary adenocarcinoma using the Surveillance, Epidemiology, and End Results (SEER) database. Our meta-analysis included 29 studies with pulmonary adenocarcinoma and SRCC components. The results showed that pulmonary adenocarcinoma with SRCC was associated with larger tumor size (OR = 1.99; 95% CI, 1.62-2.44, p < 0.001), advanced overall stage (OR = 5.18, 95% CI, 3.28-8.17, p < 0.00001) and lymph node stage (OR = 5.79, 95% CI, 1.96-17.09, p = 0.001), and worse overall survival (OS) compared to those without SRCC (HR = 1.80, 95% CI, 1.50-2.16, p < 0.00001). Analysis using the SEER dataset confirmed these findings. Our meta-analysis provides evidence that pulmonary adenocarcinoma with SRCC is associated with distinct clinicopathological features and a poorer prognosis. These findings have important implications for the management and treatment of patients. However, further studies are needed to validate these findings and explore the significance of SRCC in various subtypes of pulmonary adenocarcinoma.
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Affiliation(s)
- Yang Tan
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Ying-He Huang
- Department of Pathology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jia-Wen Xue
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Rui Zhang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Run Liu
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yan Wang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Zhen-Bo Feng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
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Ciflik KB, Dogan HT, Dogan E, Ciflik BO, Kocer B, Karaoglanoglu N, Yekeler E. Can tumour budding change the future of pulmonary adenocarcinoma? Pathol Res Pract 2023; 250:154808. [PMID: 37748210 DOI: 10.1016/j.prp.2023.154808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Pulmonary adenocarcinoma shows different prognosis even in the same pathological subtype and stage. In this study, it is aimed to investigate the relationship between tumour budding and known prognostic values and clinicopathological features in pulmonary adenocarcinoma. METHODS In this study, there have been 77 patients diagnosed with primary pulmonary adenocarcinoma. In the evaluation process, the number of budding between 0 and 4 is accepted as low budding (Bd1), the number of budding between 5 and 9 is considered as medium budding (Bd2), and the number of budding above 10 is considered as high budding (Bd3). RESULTS According to the findings of the study, it can be seen that there is a statistical difference between tumour budding and stromal fibrosis (p < 0.001). The presence of pleural invasion, lymph vascular invasion and perineural invasion in patients with Bd3 is found to be statistically higher than the patients with Bd1 (p = 0.048) (p = 0.041) (p = 0.029). CONCLUSIONS Tumour budding has been associated with pleural invasion, lymph vascular invasion, perineural invasion, and stromal fibrosis. This study is the first to show the relationship between tumour budding and stromal fibrosis in pulmonary adenocarcinomas. The role of tumour budding in lung cancers remains to be clarified.
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Affiliation(s)
| | - Hayriye Tatli Dogan
- Department of Pathology, Ankara Yildirim Beyazit University, Ankara, Turkey.
| | - Elif Dogan
- Department of Pathology, Ankara City Hospital, Ankara, Turkey.
| | | | - Bulent Kocer
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
| | | | - Erdal Yekeler
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
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FAN L, QIN J, LIN X, WU Y, HE Z, HE P. [Analysis of Clinicopathological Features on Spread Through Air Spaces
of Lung Adenocarcinoma]. Zhongguo Fei Ai Za Zhi 2023; 26:650-658. [PMID: 37985151 PMCID: PMC10600750 DOI: 10.3779/j.issn.1009-3419.2023.106.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The biological and molecular characteristics of spread through air spaces (STAS), a newly recognized invasive mode of lung cancer, remain controversial. The aim of this study was to investigate the clinicopathological features and molecular characteristics of STAS in patients with pulmonary adenocarcinoma. METHODS A total of 694 resected invasive non-mucinous lung adenocarcinomas diagnosed by clinicopathology from July 2019 to March 2021 in the First Affiliated Hospital of Guangzhou Medical University were collected, and the relationship between STAS and clinicopathological factors was analyzed. The state of protein expression of anaplastic lymphoma kinase (ALK) was detected by immunohistochemical method. Epidermal growth factor receptor (EGFR) was detected by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). ROS proto-oncogene 1-receptor (ROS1) was detected by reverse transcription-PCR (RT-PCR). RESULTS A total of 344 STAS positive cases and 350 STAS negative cases were collected. By univariate analysis, STAS positivity was statistically associated with tumor maximum diameter (P<0.001), pleural invasion (P<0.001), lymphovascular invasion (P<0.001), nerve invasion (P=0.013), lymph node metastasis (P<0.001), clinical stage (P<0.001) and histological type (P<0.001). There was a statistical correlation between STAS and ALK protein expression (P=0.001). Multivariate analysis showed that STAS positive was correlated with pleural invasion (P=0.001), vascular invasion (P<0.001), lymph node metastasis (P=0.005)and ALK protein expression (P=0.032). CONCLUSIONS STAS is associated with highly aggressive biological behavior of lung adenocarcinoma, suggesting a poor prognosis.
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Sychugov GV, Azizova TV, Zhuntova GV, Grigoryeva ES, Loffredo CA, Hamada N, Kazachkov EL. Immunohistochemical Analysis of Lung Adenocarcinoma in Russian Mayak Nuclear Workers. Cancer Invest 2023; 41:686-698. [PMID: 37291892 DOI: 10.1080/07357907.2023.2218489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
Specimens of lung adenocarcinoma (AdCa) from Russian nuclear workers (n = 54) exposed to alpha particles and gamma rays and from individuals non-exposed to radiation (n = 21) were examined using immunohistochemistry. Estimated significant associations with alpha dose were negative for Ki-67 and collagen IV in AdCa. Associations with gamma-ray dose were negative for tissue inhibitor of matrix metalloproteinase 2 and caspase 3 and positive for matrix metalloproteinase 2 and leukemia inhibiting factor in AdCa. The findings provide some evidence supporting alterations in apoptosis, cell proliferation and extracellular matrix in lung tissues affected by chronic radiation exposure that can contribute to radiogenic cancerogenesis.
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Affiliation(s)
- Gleb V Sychugov
- South Ural State Medical University, Ministry of Health, Chelyabinsk, Russia
| | - Tamara V Azizova
- Southern Urals Biophysics Institute, Russian Federal Medical Biological Agency, Ozyorsk, Russia
| | - Galina V Zhuntova
- Southern Urals Biophysics Institute, Russian Federal Medical Biological Agency, Ozyorsk, Russia
| | - Evgeniya S Grigoryeva
- Southern Urals Biophysics Institute, Russian Federal Medical Biological Agency, Ozyorsk, Russia
| | - Christopher A Loffredo
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
| | - Evgeniy L Kazachkov
- South Ural State Medical University, Ministry of Health, Chelyabinsk, Russia
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Liu J, Xie C, Li Y, Xu H, He C, Qing H, Zhou P. The solid component within part-solid nodules: 3-dimensional quantification, correlation with the malignant grade of nonmucinous pulmonary adenocarcinomas, and comparisons with 2-dimentional measures and semantic features in low-dose computed tomography. Cancer Imaging 2023; 23:65. [PMID: 37349824 DOI: 10.1186/s40644-023-00577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/29/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND There is no consensus on 3-dimensional (3D) quantification method for solid component within part-solid nodules (PSNs). This study aimed to find the optimal attenuation threshold for the 3D solid component proportion in low-dose computed tomography (LDCT), namely the consolidation/tumor ratio of volume (CTRV), basing on its correlation with the malignant grade of nonmucinous pulmonary adenocarcinomas (PAs) according to the 5th edition of World Health Organization classification. Then we tested the ability of CTRV to predict high-risk nonmucinous PAs in PSNs, and compare its performance with 2-dimensional (2D) measures and semantic features. METHODS A total of 313 consecutive patients with 326 PSNs, who underwent LDCT within one month before surgery and were pathologically diagnosed with nonmucinous PAs, were retrospectively enrolled and were divided into training and testing cohorts according to scanners. The CTRV were automatically generated by setting a series of attenuation thresholds from - 400 to 50 HU with an interval of 50 HU. The Spearman's correlation was used to evaluate the correlation between the malignant grade of nonmucinous PAs and semantic, 2D, and 3D features in the training cohort. The semantic, 2D, and 3D models to predict high-risk nonmucinous PAs were constructed using multivariable logistic regression and validated in the testing cohort. The diagnostic performance of these models was evaluated by the area under curve (AUC) of receiver operating characteristic curve. RESULTS The CTRV at attenuation threshold of -250 HU (CTRV- 250HU) showed the highest correlation coefficient among all attenuation thresholds (r = 0.655, P < 0.001), which was significantly higher than semantic, 2D, and other 3D features (all P < 0.001). The AUCs of CTRV- 250HU to predict high-risk nonmucinous PAs were 0.890 (0.843-0.927) in the training cohort and 0.832 (0.737-0.904) in the testing cohort, which outperformed 2D and semantic models (all P < 0.05). CONCLUSIONS The optimal attenuation threshold was - 250 HU for solid component volumetry in LDCT, and the derived CTRV- 250HU might be valuable for the risk stratification and management of PSNs in lung cancer screening.
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Affiliation(s)
- Jieke Liu
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Chaolian Xie
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Li
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Xu
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Changjiu He
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Haomiao Qing
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
| | - Peng Zhou
- Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
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Im D, Alsheimer K, Poulose J, Zeykan V, Talamo G. Relapse of Lung Adenocarcinoma Manifested by Spontaneous Tumor Lysis Syndrome. Case Rep Oncol 2023; 16:1306-1310. [PMID: 37942403 PMCID: PMC10629853 DOI: 10.1159/000534398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/28/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Tumor lysis syndrome (TLS) is an oncologic emergency characterized by several metabolic derangements, such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. TLS is typically observed in hematologic malignancies, especially after starting the first administration of antineoplastic therapies. TLS in a solid malignancy is very unusual, and exceedingly rare when occurring spontaneously, in the absence of chemotherapy. Case Presentation We report a case of a 76-year-old man with lung adenocarcinoma, which started as a cancer with indolent behavior and small tumor burden but relapsed in 5 months with rapidly proliferating metastatic disease. Spontaneous TLS was the presenting clinical manifestation of the tumor relapse, and it led to the patient's death. Conclusion To our knowledge, this is the first case of spontaneous TLS in a relapsed adenocarcinoma of the lung reported in the medical literature. The development of the metabolic derangements of TLS should prompt the consideration of tumor relapse during the follow-up of patients with solid malignancies.
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Affiliation(s)
- Daebin Im
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USA
| | - Katie Alsheimer
- Pulmonary and Critical Care, Guthrie Robert Packer Hospital, Sayre, PA, USA
| | - Joyson Poulose
- Hematology-Oncology, Guthrie Robert Packer Hospital, Sayre, PA, USA
| | - Violeta Zeykan
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USA
| | - Giampaolo Talamo
- Hematology-Oncology, Guthrie Robert Packer Hospital, Sayre, PA, USA
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Koike H, Ashizawa K, Tsutsui S, Fukuda M, Okano S, Matsumoto K, Nagayasu T, Honda S, Uetani M. Surgically resected lung adenocarcinoma: do heterogeneous GGNs and part-solid nodules on thin-section CT show different prognosis? Jpn J Radiol 2023; 41:164-171. [PMID: 36219310 PMCID: PMC9889431 DOI: 10.1007/s11604-022-01345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/27/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to evaluate the clinical courses of patients with surgically resected stage IA pulmonary adenocarcinoma (Ad) who exhibited heterogeneous ground-glass nodules (GGNs) or part-solid nodules on thin-section computed tomography (TSCT) and to clarify the prognostic differences between them. MATERIALS AND METHODS The cases of 242 patients with proven pulmonary Ad with heterogeneous GGN or part-solid nodule who underwent surgical resection were retrospectively reviewed. After surgery, they were examined pathologically. Disease-free survival (DFS) and overall survival (OS) were also investigated. RESULTS There were no cases of recurrent pulmonary Ad or death from the primary disease in the heterogeneous GGN group. In the part-solid nodule group, recurrent pulmonary Ad and death from the primary disease were observed in 12 and 6 of 181 patients, respectively. Heterogeneous GGNs were associated with significantly longer DFS than part-solid nodules (p = 0.042). While, there was no significant difference in OS between the two groups (p = 0.134). Pathological diagnoses were available for all 242 patients. 181 part-solid nodules were classified into 116 invasive Ads, 54 minimally invasive Ads (MIAs), and 11 Ad in situ (AIS) lesions, and 61 heterogeneous GGNs were classified into 18 invasive Ads, 25 MIAs, and 18 AIS lesions. CONCLUSION Heterogeneous GGNs were significantly associated with longer DFS than part-solid nodules. Pathologically, there were significant differences between the heterogeneous GGNs and part-solid nodules.
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Affiliation(s)
- Hirofumi Koike
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kazuto Ashizawa
- Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shin Tsutsui
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Minoru Fukuda
- Clinical Oncology Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shinji Okano
- Depatment of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Keitaro Matsumoto
- Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takeshi Nagayasu
- Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Sumihisa Honda
- Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nursing, Nagasaki, 852-8501 Japan
| | - Masataka Uetani
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Shalahuddin E, Hayati F. Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study. Radiol Case Rep 2023; 18:818-23. [PMID: 36582758 DOI: 10.1016/j.radcr.2022.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/05/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
Conditions on pleura cover a broad range of pathology ranging from benign to malignant, which may potentially carry a poor prognosis and lead to high morbidity and mortality. Radiology plays a pivotal role in the diagnosis of pleural malignancy; however, the diagnostic endeavor can be challenging because of overlapping radiological appearances of one condition to another. This case report presents a 61-year-old male with worsening chronic shortness of breath. Despite early imaging resulting in highly suggested mesothelioma, subsequent biopsy proved the malignancy to be pulmonary adenocarcinoma. The patient underwent Pemetrexed-Cisplatin protocol in accordance with the biopsy result, and follow-up imaging depicted a marked improvement of the pleural condition. This case is a prime example of the challenge radiologists have to face regarding pleural tumors and dictates the necessity of a specialized multidisciplinary team to improve the patient's outcome.
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Komatsu T, Miura T, Nomoto F, Itagaki T, Sunohara D, Mochidome T, Kasai T, Ikeda U. Successful treatment of recurrent superior vena cava syndrome due to pulmonary adenocarcinoma using intravascular ultrasound. J Cardiol Cases 2022; 27:76-79. [PMID: 36788957 PMCID: PMC9911930 DOI: 10.1016/j.jccase.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/02/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
Patients with malignant diseases may develop symptoms of superior vena cava syndrome (SVCS) quickly because rapid tumor growth does not allow adequate time to develop collateral blood flow. Therefore, malignant SVCS is a medical emergency associated with neurological or pharyngeal-laryngeal signs. Recently, interventional endovascular treatment (EVT) has achieved acceptable results. We describe the case of a 55-year-old woman with pulmonary adenocarcinoma and laryngeal edema. In the first EVT, bare-metal-stent was implanted into the SVCS with intravascular ultrasound (IVUS) guidance. The IVUS showed insufficient stent-mid expansion. We did not use additional ballooning because of the risk of superior vena cava (SVC) rupture. Three months later, the SVCS recurred. A second EVT was performed, and IVUS imaging suggested tumor ingrowth into the SVC through the stent struts. We considered that the tumor ingrowth could be covered in the SVC using stent-graft. The patient showed no recurrence of SVCS for about 12 months. IVUS-guided implantation of stent for the treatment of malignant SVCS has not been reported. This case report revealed that stent therapy using IVUS for SVCS is useful. Learning objective Superior vena cava syndrome (SVCS) due to malignancy is not rare. Recently, endovascular treatment for SVCS has achieved acceptable results. However, SVC stenting in SVCS as having primary patency rate varies for each report. Intravascular ultrasound (IVUS) guided implantation of stent for malignant SVCS treatment has not been reported. In this case, we suspected insufficient stent expansion and tumor ingrowth as the possible cause of in-stent restenosis. Therefore, stent therapy using IVUS for malignant SVCS can be helpful.
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Affiliation(s)
- Toshinori Komatsu
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan,Department of Cardiology, Shinshu University Hospital, Nagano, Japan,Corresponding author at: Department of Cardiology, Nagano Municipal Hospital, Tomitake 1333-1, Nagano 381-8551, Japan.
| | - Takashi Miura
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Fumika Nomoto
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Tadashi Itagaki
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Daisuke Sunohara
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan,Department of Cardiology, Shinshu University Hospital, Nagano, Japan
| | | | - Toshio Kasai
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Uichi Ikeda
- Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan
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Zombori-Tóth N, Paróczai D, Lantos J, Almási S, Sejben A, Tiszlavicz L, Cserni G, Furák J, Zombori T. The More Extensive the Spread through Air Spaces, the Worse the Prognosis Is: Semi-Quantitative Evaluation of Spread through Air Spaces in Pulmonary Adenocarcinomas. Pathobiology 2022; 90:104-113. [PMID: 35947971 PMCID: PMC10129026 DOI: 10.1159/000525456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The extent of spread through air spaces (STAS) is less investigated among patients with lung adenocarcinoma who underwent sublobar resection. Therefore, we aimed to evaluate the extent of STAS semi-quantitatively, to assess its prognostic impact on overall survival (OS) and recurrence-free survival (RFS), and to investigate the reproducibility of this assessment. METHODS The number of tumour cell clusters and single tumour cells within air spaces was recorded in three different most prominent areas (200x field of view). The extent of STAS was categorized into three groups, and the presence of free tumour cluster (FTC) was recorded. RESULTS Sixty-one patients were included. Recurrence was more frequent with higher grade (p = 0.003), presence of lymphovascular invasion (p = 0.027), and presence of STAS of any extent (p = 0.007). In multivariate analysis, presence of FTC (HR: 5.89; 95% CI: 1.63-21.26; p = 0.005) and more pronounced STAS (HR: 7.46; 95% CI: 1.60-34.6; p = 0.01) had adverse impact on OS and RFS, respectively. Concerning reproducibility, excellent agreement was found among STAS parameters (ICC range: 0.92-0.94). DISCUSSION More extensive STAS is an unfavourable prognostic factor in adenocarcinomas treated with sublobar resection. As the evaluation of extent of STAS is reproducible, further investigation is required to gather more evidence.
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Affiliation(s)
| | - Dóra Paróczai
- Csongrád-Csanád County Hospital of Chest Diseases, Deszk, Hungary
| | - Judit Lantos
- Department of Neurology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - Szintia Almási
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - Anita Sejben
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - László Tiszlavicz
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - Gábor Cserni
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary.,Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
| | - József Furák
- Department of Surgery, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
| | - Tamás Zombori
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary
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Zhao W, Xiong Z, Jiang Y, Wang K, Zhao M, Lu X, Liu A, Qin D, Li Z. Radiomics based on enhanced CT for differentiating between pulmonary tuberculosis and pulmonary adenocarcinoma presenting as solid nodules or masses. J Cancer Res Clin Oncol 2022. [PMID: 35939114 DOI: 10.1007/s00432-022-04256-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/02/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To investigate the incremental value of enhanced CT-based radiomics in discriminating between pulmonary tuberculosis (PTB) and pulmonary adenocarcinoma (PAC) presenting as solid nodules or masses and to develop an optimal radiomics model. METHODS A total of 128 lesions (from 123 patients) from three hospitals were retrospectively analyzed and were randomly divided into training and test datasets at a ratio of 7:3. Independent predictors in subjective image features were used to develop the subjective image model (SIM). The plain CT-based and enhanced CT-based radiomics features were screened by the correlation coefficient method, univariate analysis, and the least absolute shrinkage and selection operator, then used to build the plain CT radiomics model (PRM) and enhanced CT radiomics model (ERM), respectively. Finally, the combined model (CM) combining PRM and ERM was established. In addition, the performance of three radiologists and one respiratory physician was evaluated. The areas under the receiver operating characteristic curve (AUCs) were used to assess the performance of each model. RESULTS The differential diagnostic capability of the ERM (training: AUC = 0.933; test: AUC = 0.881) was better than that of the PRM (training: AUC = 0.861; test: AUC = 0.756) and the SIM (training: AUC = 0.760; test: AUC = 0.611). The CM was optimal (training: AUC = 0.948; test: AUC = 0.917) and outperformed the respiratory physician and most radiologists. CONCLUSIONS The ERM was more helpful than the PRM for identifying PTB and PAC that present as solid nodules or masses, and the CM was the best.
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Lococo F, Guerrera F, Rena O, Ampollini L, Vannucci J, Bertoglio P, Ventura L, Lyberis P, Marchese V, Arena V, Filosso PL, Lesca A, Casadio C, Viti A, Paci M, Puma F, Ruffini E. Accuracy of 18F-FDG in Detecting Stage I Lung Adenocarcinomas According to IASLC/ATS/ERS Classification. Heart Lung Circ 2021; 31:726-732. [PMID: 34753661 DOI: 10.1016/j.hlc.2021.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 03/23/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Only a small number of studies have explored the clinicopathological features of pulmonary adenocarcinoma (PA) associated with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) false-negative (FN) results. Herein, we investigated the FDG-PET diagnostic performance by stratifying PAs according to International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification. METHODS From January 2002 to December 2016, all consecutive patients who underwent pulmonary resection for stage I PA at six thoracic surgery institutions were retrospectively reviewed. The diagnostic performance of FDG-PET was analysed according to IASLC/ATS/ERS classification and two validated subclassifications. Univariable and multivariable logistic analysis were used to identify predictors of FDG-PET FN results. RESULTS Five hundred and fifty (550) patients with stage I PA were included in the analyses. Most of the patients were male (n=354 [64.4%]) and smokers (n=369 [67.1%]). Ninety-seven (n=97 [17.6%]) FN cases were observed at FDG-PET imaging. On multivariable analysis, a lepidic pattern was found to be independently associated with FDG-PET FN results (odds ratio [OR], 3.20; p<0.001), while a solid pattern more commonly presented with a positive finding (OR, 0.40; p=0.066). According to Nakamura's classification, we observed an independent association between lepidic pattern and FDG-PET FN results (OR, 3.17; p<0.001), while solid/micropapillary patterns were independently related with increased FDG uptake (OR, 0.35; p=0.021). According to Yoshizawa's classification, Intermediate-grade tumours were independently correlated with FN FDG-PET results (OR, 2.78; p=0.005). CONCLUSIONS In our cohort, histopathological features were significantly associated with FDG uptake. In particular, some adenocarcinoma subtypes (mostly Lepidic pattern) have a tendency towards FN FDG-PET findings. The correlation between computed tomography findings, clinical characteristics, and FDG uptake is mandatory, in order to tailor the precise diagnostic and therapeutic pathway for each patient.
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Affiliation(s)
- Filippo Lococo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Guerrera
- Department of Surgical Sciences, University of Torino, Torino, Italy; Department of Cardiovascular and Thoracic Surgery, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
| | - Ottavio Rena
- Department of Thoracic Surgery, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Luca Ampollini
- Department of Thoracic Surgery, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy
| | - Pietro Bertoglio
- Division of Thoracic Surgery, Sacro Cuore-Don Calabria Research Hospital and Cancer Care Centre Negrar-Verona, Verona, Italy
| | - Luigi Ventura
- Department of Thoracic Surgery, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | - Paraskevas Lyberis
- Department of Cardiovascular and Thoracic Surgery, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | | | | | | | - Adriana Lesca
- Nuclear Medicine Unit, Department of Radiology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Caterina Casadio
- Department of Thoracic Surgery, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Andrea Viti
- Division of Thoracic Surgery, Sacro Cuore-Don Calabria Research Hospital and Cancer Care Centre Negrar-Verona, Verona, Italy
| | - Massimiliano Paci
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Puma
- Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy
| | - Enrico Ruffini
- Department of Surgical Sciences, University of Torino, Torino, Italy
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Chen CY, Su CW, Tseng CH, Chen YK. Metastasis of pulmonary adenocarcinoma to the buccal mucosa and submandibular area. J Dent Sci 2021; 16:1315-6. [PMID: 34484606 DOI: 10.1016/j.jds.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/15/2021] [Indexed: 11/23/2022] Open
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Ohara F, Harada Y, Tanikawa Y, Narita M, Kagami Y, Hiraga J. [A rare synchronous occurrence of multiple myeloma and pulmonary adenocarcinoma with multiple solitary extramedullary plasmacytomas of the liver]. Rinsho Ketsueki 2021; 62:727-732. [PMID: 34349055 DOI: 10.11406/rinketsu.62.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report the case of a 62-year-old woman with multiple liver tumors. She was diagnosed with synchronous occurrence of multiple myeloma (MM) and primary pulmonary adenocarcinoma 4 years ago. She was treated with bortezomib and dexamethasone for MM, and then she underwent thoracoscopic lobectomy. After the surgery, she received autologous peripheral blood stem cell transplantation. However, recurrence of MM was observed 9 months later. She received multiple chemotherapies for MM, but the effect was limited. Meanwhile, brain metastasis of pulmonary adenocarcinoma was observed; therefore, she underwent surgical resection and received radiation therapy. Furthermore, she had elevated levels of liver enzymes, and ultrasonography revealed multiple liver tumors. Because of thrombocytopenia, liver biopsy could not be performed, and chemotherapies for MM did not improve the tumors. Therefore, we clinically determined that the liver tumors were metastatic pulmonary adenocarcinomas. The epidermal growth factor receptor mutation was present in the pulmonary adenocarcinoma, so gefitinib was administered. However, the tumors were uncontrollable and the patient died within 1 month. From autopsy, the liver lesion was confirmed to be MM. Synchronous occurrence of MM and other primary cancers is very rare, and no standard treatment has yet been established. Thus, it is crucial to accumulate synchronous cases and develop treatment methods in the future.
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Deng C, Zheng Q, Zhang Y, Jin Y, Shen X, Nie X, Fu F, Ma X, Ma Z, Wen Z, Wang S, Li Y, Chen H. Validation of the Novel International Association for the Study of Lung Cancer Grading System for Invasive Pulmonary Adenocarcinoma and Association With Common Driver Mutations. J Thorac Oncol 2021; 16:1684-1693. [PMID: 34302987 DOI: 10.1016/j.jtho.2021.07.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/16/2021] [Accepted: 07/08/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION We aimed to validate the use of the novel grading system proposed by the International Association for the Study of Lung Cancer pathology committee for prognosis stratification of invasive pulmonary adenocarcinomas (ADCs) in Chinese patients. Correlations between the grading system, common driver mutations, and adjuvant chemotherapy (ACT) were also investigated. METHODS From 2008 to 2016, the histologic patterns of a large cohort of 950 patients with invasive ADCs (stage I-III) were retrospectively analyzed and classified according to the proposed grading system. Subsequently, tumor grading was correlated with genetic data, ACT, and patient outcome. RESULTS Compared with conventional predominant pattern-based groups, the novel grading system carried improved survival discrimination (area under the curve = 0.768 for recurrence-free survival and 0.775 for overall survival). The area under the curve was not further improved when incorporated lymphovascular invasion status. EGFR mutations (p < 0.001) were correlated with moderate grade, whereas KRAS mutations (p = 0.041) and ALK fusions (p = 0.021) were significantly more prevalent in poor grade. The reclassification of the grading system based on EGFR mutation status revealed excellent survival discrimination (p < 0.001). In particular, patients on stage Ib to III with novel high-grade ADCs had an improved prognosis with ACT. CONCLUSIONS The novel International Association for the Study of Lung Cancer grading system is a practical and efficient discriminator for patient prognosis and should be part of an integrated pathologic-genetic subtyping to improve survival prediction. In addition, it may support patient stratification for aggressive adjuvant chemotherapy.
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Affiliation(s)
- Chaoqiang Deng
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Qiang Zheng
- Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Yang Zhang
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yan Jin
- Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Xuxia Shen
- Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Xiao Nie
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Department of Pathology, Jiangyin People's Hospital, Jiangsu, People's Republic of China
| | - Fangqiu Fu
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xiangyi Ma
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Zelin Ma
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Zhexu Wen
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Shengping Wang
- Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Yuan Li
- Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Haiquan Chen
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
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Adrian B, Priou P, Cadranel J, De Chabot G, Rousselet MC, Urban T, Gagnadoux F. A Case of Pulmonary Adenocarcinoma Presenting with Diffuse Cystic Lesions. Case Rep Oncol 2021; 14:896-900. [PMID: 34248557 PMCID: PMC8255696 DOI: 10.1159/000515863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 01/15/2023] Open
Abstract
The main causes of diffuse cystic lung diseases include lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, Birt-Hogg-Dubé syndrome, lymphoid interstitial pneumonia, light chain deposition disease, Pneumocystis jirovecii pneumonia, hypersensitivity pneumonitis, and desquamative interstitial pneumonia. Diffuse cystic lung diseases are rarely caused by a malignant process, which are secondary to metastases from sarcomas and gastrointestinal and gynecologic adenocarcinomas. Here, we present a rare case of invasive pulmonary adenocarcinoma associated with progressive diffusion of cystic lesions, revealed by chronic cough and progressive shortness of breath. It is important for clinicians to be aware of this unusual imaging manifestation of lung cancer, to avoid misdiagnoses.
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Affiliation(s)
- Benjamin Adrian
- Département de Pneumologie, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
| | - Pascaline Priou
- Département de Pneumologie, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
| | - Jacques Cadranel
- Service de Pneumologie et Oncologie Thoracique, Assistance Publique, Hôpitaux de Paris (Hôpital Tenon) and GRC#04 Theranoscan Sorbonne Université, Paris, France
| | - Gonzague De Chabot
- Département de Pneumologie, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
| | - Marie-Christine Rousselet
- Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
| | - Thierry Urban
- Département de Pneumologie, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
| | - Frédéric Gagnadoux
- Département de Pneumologie, Centre Hospitalo-Universitaire d'Angers et Université d'Angers, Angers, France
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Fanjat Y, Barazzutti H, Di Mauro I, Tabary-Martin L, Duranton-Tanneur V, Gimet S, Bérard H, Pedeutour F. Molecular follow-up of first-line treatment by osimertinib in lung cancer: Importance of using appropriate tools for detecting EGFR resistance mutation C797S. Cancer Genet 2021; 256-257:158-161. [PMID: 34157597 DOI: 10.1016/j.cancergen.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/26/2021] [Accepted: 06/06/2021] [Indexed: 12/22/2022]
Abstract
The C797S mutation encoded by EGFR exon 20 is classically observed as a tertiary event in EGFR-mutant non-small-cell lung carcinoma (NSCLC) primarily treated by first generation tyrosine kinase inhibitors (TKI) and secondarily treated by third-generation TKI, such as osimertinib, if the EGFR-T790M resistance mutation is detected. Recently, significant prolonged progression free survival has been observed following first-line osimertinib, in EGFR-mutant NSLC. While mechanisms of molecular resistance to first-generation TKI have been well studied, little is known about resistance induced by primary third-generation TKI treatments. We report the case of a 65 year-old female treated by first-line osimertinib for a multimetastatic exon 19-EGFR-mutant NSCLC. EGFR-C797S resistance mutation and PIK3CA mutation were detected together with the remaining EGFR-exon 19 deletion. This observation provides insights of acquired resistance to first line-osimertinib. It also highlights the importance of making molecular platforms which perform routine EGFR testing in lung cancer aware of the kind of therapeutic protocols given to the patient. Indeed, for rapid results or low-costs procedures, some targeted methods specifically targeting T790M may be used at relapse and may overlook alterations such as C797S or PIK3CA mutations. Targeted next generation sequencing is therefore a recommended option.
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Affiliation(s)
- Y Fanjat
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France.
| | - H Barazzutti
- Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - I Di Mauro
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France; Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), CNRS UMR 7284/INSERM U1081, Nice, France.
| | | | - V Duranton-Tanneur
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France; Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), CNRS UMR 7284/INSERM U1081, Nice, France.
| | - S Gimet
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France; Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), CNRS UMR 7284/INSERM U1081, Nice, France.
| | - H Bérard
- Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France.
| | - F Pedeutour
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France; Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), CNRS UMR 7284/INSERM U1081, Nice, France.
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Snene H, Zayen K, Salah NB, Blibech H, Farhat LB, Ayadi A, Hantous S, Mehiri N, Louzir B. [Paraneoplastic limbic encephalitis complicating pulmonary adenocarcinoma: a case report]. Pan Afr Med J 2021; 39:95. [PMID: 34466197 PMCID: PMC8379404 DOI: 10.11604/pamj.2021.39.95.26568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/13/2021] [Indexed: 11/24/2022] Open
Abstract
Limbic encephalitis (LE) is a rare disease often of paraneoplastic origin. It is frequently associated with bronchopulmonary cancer. Diagnosis is based on brain magnetic resonance imaging (MRI). We here report the case of a 54-year-old female patient with a history of active smoking, presenting with chronic dry cough. Chest X-ray showed suspicious right lung opacity. Bronchial fibroscopy and bronchial biopsies were not contributory. Thoraco-abdomino-pelvic computed tomography (CT)-scan and brain CT-scan showed a mass in the right upper lobe classified as T4N2M1a. CT-guided lung biopsy confirmed the diagnosis of bronchopulmonary adenocarcinoma. The patient had reported a recent history of memory disturbances associated with depressed mood, anxiety and paroxysmal confusion. Metabolic screening and tests for detecting infection were normal and brain MRI suggested limbic encephalitis. The evolution was characterized by rapid disease progression; the patient died in about ten days.
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Affiliation(s)
- Houda Snene
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
| | - Khalil Zayen
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
| | - Nozha Ben Salah
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
| | - Hana Blibech
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
| | - Leila Ben Farhat
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Radiologie, Tunis, Tunisie
| | - Aïda Ayadi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Abderrahmen Mami, Service d´Anatomie Pathologie, Ariana, Tunisie
| | - Saoussen Hantous
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Abderrahmen Mami, Service de Radiologie, Ariana, Tunisie
| | - Nadia Mehiri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
| | - Béchir Louzir
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim, La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie
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22
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Livi V, Paioli D, Cancellieri A, Betti S, Natali F, Ferrari M, Fiorentino M, Trisolini R. Diagnosis and Molecular Profiling of Lung Cancer by Percutaneous Ultrasound-Guided Biopsy of Superficial Metastatic Sites Is Safe and Highly Effective. Respiration 2021; 100:515-522. [PMID: 33827098 DOI: 10.1159/000514316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diagnosis, staging, and molecular profiling of lung cancer are mostly carried out with bronchoscopy or CT-guided aspiration/biopsy. However, patients with locally advanced or advanced disease often harbor "superficial" metastases for which a percutaneous, ultrasound-assisted needle aspiration/biopsy (US-NAB) might represent an equally effective yet less invasive and costly alternative. PATIENTS AND METHODS We reviewed a prospectively collected database of consecutive patients with known/suspected lung cancer who underwent a US-NAB of a suspected "superficial" metastasis. Cancer genotyping was carried out with next-generation sequencing using the Oncomine™ Focus DNA and RNA fusion panels. PD-L1 immunohistochemistry was performed with the SP263 antibody. Feasibility, diagnostic yield for tissue diagnosis, sensitivity for malignancy, diagnostic yield for the molecular profiling, and complications were the study endpoints. RESULTS A total of 98 lesions were evaluated, and 93 were biopsied (95% feasibility). The spectrum of sampled sites included lymph nodes (63 patients), bone (11), subcutaneous tissue (8), muscle (7), and the pleura (4). The diagnostic yield for a tissue diagnosis was 93% (91/98). US-NAB correctly identified 85 of the 87 patients finally diagnosed with malignancy (98% sensitivity). Cancer genotyping and PDL1 testing were successfully completed in 41/42 patients (98%) and in 40/50 patients (80%) for whom these tests were requested, respectively. No complications were observed. CONCLUSION US-NAB of "superficial" metastasis of lung cancer is safe and is associated with high success for diagnosis and molecular profiling. In this clinical setting, using US-NAB as a first-step technique would significantly limit the use of more invasive and costly diagnostic procedures.
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Affiliation(s)
- Vanina Livi
- Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Daniela Paioli
- Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Sara Betti
- Respiratory and Critical Care Unit, DIMES, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Filippo Natali
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Marco Ferrari
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Rocco Trisolini
- Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Catholic University of the Sacred Hearth, Roma, Italy
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23
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Kalakech S, El Abiad R, Kesrouani C, Kattan J, Nassereddine H. [Acrometastasis revealing a pulmonary adenocarcinoma: Report of a case with unusual histopathological findings]. Ann Pathol 2021; 41:405-409. [PMID: 33820661 DOI: 10.1016/j.annpat.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/24/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
Acrometastasis are rare and can be exceptionally indicative of an occult carcinoma. The prognosis is generally poor. The radiological and immunohistochemical findings can be of great value to determine the primary and to guide treatment. We report a case of a 56-years-old man with acrometastasis at the fourth finger of the left hand revealing a pulmonary adenocarcinoma. Histopathological analysis showed a cribriform adenocarcinoma with an unusual cytoplasmic co-expression of TTF1 and Hepar-1 upon immunohistochemical analysis. There was no nuclear TTF1 immunostaining. Imaging explorations showed a 6-cm mass of the left superior pulmonary lobe. The patient received immunochemotherapy. Upon follow-up, there was evidence of disease progression on chest computed tomography scan.
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Affiliation(s)
- Sylvana Kalakech
- Service de pathologie, Hôtel-Dieu de France, université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban.
| | - Rami El Abiad
- Service d'orthopédie, Hôtel-Dieu de France, université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban
| | - Carole Kesrouani
- Service de pathologie, Hôtel-Dieu de France, université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban
| | - Joseph Kattan
- Service d'oncologie, Hôtel-Dieu de France, Université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban
| | - Hussein Nassereddine
- Service de pathologie, Hôtel-Dieu de France, université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban
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24
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Wang X, Chen K, Wang W, Li Q, Liu K, Li Q, Cui X, Tu W, Sun H, Xu S, Zhang R, Xiao Y, Fan L, Liu S. Can peritumoral regions increase the efficiency of machine-learning prediction of pathological invasiveness in lung adenocarcinoma manifesting as ground-glass nodules? J Thorac Dis 2021; 13:1327-1337. [PMID: 33841926 PMCID: PMC8024795 DOI: 10.21037/jtd-20-2981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background The peri-tumor microenvironment plays an important role in the occurrence, growth and metastasis of cancer. The aim of this study is to explore the value and application of a CT image-based deep learning model of tumors and peri-tumors in predicting the invasiveness of ground-glass nodules (GGNs). Methods Preoperative thin-section chest CT images were reviewed retrospectively in 622 patients with a total of 687 pulmonary GGNs. GGNs are classified according to clinical management strategies as invasive lesions (IAC) and non-invasive lesions (AAH, AIS and MIA). The two volumes of interest (VOIs) identified on CT were the gross tumor volume (GTV) and the gross volume of tumor incorporating peritumoral region (GPTV). Three dimensional (3D) DenseNet was used to model and predict GGN invasiveness, and five-fold cross validation was performed. We used GTV and GPTV as inputs for the comparison model. Prediction performance was evaluated by sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Results The GTV-based model was able to successfully predict GGN invasiveness, with an AUC of 0.921 (95% CI, 0.896–0.937). Using GPTV, the AUC of the model increased to 0.955 (95% CI, 0.939–0.971). Conclusions The deep learning method performed well in predicting GGN invasiveness. The predictive ability of the GPTV-based model was more effective than that of the GTV-based model.
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Affiliation(s)
- Xiang Wang
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Kaili Chen
- Department of Hematology, The Myeloma & Lymphoma Center, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Wei Wang
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China.,71282 Hospital, Baoding, China
| | - Qingchu Li
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Kai Liu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Qianyun Li
- Department of Radiology, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Xing Cui
- Beijing Infervision Technology Co. Ltd., Beijing, China
| | - Wenting Tu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Hongbiao Sun
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Shaochun Xu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Rongguo Zhang
- Beijing Infervision Technology Co. Ltd., Beijing, China
| | - Yi Xiao
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Li Fan
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Shiyuan Liu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, China
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25
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Watanabe T, Sawabata N, Kawaguchi T, Yoshikawa D, Kushibe K, Nakane S, Taniguchi S. Clustered Circulating Tumor Cells in Lung Adenocarcinoma: Implications of Test Results of Continuous Variables. Anticancer Res 2020; 40:7089-7094. [PMID: 33288607 DOI: 10.21873/anticanres.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We investigated the relationship between solid component size (SS), carcinoembryonic antigen (CEA), and standardized uptake value (SUVmax) as continuous variables and postoperative clustered circulating tumor cell (C-CTC) detection in patients with pulmonary adenocarcinoma who underwent surgery. PATIENTS AND METHODS C-CTC detection was the main evaluation item, which was analyzed using the receiver operating characteristic curve to calculate areas under the curves (AUCs) for the variables. Additionally, the two-year recurrence-free survival rates (2Y-RFSRs) were analyzed. RESULTS Among the 84 patients examined, SS, CEA, and SUVmax had AUCs>0.7, and were independent. Their thresholds were 2.1 cm, 7.5 ng/ml, and 2.9, respectively. The 2Y-RFSR were significantly better in the non-C-CTC group (n=58) and in the group of patients without high levels of these predictors (n=32). CONCLUSION SS, CEA level, and SUVmax predicted postoperative CTC detection in pulmonary adenocarcinoma patients.
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Affiliation(s)
- Takashi Watanabe
- Department of General Thoracic Surgery, Nara Prefectural General Medical Center, Nara, Japan.,Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
| | - Noriyoshi Sawabata
- Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan .,Department of General Thoracic Surgery, JCHO Hoshigaoka Medical Center, Osaka, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
| | - Daiki Yoshikawa
- Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
| | - Keiji Kushibe
- Department of General Thoracic Surgery, Nara Prefectural General Medical Center, Nara, Japan
| | - Shigeru Nakane
- Department of General Thoracic Surgery, JCHO Hoshigaoka Medical Center, Osaka, Japan
| | - Shigeki Taniguchi
- Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
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Xie Q, Li F, Zhao S, Guo T, Li Z, Fang L, Wang S, Liu W, Gu C. GalNAc-T3 and MUC1, a combined predictor of prognosis and recurrence in solitary pulmonary adenocarcinoma initially diagnosed as malignant solitary pulmonary nodule (≤ 3 cm). Hum Cell 2020; 33:1252-1263. [PMID: 32776306 DOI: 10.1007/s13577-020-00400-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/13/2020] [Indexed: 12/20/2022]
Abstract
The significance of the polypeptide N-acetyl-galactosaminyl transferase-3 (GalNAc-T3) and mucin 1 (MUC1) in solitary pulmonary adenocarcinoma (SPA) initially diagnosed as malignant solitary pulmonary nodule (≤ 3 cm), especially as a combined predictor of prognosis and recurrence, was explored in this study. A retrospective analysis of 83 patients with SPA (≤ 3 cm), which revealed postoperative pathological diagnosis was lung adenocarcinoma after complete resection. Immunohistochemical staining was used to detect the expression of GalNAc-T3 and MUC1 in primary tumor specimens. The relationship between expression and various clinicopathological factors was analyzed, as well as the effects of patients' overall survival (OS) and disease-free survival (DFS). In all patients, GalNAc-T3 was highly expressed in 53 (63.9%) cases; MUC1 was highly expressed in 31 (37.3%) cases. The GalNAc-T3 expression was correlated with differentiation, pathological risk group, N stage, and TNM stage. The group with high GalNAc-T3 expression and low MUC1 expression (GalNAc-T3Hig/MUC1Low) is correlated to pathological differentiation and has a trend related to the TNM stage. The patients with better differentiation, lower pathological risk group, lower N stage, and GalNAc-T3 high expression had better overall survival, especially the GalNAc-T3Hig/MUC1Low group. Moreover, the moderate differentiation, N3 stage, and GalNAc-T3Hig/MUC1Low group were independent predictive factors for OS. Besides, patients with lower N stage, lower TNM stage, higher GalNAc-T3 expression got better disease-free survival (DFS), especially the GalNAc-T3Hig/MUC1Low group. The GalNAc-T3Hig/MUC1Low group was an independent predictive factor for DFS. In conclusion, GalNAc-T3 and MUC1 were combined predictors of prognosis and recurrence in SPA (≤ 3 cm).
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Affiliation(s)
- Qiang Xie
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Fengzhou Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Shilei Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Tao Guo
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Zhuoshi Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Lei Fang
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Shiqing Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Wenzhi Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China
| | - Chundong Gu
- Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, Liaoning, People's Republic of China.
- Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, People's Republic of China.
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Trisolini R, Cancellieri A, Livi V, Annema JT, Ferrari M, Natali F, Paioli D, Conci N, Altimari A, Fiorentino M, Ardizzoni A. Pulmonary adenocarcinoma with psammoma bodies is associated with a specific endobronchial ultrasound pattern and a high prevalence of actionable driver mutations. Lung Cancer 2020; 147:204-208. [PMID: 32736279 DOI: 10.1016/j.lungcan.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Pulmonary adenocarcinoma with psammoma bodies (PAPBs) is a rare histological variant whose association with a high prevalence of targetable mutations has been suggested by scant literature reports describing small series. We aim to describe the endobronchial ultrasound (EBUS) pattern and the molecular profile by next-generation sequencing of an Italian series of patients with PAPBs. MATERIAL AND METHODS Over a 8-year period (2012-2019), we identified 15 patients with a very uncommon endobronchial ultrasound (EBUS) heterogeneity pattern characterized by the presence of multiple to countless, punctate non-shadowing foci ("starry sky" sign) which were not evident at CT and corresponded to psammoma bodies at pathological examination. The clinical, radiological, pathological and molecular findings of these patients were retrieved and analyzed. RESULTS Pathological examination of the EBUS-TBNA specimens revealed malignancy (12 pulmonary adenocarcinoma, 2 breast carcinoma, 1 colonic carcinoma) and showed the presence of psammoma bodies in all of the 15 patients with the starry sky sign. Among the 12 patients with pulmonary adenocarcinoma with psammoma bodies, female sex (8/12, 66.7 %) and never-smoking habit (6/12, 50 %) were prevalent. Molecular tumor profiling using the Oncomine™ Focus DNA and RNA fusion panels was successfully performed in 11/12 patients and revealed 10 genetic alterations (BRAF mutation, 4; EGFR mutation, 2; ALK rearrangement, RET rearrangement, PIK3CA mutation, CDK4 amplification 1) in 7 patients (63.6 %). CONCLUSION The present series suggests that pulmonary adenocarcinoma with psammoma bodies is associated with a readily identifiable EBUS pattern and with a high prevalence of different, often uncommon and actionable, driver mutations.
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Affiliation(s)
- Rocco Trisolini
- Interventional Pulmonology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Bologna, Italy; Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Alessandra Cancellieri
- Pathology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Bologna, Italy; Pathology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Vanina Livi
- Interventional Pulmonology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Bologna, Italy; Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Jouke T Annema
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marco Ferrari
- Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Filippo Natali
- Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Daniela Paioli
- Interventional Pulmonology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Bologna, Italy; Interventional Pulmonology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Nicole Conci
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Università di Bologna, Bologna, Italy
| | - Annalisa Altimari
- Laboratory of Oncologic Molecular Pathology, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Università di Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Experimental, Diagnostic and Specialty Medicine, Università di Bologna, Bologna, Italy
| | - Andrea Ardizzoni
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Policlinico S. Orsola, Università di Bologna, Bologna, Italy
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28
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Lee YJ, Oh H, Kim E, Ahn B, Lee JH, Lee Y, Chae YS, Kim CH. Morule-like features in pulmonary adenocarcinoma associated with epidermal growth factor receptor mutations: two case reports with targeted next-generation sequencing analysis. J Pathol Transl Med 2019; 54:119-122. [PMID: 31674165 PMCID: PMC6986969 DOI: 10.4132/jptm.2019.09.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/26/2019] [Indexed: 12/31/2022] Open
Abstract
Morules, or morule-like features, can be identified in benign and malignant lesions in various organs. Morular features are unusual in pulmonary adenocarcinoma cases with only 26 cases reported to date. Here, we describe two cases of pulmonary adenocarcinoma with morule-like features in Korean women. One patient had a non-mucinous-type adenocarcinoma in situ and the other had an acinarpredominant adenocarcinoma with a micropapillary component. Both patients showed multiple intra-alveolar, nodular, whorled proliferative foci composed of atypical spindle cells with eosinophilic cytoplasm. Targeted next-generation sequencing was performed on DNA extracted from formalin-fixed paraffin-embedded samples of the tumors. Results showed unusual epidermal growth factor receptor (EGFR) mutations, which are associated with drug resistance to EGFR tyrosine kinase inhibitors, revealing the importance of identifying morule-like features in pulmonary adenocarcinoma and the need for additional study, since there are few reported cases.
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Affiliation(s)
- Yoo Jin Lee
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Harim Oh
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Eojin Kim
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Bokyung Ahn
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Jeong Hyeon Lee
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Youngseok Lee
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Yang Seok Chae
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Chul Hwan Kim
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
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29
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Suzuki Y, Imasato M, Nakahara Y, Naito A, Mikamori M, Ohtsuka M, Furukawa K, Moon JH, Asaoka T, Kishi K, Yasuoka H, Komuta K, Akamatsu H. Metachronous rectal metastasis from pulmonary adenocarcinoma after 11 years of chemo-, immuno-, and radiotherapy for recurrent lesions: a case report. Surg Case Rep 2019; 5:151. [PMID: 31650415 PMCID: PMC6813376 DOI: 10.1186/s40792-019-0722-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/27/2019] [Indexed: 12/29/2022] Open
Abstract
Background Rectal metastasis from pulmonary adenocarcinoma is rare, and it has been regarded as an end-stage phenomenon. Recently, however, advances in lung cancer treatment have improved the chance of long-term survival of patients with unresectable distant metastases. We describe the occurrence and management of metastatic spread of a pulmonary carcinoma to the rectum. Case presentation The patient was a 79-year-old woman who had undergone thoracoscopic left lobectomy for pulmonary adenocarcinoma and then, over the next 11 years, various drugs (carboplatin + paclitaxel (as adjuvant therapy), gefitinib, gemcitabine + vinorelbine, S1 (an oral 5-fluorouracil-based drug), carboplatin + pemetrexed + bevacizumab, erlotinib, nivolumab, afatinib, and carboplatin+ S1) were administered, especially for hilar and mediastinal lymph node recurrences. During the eleventh postoperative year, left and right iliac bone metastases were detected, and radiation therapy was undertaken for local control of these lesions. When 18F-fluorodeoxyglucose positron emission tomography was performed for evaluation of the disease, tracer accumulation in the upper rectum was seen. Colonoscopic examination of the rectum revealed an intramural mass with central ulceration, and the mass was diagnosed histologically as an adenocarcinoma. The bone metastases appeared to be controlled, and the patient’s performance status was good, but she had suffered constipation for about a year and desired treatment. Thus, laparoscopic low anterior resection was performed. Histopathologic analysis revealed a moderately differentiated adenocarcinoma existing mainly between the submucosa and serosa, and immunohistochemical analysis showed the tumor to be positive for cytokeratin (CK) 7, negative for CK20, positive for thyroid transcription factor-1, and negative for special AT-rich sequence-binding protein 2 and caudal type homeobox 2, confirming the diagnosis of rectal metastasis from the primary pulmonary adenocarcinoma. The patient recovered well without any change in her functional status. Systemic chemotherapy was resumed, and she continues to do well, now 6 months after surgery. Conclusions Surgery may be a good option for the management of an isolated rectal metastasis from pulmonary cancer in patients whose functional status is good.
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Affiliation(s)
- Yozo Suzuki
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan.
| | - Mitsunobu Imasato
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Yujiro Nakahara
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Atsushi Naito
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Manabu Mikamori
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Masahisa Ohtsuka
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Kenta Furukawa
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Jeong Ho Moon
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Tadafumi Asaoka
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Kentaro Kishi
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Hironao Yasuoka
- Department of Pathology, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
| | - Kiyoshi Komuta
- Department of Respiratory Medicine, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan.,Department of Respiratory Medicine, Daini Osaka Police Hospital, Tennoji-Ku Karasugatsuji 2-6-40, Osaka City, Osaka, 543-8922, Japan
| | - Hiroki Akamatsu
- Department of Gastroenterological Surgery, Osaka Police Hospital, Tennoji-Ku Kitayamacho 10-31, Osaka City, Osaka, 543-0035, Japan
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Bozdag Z, Tutar E, Dizibuyuk OF, Bakir K. Monoclonal Caveolin 1 Expression in the Differential Diagnosis of Malignant Pleural Mesothelioma and Pulmonary Adenocarcinoma: Is it Useful? Pathol Oncol Res 2019; 26:1651-1656. [PMID: 31512057 DOI: 10.1007/s12253-019-00751-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
In this study we aim to demonstrate the value of monoclonal Caveolin 1 expression in distinguishing between malignant pleural mesothelioma and pulmonary adenocarcinoma. Total of 129 cases, consisting of 68 cases of malignant pleural mesothelioma (51 epitheloid, 12 biphasic, and 5 sarcomatoid type) and 61 cases of pulmonary adenocarcinoma were examined and stained with monoclonal Caveolin-1. Caveolin 1 expression with a membranous and /or cytoplasmic pattern was detected only in 32.35% (n:22/68) of malignant pleural mesothelioma and 6.5% (n:4/61) of pulmonary adenocarcinoma cases. This finding suggests that the choice of poly/monoclonal antibody for Caveolin 1 in the differential diagnosis of malignant pleural mesothelioma and pulmonary adenocarcinoma is important.
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Affiliation(s)
- Zehra Bozdag
- Department of Pathology, Gaziantep University, Medical School, Gaziantep, Turkey.
| | - Ediz Tutar
- Department of Pathology, Gaziantep University, Medical School, Gaziantep, Turkey
| | - Omer Faruk Dizibuyuk
- Department of Pathology, Gaziantep University, Medical School, Gaziantep, Turkey
| | - Kemal Bakir
- Department of Pathology, Gaziantep University, Medical School, Gaziantep, Turkey
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Rodriguez EF, Jones R, Morris CP, Ettinger D, Chowsilpa S, Maleki Z. Molecular Alterations in Pulmonary Adenocarcinoma of African Americans. Am J Clin Pathol 2019; 152:237-242. [PMID: 31114847 DOI: 10.1093/ajcp/aqz038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Identify molecular alterations in pulmonary adenocarcinoma (ADC) in African American (AA) patients diagnosed on cytology specimens. METHODS After institutional review board approval, we searched our database from 2013 to 2017 for AA patients with a diagnosis of pulmonary ADC. Molecular and clinical data were reviewed. White patients also diagnosed with pulmonary ADC on cytology samples formed a control group. RESULTS A total of 113 patients were identified. Mean age was 63.4 years. Molecular tests were available for 91 patients. Mutations were identified in 53 (58.2%) cases. The most common mutations were EGFR (n = 19 cases, 36%) and KRAS (n = 24 cases, 45%). When compared with whites, AA patients were diagnosed at higher stages (P = .045) and demonstrated shorter overall survival (17 vs 47 months, P = .0150). No differences were noted regarding distribution of molecular alterations. CONCLUSION AA patients have similar molecular alterations in ADCs as their white counterparts. However, they have worse outcomes.
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Affiliation(s)
- Erika F Rodriguez
- Departments of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, MD
| | - Robert Jones
- Departments of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, MD
| | - C Paul Morris
- Departments of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, MD
| | - David Ettinger
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - Sayanan Chowsilpa
- Departments of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, MD
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Zahra Maleki
- Departments of Pathology, Division of Cytopathology, The Johns Hopkins Hospital, Baltimore, MD
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Cho JH, Jung HA, Lee SH, Ahn JS, Ahn MJ, Park K, Sun JM. Impact of EGFR mutation on the clinical efficacy of PD-1 inhibitors in patients with pulmonary adenocarcinoma. J Cancer Res Clin Oncol 2019; 145:1341-1349. [PMID: 30900155 DOI: 10.1007/s00432-019-02889-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/08/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE We evaluated the predictive role of EGFR mutation on the efficacy of PD-1/PD-L1 inhibitor therapy in patients with advanced pulmonary adenocarcinoma while considering clinical factors such as PD-L1 expression, gender, and smoking status. METHODS Patients were required to have available data for EGFR mutation, PD-L1 expression, and efficacy of PD-1/PD-L1 inhibitors. RESULTS Among 178 patients with EGFR-mutant (n = 38) or wild-type (WT) (n = 140) tumors, the EGFR mutation group had a lower objective response rate (ORR) (15.8% vs. 32.9%, p = 0.04) than the EGFR WT group, similar to the pattern observed for other factors: weak/negative PD-L1 expression vs. strong PD-L1 expression (17.3% vs. 39.2%, p = 0.001); never smokers vs. smokers (19.4% vs. 35.1%, p = 0.03); and females vs. males (21.0% vs. 33.6%, p = 0.08). EGFR mutation and weak/negative PD-L1 expression were associated with a significantly shorter median PFS than EGFR WT (1.9 vs. 3.0 months, p = 0.04) and strong PD-L1 expression (1.6 vs. 3.9 months, p = 0.007), respectively. In multivariate analysis, EGFR mutation predicted worse ORR [hazard ratio (HR) 3.15; 95% confidence interval (CI) 1.15-8.63] and PFS (HR 1.75, 95% CI 1.11-2.75), as did weak/negative PD-L1 expression (ORR, HR 3.46, 95% CI 1.62-7.37; and PFS, HR 1.72, 95% CI 1.17-2.53). CONCLUSIONS Together with PD-L1 expression, EGFR mutation status is an important factor to predict the efficacy of PD-1/PD-L1 inhibitors in patients with pulmonary adenocarcinoma.
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Affiliation(s)
- Jang Ho Cho
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Hyun Ae Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Kim B, Jang YJ, Park S, Lee JI, Kim HK, Han J. Histopathologic analysis of brain metastasis in pulmonary adenocarcinoma: Necrosis is a new risk factor. Pathol Res Pract 2019; 215:807-815. [PMID: 30686548 DOI: 10.1016/j.prp.2019.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/03/2019] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Studies have shown that 30-50% of non-small cell lung cancer (NSCLC) patients develop brain metastasis (BM). Since BM shortens overall survival and decreases the quality of life, early detection and treatment of BM are vital. While data are available for clinical risk factors of NSCLC with BM, histopathological factors are not well understood. Therefore, we evaluated the histopathological related factors which will help early detection and selection of effective treatment options. MATERIALS AND METHODS A total of 117 surgical lung specimens diagnosed as NSCLC with BM were included as a study group. We included 237 cases without BM as a control group. One pathologist reviewed H&E slides and analyzed the histopathologic factors of all cases. RESULTS In pulmonary adenocarcinoma, vascular invasion, N stage, micropapillary pattern and necrosis were significantly associated with BM in multivariate analysis (vascular invasion, p = 0.009; micropapillary pattern, p = 0.024; others, p < 0.001). Tumor with extensive necrosis had higher hazard ratio and shorter time to BM (p < 0.001). CONCLUSION Our findings suggest that necrosis is a new predictive factor of BM in pulmonary adenocarcinoma. Short term follow-up is needed especially when extensive necrosis is present.
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Affiliation(s)
- Binnari Kim
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yun-Jeong Jang
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sujin Park
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung-Il Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Kwan Kim
- Department of Thoracic Surgery and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joungho Han
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Predina JD, Okusanya O, D Newton A, Low P, Singhal S. Standardization and Optimization of Intraoperative Molecular Imaging for Identifying Primary Pulmonary Adenocarcinomas. Mol Imaging Biol 2018; 20:131-138. [PMID: 28497233 DOI: 10.1007/s11307-017-1076-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Intraoperative molecular imaging (IMI) is an emerging technology used to locate pulmonary adenocarcinomas and identify positive margins during surgery. Background noise and tissue autofluorescence have been major obstacles. The goal of this study is to optimize the image quality of folate receptor alpha (FRα) targeted IMI for pulmonary adenocarcinomas by modifying emission data. PROCEDURES A total of 15 lung cancer patients were enrolled in a pilot study. In the first cohort, FRα upregulation within pulmonary adenocarcinoma tumors was confirmed by analyzing specimens from five pulmonary adenocarcinoma patients with flow cytometry and immunohistochemistry. Next, in a cohort of five additional patients, autofluorescence of intrathoracic structures and tissues was quantified. Lastly, five patients with tumors at various depths from the pleural surface were enrolled and received the FRα-targeted optical contrast agent, EC17. In this final cohort, resected pulmonary adenocarcinomas were imaged at a wide range of fluorescence exposure times (0 to 200 ms), various laser powers, and with unique filter configurations. Tumor-to-noise ratio (TNR) for images was generated using region of interest software. RESULTS Pulmonary adenocarcinomas highly express FRα. Significant autofluorescence from native thoracic tissues was found with the highest fluorescent signals at the bronchial stump (547 ± 98, range 423-699), the pulmonary artery (267 ± 64, range 200-374), and cortical bone (266 ± 17, range 243-287). High levels of autofluorescence were appreciated after systemic administration of EC17; however, TNR was improved by altering exposure settings at the time of the imaging. Optimal fluorescent exposure time occurs at 40 ms (25 frames/s). CONCLUSIONS Exposure properties can be manipulated to maximize TNR thus allowing for successful intraoperative detection of pulmonary adenocarcinomas during surgery. Optimization of the conditions for intraoperative molecular imaging sets the stage for future clinical trials utilizing targeted IMI techniques which can aid the surgeon at the time of cancer resection.
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Affiliation(s)
- Jarrod D Predina
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania School of Medicine, 6 White Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Precision Surgery, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA
| | - Olugbenga Okusanya
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania School of Medicine, 6 White Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Precision Surgery, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA
| | - Andrew D Newton
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania School of Medicine, 6 White Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.,Center for Precision Surgery, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA
| | - Philip Low
- Department of Chemistry, Purdue University, West Lafayette, IN, USA
| | - Sunil Singhal
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania School of Medicine, 6 White Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA. .,Center for Precision Surgery, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA.
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Lee JS, Hur JY, Kim IA, Kim HJ, Choi CM, Lee JC, Kim WS, Lee KY. Liquid biopsy using the supernatant of a pleural effusion for EGFR genotyping in pulmonary adenocarcinoma patients: a comparison between cell-free DNA and extracellular vesicle-derived DNA. BMC Cancer 2018; 18:1236. [PMID: 30526536 PMCID: PMC6288853 DOI: 10.1186/s12885-018-5138-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND EGFR genotyping in pulmonary adenocarcinoma patients who develop pleural effusions is mostly performed using cytology or cell block slides with low sensitivity. Liquid biopsy using the supernatant of pleural effusions may be more effective because they contain many components released by cancer cells. Extracellular vesicles (EVs) are known to carry oncogenic double-stranded DNA that is considered a notable biomarker. Here, we investigate the efficiency of liquid biopsy using cell-free DNA (cfDNA) and extracellular vesicle-derived DNA (EV-derived DNA) from the supernatant of pleural effusions for EGFR genotyping in patients with pulmonary adenocarcinoma. METHODS Fifty pleural effusion samples from patients with pulmonary adenocarcinoma were evaluated. The supernatant, after removing the cell pellet by centrifugation, was used for liquid biopsy, and EVs were isolated from the pleural effusion by ultracentrifugation. EV-derived DNA and cfDNA were extracted separately, and EGFR genotyping was performed by the PNA clamping method. RESULTS Among 32 patients who were EGFR-tyrosine kinase inhibitor (TKI) naïve with a known tissue EGFR genotype, liquid biopsy using EV-derived DNA from the pleural effusion supernatant showed 100% matching results with tissue EGFR genotyping in 19 EGFR mutant cases and detected three additional EGFR mutations in patients with wild-type (WT) tissue. Liquid biopsy using cfDNA from pleural effusion supernatants missed two cases of tissue-based EGFR mutations and found two additional EGFR mutation cases. In 18 patients who acquired resistance to EGFR-TKI, EGFR genotyping using EV-derived DNA from the pleural effusion supernatant detected the T790 M mutation in 13 of 18 (72.2%) patients, and this mutation was detected in 11 (61.1%) patients using cfDNA. By contrast, only three patients were found to present the T790 M mutation when using cell block or cytology slides. CONCLUSIONS Liquid biopsy using the supernatant of pleural effusions showed significantly improved results for EGFR genotyping compared to those using conventional cell block or cytology samples. Liquid biopsy using EV-derived DNA is promising for EGFR genotyping, including T790 M detection in pulmonary adenocarcinoma patients who develop pleural effusions.
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Affiliation(s)
- Jong Sik Lee
- Department of Pulmonary, Lung Cancer Center, Konkuk University Medical Center and Medicine, Konkuk University School of Medicine, 120-1 Hwayang-dong, Gwangjin-Gu, Seoul, 05030, Republic of Korea
| | - Jae Young Hur
- Department of Pulmonary, Lung Cancer Center, Konkuk University Medical Center and Medicine, Konkuk University School of Medicine, 120-1 Hwayang-dong, Gwangjin-Gu, Seoul, 05030, Republic of Korea.,Department of Pathology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - In Ae Kim
- Department of Pulmonary, Lung Cancer Center, Konkuk University Medical Center and Medicine, Konkuk University School of Medicine, 120-1 Hwayang-dong, Gwangjin-Gu, Seoul, 05030, Republic of Korea
| | - Hee Joung Kim
- Department of Pulmonary, Lung Cancer Center, Konkuk University Medical Center and Medicine, Konkuk University School of Medicine, 120-1 Hwayang-dong, Gwangjin-Gu, Seoul, 05030, Republic of Korea.,Department of Pulmonary Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae Chol Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Kye Young Lee
- Department of Pulmonary, Lung Cancer Center, Konkuk University Medical Center and Medicine, Konkuk University School of Medicine, 120-1 Hwayang-dong, Gwangjin-Gu, Seoul, 05030, Republic of Korea. .,Department of Pulmonary Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
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Tosic L, Baschera D, Jentsch B, Feuerstein T, Alfieri A. Tumor-to-tumor metastasis of lung adenocarcinoma into a spinal intradural solitary fibrous tumor: a case report. Acta Neurochir (Wien) 2018; 160:2393-2396. [PMID: 30315364 DOI: 10.1007/s00701-018-3700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/05/2018] [Indexed: 11/30/2022]
Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms commonly involving visceral or parietal pleura. We present the first report of tumor-to-tumor metastasis involving a pulmonary adenocarcinoma donor and an intradural SFT recipient. The patient presented with a 1 year history of diffuse back pain. A spinal intradural contrast-enhancing mass at the T9/10 level and a tumor of the lung were diagnosed radiologically. Bronchoscopic biopsy confirmed pulmonary adenocarcinoma in the right upper lung lobe. Due to deteriorating neurological status with conus medullaris syndrome, we performed a neurosurgical excision of the lesion. Histological analysis of the tumor revealed tumor-to-tumor metastasis of the adenocarcinoma to the SFT.
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Affiliation(s)
- Lazar Tosic
- Department of Neurosurgery, Winterthur Cantonal Hospital, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Dominik Baschera
- Department of Neurosurgery, Winterthur Cantonal Hospital, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Bastian Jentsch
- Department of Pathology, Winterthur Cantonal Hospital, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Thomas Feuerstein
- Department of Neurosurgery, Winterthur Cantonal Hospital, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Alex Alfieri
- Department of Neurosurgery, Winterthur Cantonal Hospital, Brauerstrasse 15, 8401, Winterthur, Switzerland
- Brandenburg Medical School, Fehrbellinerstrasse 38, 16816, Neuruppin, Germany
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Ambrosini YM, Johnson KA, Matthews M, Sato AF. Unusual invasion of primary pulmonary adenocarcinoma in a cat. JFMS Open Rep 2018; 4:2055116918810897. [PMID: 30450217 PMCID: PMC6236497 DOI: 10.1177/2055116918810897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary An 11-year-old female spayed domestic shorthair cat was referred to the Foster Hospital for Small Animals, USA for suspected dysautonomia based on weight loss, vomiting and referral radiographs that showed severe dilation of the esophagus, stomach and entire gastrointestinal tract. After recheck radiographs revealed a decrease in gas compared with the referral images, persistently reduced gastrointestinal motility was deemed less likely; however, cardiomegaly and a soft tissue opacity overlying the esophagus were noted. Echocardiogram identified a pulmonary mass either impinging on or invading the local organs. At necropsy, gross pathology and histopathology showed an aggressive pulmonary carcinoma invading the heart, trachea and esophagus, resulting in a focal esophageal stricture. Gastrointestinal gas dilation was most likely secondary to aerophagia as a result of chronic partial esophageal obstruction. Relevance and novel information To our knowledge, this is the first reported feline case of invasion of the esophagus and heart by a pulmonary adenocarcinoma. Other than weight loss, the clinical signs for this invasive neoplasm were not evident until the cat was diagnosed with hyperthyroidism and prescribed oral medications. This reinforces the fact that pulmonary adenocarcinoma is difficult to detect clinically until secondary problems from the primary or metastatic neoplasm arise.
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Affiliation(s)
- Yoko M Ambrosini
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Kelsey A Johnson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Morgan Matthews
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Amy F Sato
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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Zhu Z, Liang Z, Tong J, Mao X, Yin Y, Manor LC, Shen Z. Survival analysis in Caucasian pulmonary adenocarcinoma patients based on differential targets between Caucasian and Asian population. Saudi J Biol Sci 2018; 25:1003-1006. [PMID: 30108455 PMCID: PMC6088109 DOI: 10.1016/j.sjbs.2018.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 05/15/2018] [Accepted: 05/21/2018] [Indexed: 11/10/2022] Open
Abstract
Ethnicity differences may contribute to the variety of overall survival in pulmonary adenocarcinoma, while the influence of ethnicity relevant somatic driver mutations (ERSDM) profile on Caucasian survival is not well investigated. In this study, we studied epidermal growth factor receptor (EGFR), tumor protein p53 (TP53), Kirsten rat sarcoma 2 viral oncogene homolog (KRAS), and Serine/Threonine Kinase 11 (STK11) to construct the ERSDM profile. Those genes were selected as harboring somatic driver mutations with >10% prevalence and with different occurrence between Caucasian and Asian ethnicity. Clinical information and transcriptome sequencing of 173 Caucasian pulmonary adenocarcinoma patients with matched mutation data are retrieved from TCGA, Kaplan-Meier analyses and Cox proportional-hazards regression models are further used to analyze the effect of the ERSDM profile on overall survival. There is no significant correlation between single gene mutation and overall survival, while patients with less than two mutated genes have a better overall survival compared with those with at least two mutated genes (p = 0.034). All of these indicate that multiple mutations in the ERSDM profile may be a negative prognostic factor for overall survival in Caucasian pulmonary adenocarcinoma patients.
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Affiliation(s)
- Zheng Zhu
- Institute for Cardiovascular Science & Department of Cardiovascular Surgery of the First Affiliated Hospital, Soochow University, China
| | - Zhigang Liang
- Department of Thoracic Surgery, Ningbo First Hospital, Ningbo, Zhejiang 315000, China
| | - Jichun Tong
- Department of Cardiovascular Thoracic Surgery, Changzhou No.2 People's Hospital, Nanjing Medical University, Changzhou, China
| | - Xiaoliang Mao
- Department of Cardiovascular Thoracic Surgery, Changzhou No.2 People's Hospital, Nanjing Medical University, Changzhou, China
| | - Yajun Yin
- Department of Cardiovascular Thoracic Surgery, Changzhou No.2 People's Hospital, Nanjing Medical University, Changzhou, China
| | - Lydia C Manor
- Department of Biology Products, American Informatics LLC, Rockville 20850, USA
| | - Zhenya Shen
- Institute for Cardiovascular Science & Department of Cardiovascular Surgery of the First Affiliated Hospital, Soochow University, China
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39
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Liu YY, Ying Y, Chen C, Hu YK, Yang FF, Shao LY, Cheng XJ, Huang YX. Primary pulmonary amebic abscess in a patient with pulmonary adenocarcinoma: a case report. Infect Dis Poverty 2018; 7:34. [PMID: 29699585 PMCID: PMC5921995 DOI: 10.1186/s40249-018-0419-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 04/05/2018] [Indexed: 12/05/2022] Open
Abstract
Background Primary pulmonary amoeba is very rare and here we report a case of a 68-year-old man presenting with primary pulmonary amoeba after undergoing chemotherapy for lung adenocarcinoma. Case presentation In October 2016, the man aged 68 was admitted to our hospital because of repeated cough for 8 months and hemoptysis for 1 month. He was diagnosed lung adenocarcinoma and underwent surgery in 2012 without receiving chemotherapy. In March 2016, the patients suffered recurrence of cancer and was treated with chemotherapy. After 2 months of chemotherapy, the patient had consistent cough with white sputum, and chest CT showed a local lung nodule. The physicians suspected that the patient had pulmonary infectious diseases, and he was treated with empirical antibacterial treatment. However, his symptom wasn’t relieved and later the percutaneous lung biopsy found trophozites of Entamoeba histolytica. After administration of metronidazole, the symptoms of the patient were markedly relieved and the lesions were absorbed. Conclusions In such cases where patients with pulmonary nodules were in immunodeficiency state and had adequate but ineffective anti-bacterial treatment, Entamoeba histolytica infection could be one of the rare causes. Percutaneous lung biopsy should be recommended and specific dying for parasites should be done when necessary. Electronic supplementary material The online version of this article (10.1186/s40249-018-0419-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuan-Yuan Liu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Yue Ying
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Chong Chen
- Department of Infectious Diseases, Chongqing Kaixian People's Hospital, 8, Ankang Road, Chongqing, 405499, China
| | - Yue-Kai Hu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Fei-Fei Yang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Ling-Yun Shao
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Xun-Jia Cheng
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, 130 Dongan Road, Shanghai, 200032, China
| | - Yu-Xian Huang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China.
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Predina JD, Newton A, Connolly C, Singhal S. Folate receptor-targeted molecular imaging improves identification of malignancy during pulmonary resection: a case report. J Cardiothorac Surg 2017; 12:110. [PMID: 29202877 PMCID: PMC5716373 DOI: 10.1186/s13019-017-0664-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background During minimally invasive pulmonary resection, both limited visualization and tactile feedback can make localization of pulmonary nodules and assessment for synchronous disease challenging. Intraoperative molecular imaging is an emerging technology that can enhance a surgeon’s ability to detect cancers at the time of resection. Case presentation In this report, we describe the application of a folate receptor-targeted, near infrared optical contrast agent (OTL38) for the detection of an invasive pulmonary adenocarcinoma. During molecular imaging, an otherwise undetectable synchronous nodule was also identified. This finding resulted in intraoperative upstaging and operative plan modifications. Conclusion This report marks the first successful utilization of a targeted, near infrared intraoperative molecular imaging probe useful for thoracic malignancies. This rapidly evolving technology may enhance the surgeon’s ability to perform a number of oncologic procedures including tumor localization, margin assessment and intraoperative staging. Electronic supplementary material The online version of this article (10.1186/s13019-017-0664-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jarrod D Predina
- Center for Precision Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA. .,Division of Thoracic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, 6 White building; 3400 Spruce St, Philadelphia, PA 19104, USA.
| | - Andrew Newton
- Center for Precision Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.,Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Courtney Connolly
- Center for Precision Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.,Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Sunil Singhal
- Center for Precision Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA. .,Division of Thoracic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, 6 White building; 3400 Spruce St, Philadelphia, PA 19104, USA.
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Zhang J, Sun J, Zhang Z, Liang X, Luo Y, Wu S, Liang Z. Protein overexpression and gene amplification of cellular mesenchymal-epithelial transition factor is associated with poor prognosis in micropapillary-predominant subtype pulmonary adenocarcinoma. Hum Pathol 2017; 72:59-65. [PMID: 29128478 DOI: 10.1016/j.humpath.2017.10.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/22/2017] [Accepted: 10/27/2017] [Indexed: 11/26/2022]
Abstract
Micropapillary-predominant subtype pulmonary adenocarcinoma (MPPAC) is a subtype of lung cancer with poor prognosis. Cellular mesenchymal-epithelial transition factor (c-MET) is a promising pharmaceutic target found to be associated with the survival of patients with pulmonary adenocarcinoma. In this study, we aimed to analyze c-MET protein overexpression and gene amplification in MPPAC samples and to elucidate their relationship with the clinicopathological characteristics of the patients. c-MET protein expression was examined by immunohistochemical analyses, and gene amplification was detected by fluorescence in situ hybridization. A total of 86 MPPAC cases were included in this study. The prevalence of c-MET protein overexpression and gene amplification were 62.8% and 10.5%, respectively. C-MET protein overexpression was significantly associated with smoking status, lymphatic and venous invasion, and tumor-node-metastasis stage (P = .014, P = .040, and P = .004, respectively), but c-MET gene amplification showed no relation with any of these characteristics. Univariate analysis revealed that pleural invasion, lymph node metastasis, lymphatic and venous invasion, tumor-node-metastasis stage, c-MET protein overexpression, and c-MET gene amplification were associated with poor prognosis (P = .041, P < .001, P = .001, P < .001, P = .001 and P = .001, respectively), but only c-MET gene amplification was an independent prognostic marker (P = .04). These results indicated that c-MET is an important biomarker. Also, c-MET protein overexpression and gene amplification are highly related to poor prognosis in patients with MPPAC.
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Affiliation(s)
- Jing Zhang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Jian Sun
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Zhiwen Zhang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Xiaolong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Yufeng Luo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Shafei Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, People's Republic of China, 100730.
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42
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Sun YQ, Langhammer A, Wu C, Skorpen F, Chen Y, Nilsen TIL, Romundstad PR, Mai XM. Associations of serum 25-hydroxyvitamin D level with incidence of lung cancer and histologic types in Norwegian adults: a case-cohort analysis of the HUNT study. Eur J Epidemiol 2018; 33:67-77. [PMID: 29080012 DOI: 10.1007/s10654-017-0324-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/07/2017] [Indexed: 12/24/2022]
Abstract
Previous prospective studies have shown inconsistent associations between serum 25-hydroxyvitamin D [25(OH)D] level and lung cancer incidence. The aim of the present study was to explore the associations of serum 25(OH)D levels with incidence of lung cancer overall and different histologic types. We performed a population-based prospective case-cohort study including 696 incident lung cancer cases and 5804 individuals in a subcohort who participated in the second survey of the Nord-Trøndelag Health Study in Norway. Cox proportional hazards regression models counting for the case-cohort design were used to estimate hazard ratios (HRs) with 95% confidence interval (CIs) for lung cancer overall or histologic types in relation to serum 25(OH)D levels. Compared with the fourth season-specific quartile of 25(OH)D (median 68.0 nmol/L), lower 25(OH)D levels were not associated with the incidence of overall, small or squamous cell lung cancer. However, the risk of adenocarcinoma was lower in the second and third quartiles (median 39.9 and 51.5 nmol/L) compared with the fourth quartile, with HRs of 0.63 (95% CI 0.41-0.98) and 0.58 (0.38-0.88), respectively. The associations of lower levels of 25(OH)D with a reduced risk of adenocarcinoma were only observed in the overweight/obese subjects [HRs for second and third quartiles: 0.40 (0.22-0.72) and 0.50 (0.27-0.92)] but not in the normal weight subjects [HRs: 0.95 (0.52-1.75) and 0.60 (0.32-1.10)]. Serum 25(OH)D levels were not associated with the risk of lung cancer in general. The observation that lower 25(OH)D levels were associated with a lower risk of adenocarcinoma should be interpreted with caution.
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Pluchart H, Pinsolle J, Cohen J, Ferretti GR, Bedouch P, Giaj Levra M, Toffart AC, Moro-Sibilot D. Partial response of pulmonary adenocarcinoma with symptomatic brain metastasis to nivolumab plus high-dose oral corticosteroid: a case report. J Med Case Rep 2017; 11:183. [PMID: 28679408 PMCID: PMC5499003 DOI: 10.1186/s13256-017-1334-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 05/26/2017] [Indexed: 11/21/2022] Open
Abstract
Background Nivolumab, a monoclonal antibody targeting the programmed death-1 receptor, is indicated in locally advanced or metastatic non-small cell lung cancer, with progression after platinum-based chemotherapy. Up-to-now, few data are available concerning brain activity of this treatment and concomitant use of corticosteroids. Case presentation A 64-year-old caucasian man with a pulmonary adenocarcinoma associated with brain metastases received four courses of nivolumab in concomitance with a high dose of corticosteroids for his neurologic symptoms. He experienced a partial response in his brain and chest with an improvement in his general condition. Nivolumab was effective in shrinking symptomatic brain metastases, and metastases at other sites, in a patient with non-small cell lung cancer and first-line chemotherapy failure. The effect of nivolumab was obtained despite concomitant high-dose corticosteroid therapy. Combined nivolumab and high-dose corticosteroid therapy did not induce unexpected adverse events. Conclusion Nivolumab and concomitant high-dose corticosteroid therapy was found to be efficient and well tolerated.
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Affiliation(s)
- Hélène Pluchart
- Pôle pharmacie, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.
| | - Julian Pinsolle
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France
| | - Julien Cohen
- Pôle radiologie et imagerie médicale, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France
| | - Gilbert R Ferretti
- Pôle radiologie et imagerie médicale, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France
| | - Pierrick Bedouch
- Pôle pharmacie, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.,Université Grenoble Alpes/CNRS, ThEMAS TIMC UMR 5525, Grenoble, F-38041, France
| | - Matteo Giaj Levra
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France
| | - Anne-Claire Toffart
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.,Institut pour l'Avancée des Biosciences, CRI UGA/Inserm U 1209/CNRS UMR 5309, Grenoble, France
| | - Denis Moro-Sibilot
- Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.,Institut pour l'Avancée des Biosciences, CRI UGA/Inserm U 1209/CNRS UMR 5309, Grenoble, France
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Kim S, Koh J, Kwon D, Keam B, Go H, Kim YA, Jeon YK, Chung DH. Comparative analysis of PD-L1 expression between primary and metastatic pulmonary adenocarcinomas. Eur J Cancer 2017; 75:141-149. [PMID: 28222308 DOI: 10.1016/j.ejca.2017.01.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/09/2016] [Accepted: 01/02/2017] [Indexed: 12/11/2022]
Abstract
Programmed death-ligand 1 (PD-L1) expression in pulmonary adenocarcinomas (pADCs) was implicated in predicting anti-PD-1/PD-L1 therapy efficacy. However, the differential expression of PD-L1 between primary and metastatic pADC remains unclear. Thus, we addressed this issue. In total, 161 paired primary and metastatic tumour tissues from 146 patients with pADC were collected. Most of the cases had regional nodal metastasis (134/161, 83.2%). PD-L1 expression was categorised based on the proportion of immunostained tumour cells using cutoff values of 1%, 5%, 10% and 50%. In primary tumours, PD-L1 positivity was observed in 28.1% (41/146), 27.4% (40/146), 22.6% (33/146) and 13.0% (19/146) of cases using cutoff values of 1%, 5%, 10% and 50%, respectively. The overall concordance rate for PD-L1 expression between primary and metastatic tumours was 75.2% (121/161). The concordance rate in primary tumours expressing PD-L1 in <1% or ≥50% of tumour cells was 87.2% (102/117) or 70% (14/20), respectively. In contrast, the concordance rate in tumours expressing PD-L1 in ≥1% to <50% of cells was only 20.8% (5/24). After dichotomising the cases using cutoff values of 1% and 50%, the concordance rate increased to 80.1% (129/161) and 90.7% (146/161) in all paired cases and to 70.4% (19/27) and 85.2% (23/27) in cases with distant metastases, respectively. This study demonstrates that the concordance of PD-L1 expression between primary and metastatic pADC is high when using cutoff values of 1% and 50%. Thus, evaluation of PD-L1 in either primary or metastatic tumours would be helpful for guiding anti-PD-1/PD-L1 immunotherapy in patients with advanced pADC.
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Affiliation(s)
- Sehui Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jaemoon Koh
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Dohee Kwon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Heounjeong Go
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Young A Kim
- Department of Pathology, Seoul Metropolitan Government Boramae Hospital, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Republic of Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Tumor Microenvironment Global Core Research Center, Cancer Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Doo Hyun Chung
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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45
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Nottegar A, Luchini C, Cingarlini S, Beccari S, Grego E, Gilioli E, Manfrin E, Bonetti F. Pathological complete response in a patient affected by multiple synchronous, breast and lung primary malignancies: a case report and review of the literature. Pathologica 2016; 108:164-168. [PMID: 28195257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
A pathological complete response in a patient affected by multiple synchronous, breast and lung primary malignancies is reported. A 63-year-old woman presented with an invasive ductal carcinoma of the breast and a lung adenocarcinoma. After multidisciplinary discussion, the patient underwent pulmonary left lower lobectomy followed by radio-chemotherapy with cisplatin and vinorelbine and started hormone therapy with letrozole. Ten months later, a left mastectomy with axillary lymph nodes dissection was performed. Histologically, a pathological complete response (pCR) was documented. With a review of the Literature, we discuss the issue of multiple primary malignancies, with its diagnostic and therapeutic implications. In cases of multiple synchronous malignancies it has been highlighted the importance of the choice of the best therapeutic approach for both the malignancies, reducing collateral individual effects.
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Affiliation(s)
- A Nottegar
- Department of Pathology and Diagnostics, University of Verona, Italy
| | - C Luchini
- Department of Pathology and Diagnostics, University of Verona, Italy
| | - S Cingarlini
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - S Beccari
- Department of Pathology and Diagnostics, University of Verona, Italy
| | - E Grego
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - E Gilioli
- Department of Pathology and Diagnostics, University of Verona, Italy
| | - E Manfrin
- Department of Pathology and Diagnostics, University of Verona, Italy
| | - F Bonetti
- Department of Pathology and Diagnostics, University of Verona, Italy
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Sahin N, Akatli AN, Celik MR, Ulutas H, Samdanci ET, Colak C. The Role of CD90 in the Differential Diagnosis of Pleural Malignant Mesothelioma, Pulmonary Carcinoma and Comparison with Calretının. Pathol Oncol Res 2016; 23:487-491. [PMID: 27761727 DOI: 10.1007/s12253-016-0135-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/12/2016] [Indexed: 01/05/2023]
Abstract
Pleural Malignant Mesothelioma (MM) is a fatal disease that has been associated with asbestos exposure. Differential diagnosis between the pleural infiltration of pulmonary carcinomas and MM is rather difficult particularly for epitheloid type mesothelioma.We aimed to investigate the utility of CD90, a cancer stem cell marker, in the differential diagnosis of MM and lung carcinoma, its prognostic significance and compare its value with that of Calretinin. Ninety pathology specimens including MM (n:30), pulmonary adenocarcinoma (n:30) and pulmonary squamous cell carcinoma (n:30) were used in this study. Immunohistochemical comparision of CD 90 and Calretinin was made in all groups. Calretinin was positive in 20 cases with MM (64.5 %), and was negative in 10 (32.3 %). CD 90 was positive in 25 of these cases (80 %) and negative in 5 (16 %). On the other hand pulmonary adenocarcinomas and squamous cell carcinomas showed positivity with CD90, 63,6 % and 73 %, respectively. We think that CD 90 has no place in the differential diagnosis between mesothelioma and pulmonary carcinoma because of the low specificity in spite of the high sensitivity.
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Affiliation(s)
- Nurhan Sahin
- Turgut Ozal Medical Center, Department of Pathology, Inonu University, 44280, Malatya, Turkey.
| | - Ayse Nur Akatli
- Turgut Ozal Medical Center, Department of Pathology, Inonu University, 44280, Malatya, Turkey
| | - Muhammet Reha Celik
- Turgut Ozal Medical Center, Department of Thoracic Surgery, Inonu University, Malatya, Turkey
| | - Hakkı Ulutas
- Turgut Ozal Medical Center, Department of Thoracic Surgery, Inonu University, Malatya, Turkey
| | - Emine Turkmen Samdanci
- Turgut Ozal Medical Center, Department of Pathology, Inonu University, 44280, Malatya, Turkey
| | - Cemil Colak
- Medical Faculty, Department of Biostatistic, Inonu University, Malatya, Turkey
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Igarashi T, Teramoto K, Ishida M, Hanaoka J, Daigo Y. Scoring of PD-L1 expression intensity on pulmonary adenocarcinomas and the correlations with clinicopathological factors. ESMO Open 2016; 1:e000083. [PMID: 27843633 PMCID: PMC5070269 DOI: 10.1136/esmoopen-2016-000083] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/08/2016] [Indexed: 12/21/2022] Open
Abstract
Introduction The contribution of programmed cell death ligand-1 (PD-L1) immune checkpoint molecule toward progression of non-small cell lung cancer (NSCLC) has not yet been elucidated, in part, because of lack of a standardised method to evaluate PD-L1 expression. In this study, we developed a novel method for the evaluation of PD-L1 expression on NSCLC cells and examined its correlation with clinicopathological characteristics. Methods After immunohistochemical examination of PD-L1 expression for surgically resected pulmonary adenocarcinomas (n=106), based on the findings that PD-L1 are consistently expressed on alveolar macrophages, PD-L1 staining intensity of tumour cells was classified into four levels relative to PD-L1 staining intensity in alveolar macrophages; PD-L1 expression scores (range, 0–300) were semiquantitatively assessed. An analysis of statistical association between PD-L1 expression score and clinicopathological characteristics was performed. Results Almost all of the alveolar macrophages in the specimens were moderately to strongly stained with PD-L1, serving as an internal positive control in the immunohistochemistry of PD-L1. PD-L1 expression score (median, 52.3) was significantly higher in tumours with G2/3 differentiation than in those with G1 (p=0.022) and higher in those with lymphatic invasion than in those without invasion (p=0.032). Postoperative relapse-free survival was significantly shorter in patients with a high PD-L1 expression score than in those with low PD-L1 expression score (p=0.035). Smoking habits, histological subtype, and epidermal growth factor receptor mutation status were not associated with PD-L1 expression score. Conclusions Given the heterogeneous distribution of PD-L1 expression in pulmonary adenocarcinoma cells, the scoring of PD-L1 expression on tumour cells relative to that in alveolar macrophages appears to be a valid indicator of PD-L1 status of patients with pulmonary adenocarcinomas, demonstrating a significant correlation with several factors associated with tumour progression.
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Affiliation(s)
- Tomoyuki Igarashi
- Department of Medical Oncology, Shiga University of Medical Science, Otsu, Japan; Department of Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Koji Teramoto
- Department of Medical Oncology, Shiga University of Medical Science, Otsu, Japan; Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Mitsuaki Ishida
- Department of Clinical Laboratory Medicine , Shiga University of Medical Science , Otsu , Japan
| | - Jun Hanaoka
- Department of Surgery , Shiga University of Medical Science , Otsu , Japan
| | - Yataro Daigo
- Department of Medical Oncology, Shiga University of Medical Science, Otsu, Japan; Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Stewart RL, West D, Wang C, Weiss HL, Gal T, Durbin EB, O'Connor W, Chen M, O'Connor KL. Elevated integrin α6β4 expression is associated with venous invasion and decreased overall survival in non-small cell lung cancer. Hum Pathol 2016; 54:174-83. [PMID: 27107458 DOI: 10.1016/j.humpath.2016.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/26/2016] [Accepted: 04/08/2016] [Indexed: 12/12/2022]
Abstract
Lung cancer carries a poor prognosis and is the most common cause of cancer-related death worldwide. The integrin α6β4, a laminin receptor, promotes carcinoma progression in part by cooperating with various growth factor receptors to facilitate invasion and metastasis. In carcinoma cells with mutant TP53, the integrin α6β4 promotes cell survival. TP53 mutations and integrin α6β4 overexpression co-occur in many aggressive malignancies. Because of the high frequency of TP53 mutations in lung squamous cell carcinoma (SCC), we sought to investigate the association of integrin β4 expression with clinicopathologic features and survival in non-small cell lung cancer (NSCLC). We constructed a lung cancer tissue microarray and stained sections for integrin β4 subunit expression using immunohistochemistry. We found that integrin β4 expression is elevated in SCC compared with adenocarcinoma (P<.0001), which was confirmed in external gene expression data sets (P<.0001). We also determined that integrin β4 overexpression associates with the presence of venous invasion (P=.0048) and with reduced overall patient survival (hazard ratio, 1.46; 95% confidence interval, 1.01-2.09; P=.0422). Elevated integrin β4 expression was also shown to associate with reduced overall survival in lung cancer gene expression data sets (hazard ratio, 1.49; 95% confidence interval, 1.31-1.69; P<.0001). Using cBioPortal, we generated a network map demonstrating the 50 most highly altered genes neighboring ITGB4 in SCC, which included laminins, collagens, CD151, genes in the EGFR and PI3K pathways, and other known signaling partners. In conclusion, we demonstrate that integrin β4 is overexpressed in NSCLC where it is an adverse prognostic marker.
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Abstract
OBJECTIVES To compare survival data in patients with resected bilateral synchronous pulmonary carcinomas with survival data from patients with lung cancer in pStages I through IV and to evaluate the usefulness of comprehensive histologic evaluation (CHE) of tumor histologic patterns to distinguish between synchronous primaries and intrapulmonary metastases. METHODS Ten-year overall survival (OS) data from 18 patients with 44 resected synchronous bilateral lung cancers, classified as "synchronous primaries" or "metastases" using CHE, were compared with survival data of 2,879 patients with lung cancer in pStages I through IV. RESULTS Forty and four tumors from 16 and two patients, respectively, were classified as synchronous primaries and metastases. There were no significant differences in survival between these 18 patients and pStage I controls or between the synchronous primaries and the metastases patient groups. However, there were significant differences in survival between the patients with resected synchronous bilateral tumors and each of the pStage II through IV control groups (P < .05). CONCLUSIONS Patients with resected synchronous bilateral lung cancers had similar 10-year OS to patients with stage I disease, regardless of CHE data. Most resected tumors were synchronous primaries by CHE.
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Affiliation(s)
- Ann E Walts
- From the Department of Pathology & Laboratory Medicine
| | | | - Trista Leong
- Cancer Registry, Cedars-Sinai Medical Center, Los Angeles, CA
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Garajová I, Funel N, Fiorentino M, Agostini V, Ferracin M, Negrini M, Frassineti GL, Gavelli G, Frampton AE, Biasco G, Giovannetti E. MicroRNA profiling of primary pulmonary enteric adenocarcinoma in members from the same family reveals some similarities to pancreatic adenocarcinoma-a step towards personalized therapy. Clin Epigenetics 2015; 7:129. [PMID: 26677401 PMCID: PMC4681170 DOI: 10.1186/s13148-015-0162-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/07/2015] [Indexed: 02/07/2023] Open
Abstract
Background Primary pulmonary enteric adenocarcinoma (PEAC) is defined as a pulmonary adenocarcinoma with a predominant component of intestinal differentiation and tumor cells positive for at least one intestinal marker. The aim of the present study was the molecular and histological characterization of a PEAC from a patient with two other family members affected by similar lung tumors, which has never been reported before. Findings We evaluated the molecular characteristics of the proband’s PEAC by using a previously validated 47-microRNA (miRNA) cancer-specific array and a predictive method to estimate tissue-of-origin probabilities. Immunohistochemical (IHC) staining for thyroid transcription factor (TTF-1), napsin A, caudal-related homeobox 2 (CDX2), cytokeratins, and mucins, as well as mutational analyses for epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), and anaplastic lymphoma kinase (ALK) were performed on formalin-fixed, paraffin-embedded (FFPE) tissues. The occurrence of PEAC in two family members was associated with similar clinicopathological features (age at diagnosis, smoking habit, tumor localization, multiple colonic polyps), histologic findings (TTF-1 negativity and CDX2 positivity), and genetic findings (KRAS (Gly12Asp) mutation, but no EGFR/ALK aberrations). miRNA profiling revealed similarities with non-small cell lung cancer (NSCLC; 75.98 %) and some overlap with pancreatic ductal adenocarcinoma (PDAC; 23.34 %), but not with colorectal cancer (CRC; less than 0.5 %). Notably, these PEACs share key PDAC-associated miRNAs associated with tumor aggressiveness (miR-31*/-126*/-506/-508-3p/-514). Conclusions We describe for the first time PEAC in members from the same family, associated with similar clinical and genetic features. miRNA profiling of the PEAC resembled a NSCLC signature, with partial overlap to a PDAC pattern. This could explain its aggressive behavior and therefore help to guide future tailored-therapeutic approaches. Electronic supplementary material The online version of this article (doi:10.1186/s13148-015-0162-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid Garajová
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, CCA room 1.52, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.,Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Niccola Funel
- Division of General and Transplant Surgery, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy.,Cancer Pharmacology Lab, AIRC Start-Up Unit, University of Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Michelangelo Fiorentino
- Department of Pathology, F. Addari Institute, S.Orsola Malpighi Hospital, University of Bologna, Viale Ercolani 4/2, 40138 Bologna, Italy
| | - Valentina Agostini
- Department of Pathology, F. Addari Institute, S.Orsola Malpighi Hospital, University of Bologna, Viale Ercolani 4/2, 40138 Bologna, Italy
| | - Manuela Ferracin
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Borsari 46, 44121 Ferrara, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Via Fossato di Mortara 70, 44121 Ferrara, Italy
| | - Massimo Negrini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Borsari 46, 44121 Ferrara, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Via Fossato di Mortara 70, 44121 Ferrara, Italy
| | - Giovanni Luca Frassineti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via Piero Maroncelli 40, 47014 Meldola, Italy
| | - Giampaolo Gavelli
- Department of Radiology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via Piero Maroncelli 40, 47014 Meldola, Italy
| | - Adam Enver Frampton
- HPB Surgical Unit, Department of Surgery & Cancer, Hammersmith Hospital Campus, Imperial College, Du Cane Road, London, W12 0HS UK
| | - Guido Biasco
- Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Elisa Giovannetti
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, CCA room 1.52, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.,Cancer Pharmacology Lab, AIRC Start-Up Unit, University of Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy.,Cancer Pharmacology Lab, Start-Up Unit, University of Pisa, via Paradisa 2, 56124 Pisa, Italy
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