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Yan W, Fu H, Liu H, Liu Z, Qi X, Chen T. Acute urinary retention due to corpus cavernosum penile metastasis from lung adenocarcinoma after targeted therapy: a case report and review of the literature. Front Oncol 2024; 14:1278245. [PMID: 38496763 PMCID: PMC10940509 DOI: 10.3389/fonc.2024.1278245] [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: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Background Metastasis in penile corpus cavernosum from adenocarcinoma of lung is a rare but fatal disease, which was reported in cases without series studies. It causes various clinical symptoms seriously affecting the quality of life. Case presentation A 72-year-old male smoker patient, who had a history of adenocarcinoma of lung after targeted therapy 36 months before, was admitted to Jiangxi Cancer Hospital because of presenting with aggressive dysuria and penis pain for one hour. A Foley catheter was inserted into the patient's bladder with difficulty. Immediately do a bladder puncture. Emergency pelvic computed tomography (CT): a soft tissue nodule of 1.1 cm×1.4 cm was found in the cavernous area of the middle part of the penis, and the proximal urethra was dilated with a wide diameter of about 1.5 cm. The diagnosis of metastatic lung adenocarcinoma from the primary was made by CT-guided biopsy. Conclusion The penis may be a site of metastasis from primary lung cancer, especially for old patient. Metastasis to the penis usually indicates that the primary lung cancer is at an advanced stage and the prognosis is very poor. More research is necessary to understand the underlying mechanism of adenocarcinoma of lung metastasis.
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Affiliation(s)
- Wei Yan
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Hui Fu
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Huiqun Liu
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Zhentian Liu
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Xueliang Qi
- Department of Urology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Tanxiu Chen
- Institute of Neurology and Department of Neurology, Jiangxi Academy of Clinical Medical Sciences, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Key Laboratory of Translational Cancer Research, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Kunishige M, Takeuchi E. Miliary brain metastases from lung adenocarcinoma with EGFR (L858R) and CTNNB1 mutations. Thorac Cancer 2023; 14:3419-3420. [PMID: 37920971 PMCID: PMC10693938 DOI: 10.1111/1759-7714.15144] [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: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
A 76-year-old man was referred to our hospital with a cough. Chest computed tomography (CT) revealed a 45-mm mass in the lingular segment of the left upper lobe. Transbronchial tumor biopsies showed adenocarcinoma. Contrast-enhanced CT and bone scintigraphy revealed lung, pleura, and bone metastases. The patient was diagnosed with left upper lobe adenocarcinoma cT2bN3M1c stage IVB. A genetic analysis of the primary tumor using the Oncomine Dx Target Test Multi-CDx system revealed positivity for epidermal growth factor receptor (EGFR) (L858R) and CTNNB1 mutations. Based on these findings, the patient was treated with osimertinib (80 mg/day) as first-line therapy. Six months later, the tumor increased in size, indicating progressive disease. Osimertinib was stopped and second-line therapy with carboplatin (area under the curve 5) and pemetrexed (500 mg/m2) was initiated. After three cycles of chemotherapy, the patient developed dementia and disorientation. Contrast-enhanced magnetic resonance imaging of the head showed miliary brain metastases. Miliary dissemination is a rare form of brain metastasis. Miliary patterns of lung metastases have been strongly associated with the EGFR exon 19 deletion. The radiological features of miliary brain metastases of non-small cell lung cancer with the exon 19 deletion have been reported. To the best of our knowledge, this is the first case report of lung cancer with miliary brain metastases and co-mutations of EGFR (L858R) and CTNNB1. In conclusion, co-mutations of EGFR (L858R) and CTNNB1 and the discontinuation of EGFR-tyrosine kinase inhibitor may contribute to the development of miliary brain metastases. Further case studies are warranted.
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Affiliation(s)
- Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochiJapan
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Li J, Liu J, Zhang G, Hu W, Wang X, Liu J. Neoadjuvant Lorlatinib Induces Pathological Complete Response in Advanced ALK-Positive Lung Cancer: A Case Report. Am J Case Rep 2023; 24:e942150. [PMID: 37934724 PMCID: PMC10642716 DOI: 10.12659/ajcr.942150] [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: 08/13/2023] [Revised: 10/29/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Chemotherapy has been the conventional treatment method for advanced non-small-cell lung cancer (NSCLC). Nevertheless, the identification and comprehension of oncogenic driver alterations have paved the way for targeted therapies, significantly enhancing patient outcomes. The management of locally advanced NSCLC that is positive for ALK presents a challenge due to the lack of reported randomized controlled trials. The efficacy of neoadjuvant and adjuvant targeted therapy in this context remains uncertain. CASE REPORT A 54-year-old man was diagnosed with stage IIIB (pT1N3M0) upper right lung adenocarcinoma carrying the EML4-ALK fusion gene. Clinically, the patient had multiple enlarged lymph nodes in the right hilum and mediastinum, with the largest measuring approximately 28×19 mm by CT scan and we found that the L4 lymph node was invaded by metastasis. Then, the patient received 1 cycle of chemotherapy with paclitaxel in combination with nedaplatin and subsequently received maintenance treatment involving lorlatinib. Two months later, clinical evaluations revealed progressive reduction of the lesions, especially the reduced size of the mediastinal lymph nodes. Therefore, the patient underwent thoracoscopic partial lobectomy and lymphadenectomy and achieved pathological complete response (pCR). After 3 months, a follow-up CT scan was similar to the first postoperative CT scan and no tumor was found. CONCLUSIONS This case demonstrates the potential advantage of lorlatinib as a neoadjuvant therapy in advanced ALK-positive NSCLC. It emphasizes the importance of identifying new therapeutic targets by next-generation sequencing (NGS) and implementing precise treatment strategies in clinical practice.
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Affiliation(s)
- Jie Li
- Department of Immunology, University of South Florida, Tampa, FL, USA
| | - Junwei Liu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Guqin Zhang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Weidong Hu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Xianguo Wang
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Jun Liu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China
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Arenas AM, Ruiz-Jiménez JM, López-Hidalgo JL, Sanjuán-Hidalgo J, Medina PP. Defining the first bona fide cell model for SMARCA4-deficient, undifferentiated tumor. J Pathol 2023; 261:5-10. [PMID: 37352131 DOI: 10.1002/path.6141] [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: 01/10/2023] [Revised: 03/23/2023] [Accepted: 05/11/2023] [Indexed: 06/25/2023]
Abstract
The World Health Organization's tumor classification guidelines are frequently updated and renewed as knowledge of cancer biology advances. For instance, in 2021, a novel lung tumor subtype named SMARCA4-deficient, undifferentiated tumor (SMARCA4-dUT, code 8044/3) was included. To date, there is no defined cell model for SMARCA4-dUT that could be used to help thoracic clinicians and researchers in the study of this newly defined tumor type. As this tumor type was recently described, it is feasible that some cell models formerly classified as lung adenocarcinoma (LUAD) could now be better classified as SMARCA4-dUT. Thus, in this work, we aimed to identify a bona fide cell model for the experimental study of SMARCA4-dUT. We compared the differential expression profiles of 36 LUAD-annotated cell lines and 38 cell lines defined as rhabdoid in repositories. These comparative results were integrated with the mutation and expression profiles of the SWI/SNF complex members, and they were surveyed for the presence of the SMARCA4-dUT markers SOX2, SALL4, and CD34, measured by RT-qPCR and western blotting. Finally, the cell line with the paradigmatic SMARCA4-dUT markers was engrafted into immunocompromised mice to assess the histological morphology of the formed tumors and compare them with those formed by a bona fide LUAD cancer cell line. NCI-H522, formerly classified as LUAD, displayed expression profiles nearer to rhabdoid tumors than LUAD tumors. Furthermore, NCI-H522 has most of the paradigmatic features of SMARCA4-dUT: hemizygous inactivating mutation of SMARCA4, severe SMARCA2 downregulation, and high-level expression of stem cell markers SOX2 and SALL4. In addition, the engrafted tumors of NCI-H522 did not display a typical differentiated glandular structure as other bona fide LUAD cell lines (A549) do but had rather a largely undifferentiated morphology, characteristic of SMARCA4-dUT. Thus, we propose the NCI-H522 as the first bona fide cell line model of SMARCA4-dUT. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Alberto M Arenas
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
- Health Research Institute of Granada (ibs.Granada), Granada, Spain
| | - José Manuel Ruiz-Jiménez
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
- FIBAO, Fundación Pública para la Investigación Biosanitaria de Andalucía Oriental Alejandro Otero, Granada, Spain
| | - Javier L López-Hidalgo
- Health Research Institute of Granada (ibs.Granada), Granada, Spain
- Hospital Universitario Clínico San Cecilio (HUCSC), Granada, Spain
| | - Juan Sanjuán-Hidalgo
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
| | - Pedro P Medina
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
- Health Research Institute of Granada (ibs.Granada), Granada, Spain
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5
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Tang L, Jin H. CD39 molecule: a negative regulator expressed on T cells in patients with lung adenocarcinoma. Arch Med Sci 2023; 19:1558-1563. [PMID: 37732039 PMCID: PMC10507747 DOI: 10.5114/aoms/170959] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/11/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction The function of cytotoxic cells may be impacted by CD39 expression on CD8-positive T lymphocytes, leading to an imbalance in tumor immunity. Methods We analyzed the correlation between the expression of CD39 on CD8-positive T lymphocytes and clinical information in 203 patients with lung adenocarcinoma. Results The expression of CD39 on CD8-positive T lymphocytes was related to T stage, lymph node metastasis and distant metastasis. Furthermore, the CD39 expression reduced the secretion of antitumor cytokines, promoted PD-1 expression and decreased CD28 expression on CD8-positive T lymphocytes. Conclusions This research demonstrated the potential value of CD39 on CD8-positive T lymphocytes as a negative regulator in cancer immunotherapy.
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Affiliation(s)
- Lu Tang
- Division of Rheumatology, Tianjin First Center Hospital, Tianjin, China
| | - Hao Jin
- Center for Precision Cancer Medicine and Translational Research, Tianjin Cancer Hospital Airport Hospital, Tianjin, China
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Sugiyama M, Matsumura M, Sekiya M, Honda E, Sekine A, Arai H, Okudela K. A distinctive cytomorphological feature of interstitial pneumonia-related lung adenocarcinoma: The potential issues and solutions in practical diagnosis. Cancer Cytopathol 2023; 131:198-206. [PMID: 36508332 DOI: 10.1002/cncy.22666] [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: 08/30/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The cytological features of interstitial pneumonia (IP)-related lung adenocarcinoma (LADC) have not been clearly described. This study aimed to describe its cytomorphological features, uncover potential problems in practical cytological diagnosis, and provide possible solutions. METHODS Bronchial brushing cytology samples from 40 IP-related LADC cases (the IP group) and 110 control cases (LADC unrelated to IP; the non-IP group) were analyzed. All patients underwent surgery after brushing cytology, and their histopathological subtypes were determined. The authors reviewed the cytological features and focused particularly on cytoplasmic mucin production. RESULTS In the IP group, neoplastic cells with cytoplasmic mucin were detected at a significantly higher frequency (44.4% [8 of 18] vs. 6.3% [4 of 64]), and most of them were invasive mucinous adenocarcinomas (IMAs). Twenty-two of the 40 LADC cases in the IP group failed to be judged as "malignant/positive" (thus, they were judged to be "equivocal and/or negative"). The frequency of equivocal and/or negative judgments was 55.0% (22 of 40) in the IP group and 41.8% (46 of 110) in the non-IP group. The cytological diagnosis of IMA was difficult because it showed only slight nuclear atypia. Therefore, the authors examined the immunocytochemical expression of hepatocyte nuclear factor 4α (HNF4α), a diagnostic marker for IMA. As a result, four of the six cases that were judged to be equivocal in the IP group showed positive signals and could be retrospectively judged as malignant/positive. CONCLUSIONS The cytological diagnosis of IP-related LADC may be more difficult because of the larger proportion of IMA. Immunocytochemistry for HNF4α can be used to improve diagnostic confidence in IP-related LADC.
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Affiliation(s)
- Misaki Sugiyama
- Clinical Laboratory Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Mai Matsumura
- Pathology Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan.,Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Motoki Sekiya
- Clinical Laboratory Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Emi Honda
- Clinical Laboratory Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Akimasa Sekine
- Respiratory Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Hiromasa Arai
- Surgery Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Koji Okudela
- Pathology Division, Kanagawa Prefecture Cardiovascular and Respiratory Center, Yokohama, Japan.,Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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7
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Xiao R, Ma Y, Li H, Li X, Sun Z, Qi Q, Yin P, Yang F, Qiu M. Lung adenocarcinoma manifesting as subsolid nodule potentially represents tumour in the equilibrium phase of immunoediting. Immunology 2023; 168:290-301. [PMID: 35503794 DOI: 10.1111/imm.13489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/18/2022] [Accepted: 04/09/2022] [Indexed: 01/17/2023] Open
Abstract
Lung adenocarcinomas manifesting as subsolid nodules (SSN-LUADs) possess distinct dormant behaviour. This study was designed to compare the immune landscapes of normal lungs (nLungs), SSN-LUADs and LUADs manifesting as solid nodules (SN-LUADs) so as to better understand the status of anti-tumour immunity in SSN-LUADs. Mass cytometry by time-of-flight analysis was performed on 299, 570 single cells from nLung, SSN-LUAD and SN-LUAD tissues. The immune cells were identified by phenotype, and the percentages of different immune cell subclusters were compared between SSN-LUADs, SN-LUADs and nLungs. Elevated percentage of CD8+ T cells were identified in SSN-LUADs compared with in nLungs and SN-LUADs. Elevated CD56bright NK cells and decreased CD56dim NK cells were identified in both SSN-LUADs and SN-LUADs compared with in nLungs. The immune landscape of SSN-LUAD fits the theory of equilibrium phase of immunoediting, thus functional adaptive anti-tumour immunity but impaired innate anti-tumour immunity potentially contributes to the maintaining of its dormant behaviour.
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Affiliation(s)
- Rongxin Xiao
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Yi Ma
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Hao Li
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Xiao Li
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Zewen Sun
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Qingyi Qi
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Ping Yin
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Mantang Qiu
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
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Okauchi S, Satoh H. Unique natural history of an EGFR mutated adenocarcinoma. Klin Onkol 2023; 36:71-74. [PMID: 36868835 DOI: 10.48095/ccko202371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Supportive care alone cannot be indicated for cancers for which established standard therapy exists unless there is a specific reason. Due to the refusal of standard therapy by the patient after proper explanation of the therapy, we experienced a long-term follow-up of >10 years with supportive care alone in an epidermal growth factor receptor (EGFR) mutated lung cancer patient. CASE A 70-year-old woman was referred due to the right lung with some ground glass opacities (GGOs). One of the GGOs which was resected in another hospital had been confirmed to be EGFR mutation-positive lung adenocarcinoma. Although EGFR-tyrosine kinase inhibitor (TKI) was explained to be the standard therapy, the patient refused receiving the therapy and wished to follow up imaging of the remaining GGOs. During the follow-up period of 13 years, the each GGO showed a gradual increase. The doubling time of the largest GGO and that of serum carcinoembryonic antigen was > 2,000 days, respectively. CONCLUSION Although very rare, some of EGFR mutated lung adenocarcinoma might have a very slow progression. Clinical course of this patient provides useful information to the clinical practice of future patients who may have similar clinical courses.
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Peng Z, Lin Z, He A, Yi L, Jin M, Chen Z, Tao Y, Yang Y, Cui C, Liu Y, Zuo M. Development and Validation of a Comprehensive Model for Predicting Distant Metastasis of Solid Lung Adenocarcinoma: 3D Radiomics, 2D Radiomics and Clinical Features. Cancer Manag Res 2022; 14:3437-3448. [PMID: 36536823 PMCID: PMC9758990 DOI: 10.2147/cmar.s393058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/18/2022] [Accepted: 11/19/2022] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE To develop and validate models for predicting distant metastases in patients with solid lung adenocarcinomas using 3D radiomic features, 2D radiomic features, clinical features, and their combinations. METHODS This retrospective study included 253 eligible patients with solid adenocarcinoma of the lung diagnosed at our hospital between August 2018 and August 2021. 3D and 2D regions of interest were segmented from computed tomography-enhanced thin-slice images of the venous phase, and 851 radiomic features were extracted in each region. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was used to select radiomic features and calculate radiomic scores, and logistic regression was used to develop the model. Development of a 3D radiomics model (model 1), a 2D radiomics model (model 2), a combined 3D radiomics and 2D radiomics model (model 3), a clinical model (model 4), and a comprehensive model (model 5) for the prediction of distant metastases in patients with solid lung adenocarcinomas. Nomograms were drawn to illustrate model 5, and receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used for model evaluation. RESULTS The AUC (area under the curve) of model 1, model 2, model 3, model 4, and model 5 in the test set was 0.711, 0.769, 0.775, 0.829, and 0.892, respectively. The Delong test showed that AUC values were statistically different between model 5 and model 1 (p=0.001), and there was no statistical difference in AUC between the other models. Based on a comprehensive review of DCA, ROC curve, and Akaike information criterion (AIC), Model 5 is demonstrated to have better clinical utility, goodness of fit, and parsimony. CONCLUSION A comprehensive model based on 3D radiomic features, 2D radiomic features, and clinical features has the potential to predict distant metastasis in patients with solid lung adenocarcinomas.
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Affiliation(s)
- Zhiwei Peng
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Ze Lin
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Anjing He
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Li Yi
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Mengni Jin
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Zhiyong Chen
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Yahong Tao
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Yuhua Yang
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Can Cui
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Ying Liu
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
| | - Minjing Zuo
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
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10
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Roy E, Shrager J, Benson J, Trope WL, Bhandari P, Lui N, Liou D, Backhus L, Berry MF. Risk of adenocarcinoma in patients with a suspicious ground-glass opacity: a retrospective review. J Thorac Dis 2022; 14:4236-4245. [PMID: 36524073 PMCID: PMC9745528 DOI: 10.21037/jtd-22-583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/27/2022] [Accepted: 09/02/2022] [Indexed: 02/11/2024]
Abstract
BACKGROUND Both primary lung adenocarcinoma and benign processes can have a ground-glass opacity (GGO) appearance on imaging. This study evaluated the incidence of and risk factors for malignancy in a diverse cohort of patients who underwent resection of a GGO suspicious for lung cancer. METHODS All patients who underwent resection of a pulmonary nodule with a GGO component and suspected to be primary lung cancer at a single institution from 2001-2017 were retrospectively reviewed. Risk factors for malignancy were evaluated using multivariable logistic regression analysis that included nodule size, age, sex, and race as potential predictors. RESULTS The incidence of pulmonary adenocarcinoma in the 243 patients who met inclusion criteria was 86% (n=208). The most common pathologic findings in 35 patients with a benign pathology was granulomatous inflammation (n=14, 40%). Risk factors for adenocarcinoma in multivariable logistic regression were age [odds ratio (OR) 1.06, P=0.003], GGO size (OR 2.76, P<0.001), female sex (OR 4.47, P=0.002), and Asian race (OR 8.35, P=0.002). In this cohort, adenocarcinoma was found in 100% (44/44) of Asian females, 86% (25/29) of Asian males, 84% (98/117) of non-Asian females, and 77% (41/53) of non-Asian males. CONCLUSIONS The likelihood of adenocarcinoma in lung nodules with a ground-glass component is influenced by sex and race. Asian females with a GGO have a much higher likelihood of having adenocarcinoma than men and non-Asians. This data can be used when deciding whether to pursue nodule resection or surveillance in a patient with a GGO.
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Affiliation(s)
- Esha Roy
- Santa Barbara Cottage Hospital, Santa Barbara, CA, USA
- Stanford University, Stanford, CA, USA
| | | | | | | | | | | | - Doug Liou
- Stanford University, Stanford, CA, USA
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11
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Maki M, JeongMin H, Nakagawa T, Kawai H, Sakamoto N, Sato Y, Noguchi M. Aberrant OCIAD2 demethylation in lung adenocarcinoma is associated with outcome. Pathol Int 2022; 72:496-505. [PMID: 35920378 DOI: 10.1111/pin.13262] [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: 04/07/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022]
Abstract
Overexpression of OCIAD2 in lung adenocarcinoma has already been reported in several research articles, but the molecular mechanism involved remains unknown. Promoter CpG methylation is a representative form of epigenetic gene regulation, and a considerable number of tumor suppressor genes show hypermethylation in many cancers. In contrast, promoter CpG hypomethylation causes oncogene overexpression, resulting in carcinogenesis and malignant progression. In the present study, we investigated the CpG methylation and expression status of OCIAD2 using tumor tissues and adjacent normal tissues from seven cases of lung adenocarcinoma. We also examined the relationship between CpG methylation status and outcome in 58 patients with adenocarcinoma. Pyrosequencing showed that CpG sites in OCIAD2 promoter regions were more frequently demethylated in tumor tissues than in adjacent normal tissues, and reverse transcription-quantitative polymerase chain reaction revealed overexpression of OCIAD2 in lung adenocarcinoma. There was a correlation between OCIAD2 CpG demethylation and the level of mRNA expression, and statistical analysis showed that CpG hypomethylation of OCIAD2 was associated with poor outcomes. Our results suggest that overexpression of OCIAD2 might be caused mainly by CpG hypomethylation and that OCIAD2 methylation status might be a useful prognostic indicator in lung adenocarcinoma.
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Affiliation(s)
- Masahiro Maki
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hong JeongMin
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tomoki Nakagawa
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hitomi Kawai
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Noriaki Sakamoto
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masayuki Noguchi
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.,Center for Clinical and Translational Science, Shonan Kamakura General Hospital, Kanagawa, Japan
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12
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Liu C, Wang LC, Chen HS, Yeh YC, Hsu PK, Huang CS, Hsieh CC, Hsu HS. Outcomes of patients with different lepidic percentage and tumor size of stage I lung adenocarcinoma. Thorac Cancer 2022; 13:2005-2013. [PMID: 35680127 PMCID: PMC9284188 DOI: 10.1111/1759-7714.14477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/16/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 12/25/2022] Open
Abstract
Background To evaluate the long‐term outcomes after surgical resection for stage I lung adenocarcinoma based on the percentage of lepidic component (LC) and invasive tumor size (IS). Methods The clinicopathological characteristics of 1049 patients with stage I lung adenocarcinoma who underwent surgery between 2006 and 2016 were retrospectively reviewed. Tumors were categorized into groups: A (LC ≥ 50%) and B (LC < 50%). Groups A0 and A1 consisted of minimally invasive adenocarcinomas (MIA) and other lepidic‐predominant invasive adenocarcinomas, respectively. Group B was categorized into B1 (IS ≤ 1 cm), B2 (1 < IS≤2 cm), and B3 (2 < IS≤3 cm) by invasive tumor size and divided into subgroups (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]) according to the presence[lep+] or absence[lep−] of LCs. Cumulative incidence of recurrence (CIR) and cancer‐specific survival (CSS) were examined. Results LC decreased with increasing IS. Only 24 (8.5%) tumors in group A had an IS >1 cm. 10‐year CIR and CSS were 15.2% and 86.0%. LC and IS were found to be independent predictors of CSS. Patients in group A had 1.4% 10‐year CIR and 100% 10‐year CSS. In group B, a significantly higher CIR and worse CSS were observed as IS increased (p < 0.001), but LC was not a predictor for CSS (p = 0.593). No significant differences in CIR or CSS were found in presence of LC or not when LC < 50% (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]: p = 0.36/0.48, p = 0.82/0.94, and p = 0.90/0.37, respectively). Conclusions LC≥50% tumors demonstrated excellent prognosis regardless of IS. The outcomes of LC < 50% tumors were well predicted by IS, corresponding to the T‐staging system. The predictive value of LC for prognosis became insignificant.
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Affiliation(s)
- Chia Liu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Lei-Chi Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Shan Chen
- Department of Health Care Administration, Chang Jung Christian University, Tainan City, Taiwan
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Kuei Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Chien-Sheng Huang
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Chih-Cheng Hsieh
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Han-Shui Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
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13
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Thaiparambil J, Dong J, Grimm SL, Perera D, Ambati CSR, Putluri V, Robertson MJ, Patel TD, Mistretta B, Gunaratne PH, Kim MP, Yustein JT, Putluri N, Coarfa C, El‐Zein R. Integrative metabolomics and transcriptomics analysis reveals novel therapeutic vulnerabilities in lung cancer. Cancer Med 2022; 12:584-596. [PMID: 35676822 PMCID: PMC9844651 DOI: 10.1002/cam4.4933] [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: 12/14/2021] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) comprises the majority (~85%) of all lung tumors, with lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) being the most frequently diagnosed histological subtypes. Multi-modal omics profiling has been carried out in NSCLC, but no studies have yet reported a unique metabolite-related gene signature and altered metabolic pathways associated with LUAD and LUSC. METHODS We integrated transcriptomics and metabolomics to analyze 30 human lung tumors and adjacent noncancerous tissues. Differential co-expression was used to identify modules of metabolites that were altered between normal and tumor. RESULTS We identified unique metabolite-related gene signatures specific for LUAD and LUSC and key pathways aberrantly regulated at both transcriptional and metabolic levels. Differential co-expression analysis revealed that loss of coherence between metabolites in tumors is a major characteristic in both LUAD and LUSC. We identified one metabolic onco-module gained in LUAD, characterized by nine metabolites and 57 metabolic genes. Multi-omics integrative analysis revealed a 28 metabolic gene signature associated with poor survival in LUAD, with six metabolite-related genes as individual prognostic markers. CONCLUSIONS We demonstrated the clinical utility of this integrated metabolic gene signature in LUAD by using it to guide repurposing of AZD-6482, a PI3Kβ inhibitor which significantly inhibited three genes from the 28-gene signature. Overall, we have integrated metabolomics and transcriptomics analyses to show that LUAD and LUSC have distinct profiles, inferred gene signatures with prognostic value for patient survival, and identified therapeutic targets and repurposed drugs for potential use in NSCLC treatment.
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Affiliation(s)
| | - Jianrong Dong
- Center for Precision and Environmental HealthBaylor College of MedicineHoustonTexasUSA,Molecular and Cellular Biology DepartmentBaylor College of MedicineHoustonTexasUSA
| | - Sandra L. Grimm
- Center for Precision and Environmental HealthBaylor College of MedicineHoustonTexasUSA,Dan L Duncan Comprehensive Cancer CenterBaylor College of MedicineHoustonTexasUSA,Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
| | - Dimuthu Perera
- Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
| | | | - Vasanta Putluri
- Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
| | - Matthew J. Robertson
- Dan L Duncan Comprehensive Cancer CenterBaylor College of MedicineHoustonTexasUSA,Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
| | - Tajhal D. Patel
- Texas Children’s Cancer and Hematology Centers and The Faris D. Virani Ewing Sarcoma CenterBaylor College of MedicineHoustonTexasUSA
| | - Brandon Mistretta
- Department of Biology and BiochemistryUniversity of HoustonHoustonTexasUSA
| | - Preethi H. Gunaratne
- Molecular and Cellular Biology DepartmentBaylor College of MedicineHoustonTexasUSA,Department of Biology and BiochemistryUniversity of HoustonHoustonTexasUSA
| | - Min P. Kim
- Houston Methodist Cancer CenterHoustonTexasUSA,Division of Thoracic Surgery, Department of SurgeryHouston Methodist HospitalHoustonTexasUSA
| | - Jason T. Yustein
- Molecular and Cellular Biology DepartmentBaylor College of MedicineHoustonTexasUSA,Dan L Duncan Comprehensive Cancer CenterBaylor College of MedicineHoustonTexasUSA,Texas Children’s Cancer and Hematology Centers and The Faris D. Virani Ewing Sarcoma CenterBaylor College of MedicineHoustonTexasUSA,Integrative Molecular and Biological Sciences ProgramBaylor College of MedicineHoustonTexasUSA
| | - Nagireddy Putluri
- Molecular and Cellular Biology DepartmentBaylor College of MedicineHoustonTexasUSA,Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
| | - Cristian Coarfa
- Center for Precision and Environmental HealthBaylor College of MedicineHoustonTexasUSA,Molecular and Cellular Biology DepartmentBaylor College of MedicineHoustonTexasUSA,Dan L Duncan Comprehensive Cancer CenterBaylor College of MedicineHoustonTexasUSA,Advanced Technology CoresBaylor College of MedicineHoustonTexasUSA
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14
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Song F, Song L, Xing T, Feng Y, Song X, Zhang P, Zhang T, Zhu Z, Song W, Zhang G. A Multi-Classification Model for Predicting the Invasiveness of Lung Adenocarcinoma Presenting as Pure Ground-Glass Nodules. Front Oncol 2022; 12:800811. [PMID: 35574301 PMCID: PMC9096139 DOI: 10.3389/fonc.2022.800811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/04/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives To establish a multi-classification model for precisely predicting the invasiveness (pre-invasive adenocarcinoma, PIA; minimally invasive adenocarcinoma, MIA; invasive adenocarcinoma, IAC) of lung adenocarcinoma manifesting as pure ground-glass nodules (pGGNs). Methods By the inclusion and exclusion criteria, this retrospective study enrolled 346 patients (female, 297, and male, 49; age, 55.79 ± 10.53 (24-83)) presenting as pGGNs from 1292 consecutive patients with pathologically confirmed lung adenocarcinoma. A total of 27 clinical were collected and 1409 radiomics features were extracted by PyRadiomics package on python. After feature selection with L2,1-norm minimization, logistic regression (LR), extra w(ET) and gradient boosting decision tree (GBDT) were used to construct the three-classification model. Then, an ensemble model of the three algorithms based on model ensemble strategy was established to further improve the classification performance. Results After feature selection, a hybrid of 166 features consisting of 1 clinical (short-axis diameter, ranked 27th) and 165 radiomics (4 shape, 71 intensity and 90 texture) features were selected. The three most important features are wavelet-HLL_firstorder_Minimum, wavelet-HLL_ngtdm_Busyness and square_firstorder_Kurtosis. The hybrid-ensemble model based on hybrid clinical-radiomics features and the ensemble strategy showed more accurate predictive performance than other models (hybrid-LR, hybrid-ET, hybrid-GBDT, clinical-ensemble and radiomics-ensemble). On the training set and test set, the model can obtain the accuracy values of 0.918 ± 0.022 and 0.841, and its F1-scores respectively were 0.917 ± 0.024 and 0.824. Conclusion The multi-classification of invasive pGGNs can be precisely predicted by our proposed hybrid-ensemble model to assist patients in the early diagnosis of lung adenocarcinoma and prognosis.
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Affiliation(s)
- Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Lan Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tongtong Xing
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiao Song
- School of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tianyi Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhenchen Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 4 + 4 MD Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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15
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Huang YE, Tsai YH, Huang YJ, Lung JH, Ho KW, Yen TC, Chan SC, Chen ST, Tsai MF, Hung MS. 18F-Fluorodeoxyglucose PET/CT for Early Prediction of Outcomes in Patients with Advanced Lung Adenocarcinomas and EGFR Mutations Treated with First-Line EGFR-TKIs. Cancers (Basel) 2022; 14:1507. [PMID: 35326662 DOI: 10.3390/cancers14061507] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Epithelial growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the first-line therapy for patients with advanced-stage lung adenocarcinoma with EGFR mutations. However, 17–31% of these patients do not respond to therapy, making early evaluation of treatment response crucial. This prospective study investigates the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for timely prediction of response and survival of these patients. We evaluated 30 patients with stage IIIB/IV lung adenocarcinomas and EGFR mutations, receiving first-line EGFR-TKI therapy. 18F-FDG PET/CT was performed before and two weeks after initiation of treatment. Positron Emission Tomography Response Criteria in Solid Tumors served as an independent predictor of non-progressive disease; baseline and change of metabolic tumor volume represented independent predictors of progression-free survival and overall survival, respectively. Therefore, 18F-FDG PET/CT is an early predictor of outcomes and individual prognosis of patients with stage IIIB/IV lung adenocarcinomas and EGFR mutations receiving first-line EGFR-TKI therapy. Abstract This study aims to investigate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in early prediction of response and survival following epithelial growth factor receptor (EGFR)–tyrosine kinase inhibitor (TKI) therapy in patients with advanced lung adenocarcinomas and EGFR mutations. Thirty patients with stage IIIB/IV lung adenocarcinomas and EGFR mutations receiving first-line EGFR-TKIs were prospectively evaluated between November 2012 and May 2015. EGFR mutations were quantified by delta cycle threshold (dCt). 18F-FDG PET/CT was performed before and 2 weeks after treatment initiation. PET response was assessed based on PET Response Criteria in Solid Tumors (PERCIST). Baseline and percentage changes in the summed standardized uptake value, metabolic tumor volume (bsumMTV and ΔsumMTV, respectively), and total lesion glycolysis of ≤5 target lesions/patient were calculated. The association between parameters (clinical and PET) and non-progression disease after 3 months of treatment in CT based on the Response Evaluation Criteria in Solid Tumors Version 1.1 (nPD3mo), progression-free survival (PFS), and overall survival (OS) were tested. The median follow-up time was 19.6 months. The median PFS and OS were 12.0 and 25.3 months, respectively. The PERCIST criteria was an independent predictor of nPD3mo (p = 0.009), dCt (p = 0.014) and bsumMTV (p = 0.014) were independent predictors of PFS, and dCt (p = 0.014) and ΔsumMTV (p = 0.005) were independent predictors of OS. 18F-FDG PET/CT achieved early prediction of outcomes in patients with advanced lung adenocarcinomas and EGFR mutations receiving EGFR-TKIs.
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16
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Gao X, Pan R, Chen M, Zhao J, Zhong W, Wang H, Si X, Zhang X, Zhang L, Xu Y, Wang M. Leptomeningeal enhancement in magnetic resonance imaging predicts poor prognosis in lung adenocarcinoma patients with leptomeningeal metastasis. Thorac Cancer 2022; 13:1059-1066. [PMID: 35238486 PMCID: PMC8977178 DOI: 10.1111/1759-7714.14362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/07/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background To investigate the prognostic value of magnetic resonance imaging (MRI) findings in the prognosis of patients with leptomeningeal metastasis from lung adenocarcinoma. Methods Patients with lung adenocarcinoma complicated with cytologically confirmed leptomeningeal metastasis who visited Peking Union Medical College Hospital (blinded for review) between January 2012 and July 2019 were retrospectively reviewed. We collected the patients' clinical and neuroimaging findings and pathological data. The presence of leptomeningeal enhancement on initial contrast MRI was used to divide patients into MRI‐positive and MRI‐negative groups. Univariate and multivariate analyses were performed to evaluate prognostic factors. Results Eighty‐six patients (38 men and 48 women; median age = 56 [range, 25–80]) were included. Seventy‐three patients (84.9%) had targetable genetic alterations. Only 30 patients (34.88%) had leptomeningeal enhancement on initial contrast MRI. No significant differences were observed in the distribution of demographics, driver gene status, intracranial pressure, complicated brain/spinal metastasis, or treatment strategies between the two groups. The median overall survival of patients in the MRI‐positive group was significantly shorter than that in the negative group (182 days vs. 352 days, p = 0.036). Cox regression analysis indicated that the presence of leptomeningeal enhancement on the initial diagnostic magnetic resonance imaging was an independent predictor of an unfavourable prognosis of leptomeningeal metastasis (hazard ratio = 1.707, p = 0.044). Conclusions This is the first time that positive initial contrast‐enhanced magnetic resonance imaging of the neuroaxis has been proposed as a risk factor for the prognosis of leptomeningeal metastasis from lung adenocarcinoma with contemporary survival data.
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Affiliation(s)
- Xiaoxing Gao
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.,Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Ruili Pan
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Minjiang Chen
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Jing Zhao
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Wei Zhong
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Hanping Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xiaoyan Si
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xiaotong Zhang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Li Zhang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yan Xu
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Mengzhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
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17
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Koga T, Suda K, Mitsudomi T. Utility of the Ba/F3 cell system for exploring on-target mechanisms of resistance to targeted therapies for lung cancer. Cancer Sci 2022; 113:815-827. [PMID: 34997674 PMCID: PMC8898722 DOI: 10.1111/cas.15263] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 09/22/2021] [Revised: 12/03/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022] Open
Abstract
Molecular targeted therapies are the standard of care for front‐line treatment of metastatic non‐small‐cell lung cancers (NSCLCs) harboring driver gene mutations. However, despite the initial dramatic responses, the emergence of acquired resistance is inevitable. Acquisition of secondary mutations in the target gene (on‐target resistance) is one of the major mechanisms of resistance. The mouse pro‐B cell line Ba/F3 is dependent on interleukin‐3 for survival and proliferation. Upon transduction of a driver gene, Ba/F3 cells become independent of interleukin‐3 but dependent on the transduced driver gene. Therefore, the Ba/F3 cell line has been a popular system to generate models with oncogene dependence and vulnerability to specific targeted therapies. These models have been used to estimate oncogenicity of driver mutations or efficacies of molecularly targeted drugs. In addition, Ba/F3 models, together with N‐ethyl‐N‐nitrosourea mutagenesis, have been used to derive acquired resistant cells to investigate on‐target resistance mechanisms. Here, we reviewed studies that used Ba/F3 models with EGFR mutations, ALK/ROS1/NTRK/RET fusions, MET exon 14 skipping mutations, or KRAS G12C mutations to investigate secondary/tertiary drug resistant mutations. We determined that 68% of resistance mutations reproducibly detected in clinical cases were also found in Ba/F3 models. In addition, sensitivity data generated with Ba/F3 models correlated well with clinical responses to each drug. Ba/F3 models are useful to comprehensively identify potential mutations that induce resistance to molecularly targeted drugs and to explore drugs to overcome the resistance.
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Affiliation(s)
- Takamasa Koga
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
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18
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Wang L, Wang H, Wei S, Zhang Z. Exploration of genes and tumor infiltrating lymphocytes in female lung adenocarcinoma microenvironment that predicted prognosis. Medicine (Baltimore) 2021; 100:e28215. [PMID: 34941080 PMCID: PMC8702234 DOI: 10.1097/md.0000000000028215] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/22/2021] [Indexed: 01/05/2023] Open
Abstract
The tumor microenvironment has an important impact on tumor growth, invasion, metastasis, anti-tumor immune tolerance, and prognosis. The present study aimed to explore female lung adenocarcinoma microenvironment-associated tumor infiltrating lymphocytes (TILs) and genes that predict prognosis in The Cancer Genome Atlas (TCGA) database. Gene expression profiles of female patients with lung adenocarcinoma were downloaded from TCGA. Base on the CIBERSORT algorithm, we determined the fractions of TILs. By applying the ESTIMATE algorithm, immune scores and stromal scores were derived. According to the immune and stromal scores, we categorized the female patients with lung adenocarcinoma into high and low score groups. We also identified the fractions of TILs and differentially expressed genes (DEGs) that were significantly related with prognosis. The proportion of M1 macrophages was significantly negatively related to overall survival in female patients with lung adenocarcinoma. There were 269 upregulated genes and 35 downregulated genes both in immune scores and stromal scores. PTPRC (protein tyrosine phosphatase receptor type C) and GIMAP6 (GTPase, IMAP family member 6) were not only hub genes, but also were significantly related to overall survival in the Kaplan-Meier Plotter online and TCGA databases. In summary, our study provided new insight into the tumor microenvironment-related cellular and molecular mechanisms of women with lung adenocarcinoma. The results will be useful for future clinical studies.
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Affiliation(s)
- Lijun Wang
- Department of Respiratory Disease, Building 8 of Tongling People's Hospital, 468 Bijiashan Road, Tongling, Anhui, PR China
| | - Hao Wang
- Department of Respiratory Oncology, Anhui Provincial Cancer Hospital (The First Affiliated Hospital of USTC West District), Hefei, Anhui, China
| | - Song Wei
- Department of Respiratory Oncology, Anhui Provincial Cancer Hospital (The First Affiliated Hospital of USTC West District), Hefei, Anhui, China
| | - Zhihong Zhang
- Department of Respiratory Oncology, Anhui Provincial Cancer Hospital (The First Affiliated Hospital of USTC West District), Hefei, Anhui, China
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19
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Wan Q, Bao Y, Xia X, Liu J, Wang P, Peng Y, Xie X, He J, Li X. Intravoxel Incoherent Motion Diffusion-Weighted Imaging for Predicting and Monitoring the Response of Anti-Angiogenic Treatment in the Orthotopic Nude Mouse Model of Lung Adenocarcinoma. J Magn Reson Imaging 2021; 55:1202-1210. [PMID: 34570394 DOI: 10.1002/jmri.27920] [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: 06/17/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The treatment efficacy of angiogenesis inhibitor could be underestimated at an early stage based on tumor volume changes. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) can quantitatively assess tumors at the cellular level, but it is unclear whether it can provide useful information for assessing treatment response of anti-angiogenic treatment for lung adenocarcinoma. PURPOSE To determine the use of IVIM-DWI for non-invasive monitoring of the early response to anti-angiogenic treatment in the orthotopic transplantation of lung adenocarcinoma model. STUDY TYPE Prospective. POPULATION Thirty-seven nude mice were randomized into two groups: treatment group (received bevacizumab + cisplatin, N = 20) and control group (received saline, N = 17). FIELD STRENGTH/SEQUENCE Single-shot turbo spin-echo (TSE) IVIM-DWI, TSE T2-weighted imaging at 3.0 T. ASSESSMENT Tumor volume, IVIM parameters (apparent diffusion coefficient [ADC], diffusivity [D], perfusion fraction [f], and pseudo-diffusion coefficient [D*]) were measured before and 2 hours, 3, 7, 10 and 14 days after treatment. Regions of interest were manually drawn along the inner edge of the tumor by two radiologists with 5 and 10-year experience in magnetic resonance imaging. Pathological examinations (hematoxylin and eosin stain, cluster of differentiation 34) were performed. STATISTICAL TESTS Kolmogorov-Smirnov test, repeated-measure two-way analysis of variance test, Mann-Whitney U test, Pearson correlation analysis, receiver operating characteristic curve. P < 0.05 was considered statistically significant. RESULTS The tumor volume of the two groups was significantly different only on day 14 (control group vs. treatment group, 43.15 ± 18.28 mm3 vs. 28.41 ± 1.71 mm3 ). ADC2h , ADC10d , D2h , D7d , D10d , and D14d were significantly higher, while f10d and f14d were significantly lower in the treatment group compared to those of the control group. Both the △ADC2h (r = -0.631) and △D2h (r = -0.700) showed moderate correlations with the relative tumor volume on day 14. DATA CONCLUSION IVIM has the potential to predict and monitor the early response to anti-angiogenic treatment, earlier than size changes, for lung adenocarcinoma. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Qi Wan
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yingying Bao
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoying Xia
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jieqiong Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Peng
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaobin Xie
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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20
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Yin G, Wang Z, Song Y, Li X, Chen Y, Zhu L, Su Q, Dai D, Xu W. Corrigendum: Prediction of EGFR Mutation Status Based on 18F-FDG PET/CT Imaging Using Deep Learning-Based Model in Lung Adenocarcinoma. Front Oncol 2021; 11:747316. [PMID: 34557420 PMCID: PMC8453350 DOI: 10.3389/fonc.2021.747316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Guotao Yin
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Ziyang Wang
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Yingchao Song
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Xiaofeng Li
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Yiwen Chen
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Lei Zhu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Qian Su
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Dong Dai
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Wengui Xu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
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21
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Wadowska K, Błasiak P, Rzechonek A, Bil-Lula I, Śliwińska-Mossoń M. New Insights on Old Biomarkers Involved in Tumor Microenvironment Changes and Their Diagnostic Relevance in Non-Small Cell Lung Carcinoma. Biomolecules 2021; 11:1208. [PMID: 34439874 PMCID: PMC8391392 DOI: 10.3390/biom11081208] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lung cancer is a multifactorial disease with a heterogeneous tumor group that hampers diagnostic and therapeutic approaches, as well as understanding of the processes that underlie its pathogenesis. Current research efforts are focused on examining alterations in the tumor microenvironment, which may affect the pathogenesis and further malignant progression in lung cancer. The aim of this study was to investigate changes in the levels of biomarkers involved in the lung tumor microenvironment and their diagnostic utility in differentiating lung cancer subtypes and stages. METHODS This study comprised 112 lung cancer patients, 50 with adenocarcinoma, 35 with squamous cell carcinoma, 13 with other non-small cell lung carcinoma subtypes, and 14 with other lung neoplasms than non-small cell lung carcinoma. Tumor markers (CEA, CYFRA 21-1, and NSE) were measured in the patients' sera and plasmas, along with IL-6, TNF-α, SAA1, CRP, MMP-2, MMP-9, glucose, lactate, and LDH, utilizing enzyme-linked immunosorbent assays, enzyme immunoassays, and automated clinical chemistry and turbidimetry systems. The results were statistically analyzed across patient groups based on the subtype and stage of lung cancer. RESULTS Glucose concentrations showed statistically significant (p < 0.05) differences both between lung cancer subtypes and stages, with the highest levels in patients with other lung neoplasms (me = 130.5 mg/dL) and in patients with stage IIB lung cancer (me = 132.0 mg/dL). In patients with advanced lung cancer, IL-6 and LDH had considerably higher concentration and activity. There was also a significant positive correlation between IL-6 and MMP-9 in adenocarcinoma and SqCC, with correlation coefficients of 0.53 and 0.49, respectively. The ROC analyses showed that the best single biomarkers for distinguishing adenocarcinoma from squamous cell carcinoma are glucose, CRP, and CYFRA 21-1; however, their combination did not significantly improve sensitivity, specificity, and the AUC value. The combinations of IL-6, glucose, LDH and CEA, IL-6, SAA1, MMP-9, and lactate can distinguish patients with stage IIB lung cancer from those with stage IIA with 100% sensitivity, 100% specificity, and with an AUC value of 0.8333 and 1.0000, respectively, whereas the combination of CEA, IL-6, and LDH can identify patients with stage IIIA lung cancer from those with stage IIB with 72.73% sensitivity, 94.44% specificity, and an AUC value of 0.8686. CONCLUSION There is a link between biomarkers of tumor microenvironment changes and tumor markers, and combinations of these markers may be clinically useful in the differential diagnosis of adenocarcinoma and squamous cell carcinoma, as well as lung cancer stages IIB and IIA, and IIIA and IIB.
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Affiliation(s)
- Katarzyna Wadowska
- Department of Medical Laboratory Diagnostics, Division of Clinical Chemistry and Laboratory Haematology, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland; (I.B.-L.); (M.Ś.-M.)
| | - Piotr Błasiak
- Department and Clinic of Thoracic Surgery, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland; (P.B.); (A.R.)
- Department of Thoracic Surgery, Lower Silesian Center for Lung Diseases, Grabiszyńska 105, 53-439 Wroclaw, Poland
| | - Adam Rzechonek
- Department and Clinic of Thoracic Surgery, Wroclaw Medical University, Grabiszyńska 105, 53-439 Wroclaw, Poland; (P.B.); (A.R.)
- Department of Thoracic Surgery, Lower Silesian Center for Lung Diseases, Grabiszyńska 105, 53-439 Wroclaw, Poland
| | - Iwona Bil-Lula
- Department of Medical Laboratory Diagnostics, Division of Clinical Chemistry and Laboratory Haematology, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland; (I.B.-L.); (M.Ś.-M.)
| | - Mariola Śliwińska-Mossoń
- Department of Medical Laboratory Diagnostics, Division of Clinical Chemistry and Laboratory Haematology, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland; (I.B.-L.); (M.Ś.-M.)
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22
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Wehbe H, Kozah M, Koubaissi SA. Lung Adenocarcinoma with Paraneoplastic Hyper-Eosinophilia Not Responding To Pembrolizumab. Clin Med Insights Circ Respir Pulm Med 2021; 15:11795484211030164. [PMID: 34377046 PMCID: PMC8327228 DOI: 10.1177/11795484211030164] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/13/2021] [Indexed: 11/17/2022]
Abstract
Background: Paraneoplastic hyper-eosinophilia associated with metastatic lung adenocarcinoma is a rare finding and has been associated with a poor prognosis when present. Early hyper-eosinophilia appearing following non-small cell lung cancer (NSCLC) treatment with immune checkpoint inhibitors (ICI) has been previously reported with contradictory outcomes. Case summary: We present the case of an elderly man with newly diagnosed metastatic lung adenocarcinoma and baseline hyper-eosinophilia, treated with pembrolizumab, and showing evidence of significant and rapid disease progression suggestive of hyper-progressive disease, worsening baseline hyper-eosinophilia, and a fatal outcome within 1 month of therapy initiation. Conclusion: Pre-treatment hyper-eosinophilia could represent a predictive factor of an unfavorable response to ICI treatment in cases of NSCLC. Additional similar cases are needed to draw a more conclusive relationship.
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Affiliation(s)
- Hisham Wehbe
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maria Kozah
- Division of Infectious diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Salwa A Koubaissi
- Division of Pulmonary and Critical Care, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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23
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Yin G, Wang Z, Song Y, Li X, Chen Y, Zhu L, Su Q, Dai D, Xu W. Prediction of EGFR Mutation Status Based on 18F-FDG PET/CT Imaging Using Deep Learning-Based Model in Lung Adenocarcinoma. Front Oncol 2021; 11:709137. [PMID: 34367993 PMCID: PMC8340023 DOI: 10.3389/fonc.2021.709137] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/01/2021] [Indexed: 12/14/2022] Open
Abstract
Objective The purpose of this study was to develop a deep learning-based system to automatically predict epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma in 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Methods Three hundred and one lung adenocarcinoma patients with EGFR mutation status were enrolled in this study. Two deep learning models (SECT and SEPET) were developed with Squeeze-and-Excitation Residual Network (SE-ResNet) module for the prediction of EGFR mutation with CT and PET images, respectively. The deep learning models were trained with a training data set of 198 patients and tested with a testing data set of 103 patients. Stacked generalization was used to integrate the results of SECT and SEPET. Results The AUCs of the SECT and SEPET were 0.72 (95% CI, 0.62–0.80) and 0.74 (95% CI, 0.65–0.82) in the testing data set, respectively. After integrating SECT and SEPET with stacked generalization, the AUC was further improved to 0.84 (95% CI, 0.75–0.90), significantly higher than SECT (p<0.05). Conclusion The stacking model based on 18F-FDG PET/CT images is capable to predict EGFR mutation status of patients with lung adenocarcinoma automatically and non-invasively. The proposed model in this study showed the potential to help clinicians identify suitable advanced patients with lung adenocarcinoma for EGFR‐targeted therapy.
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Affiliation(s)
- Guotao Yin
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Ziyang Wang
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Yingchao Song
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Xiaofeng Li
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Yiwen Chen
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Lei Zhu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Qian Su
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Dong Dai
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Wengui Xu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
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24
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Gummlich BP, Ströbel P, Hosseini ASA, Neesse A, Ellenrieder V, Schwörer H. Systemic IgG4-Related Disease Masquerading as Cholangiocarcinoma: A Case Report Underscoring the Importance of Medical History. Am J Case Rep 2021; 22:e930729. [PMID: 34052827 PMCID: PMC8174605 DOI: 10.12659/ajcr.930729] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/26/2021] [Accepted: 03/25/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Immunoglobulin (Ig) G4-related disease is a rare disease of unknown pathophysiology, which can affect multiple organs leading to tissue fibrosis and organ failure. The present case report describes a patient with systemic IgG4-related disease (IgG4-RD) that occurred over a 1-year period and affected multiple organs at different times. Imaging studies, interventional procedures, changes in laboratory parameters, and histopathology demonstrate the novel and known aspects of this disease before and during prednisolone monotherapy and in combination with azathioprine. CASE REPORT A 64-year-old man presented with weight loss and painless jaundice, which was highly suspicious for cholangiocarcinoma. A thorough medical history together with laboratory tests, imaging procedures, and endoscopic interventions confirmed that surgery was not needed and led to the final diagnosis of histologically-confirmed, IgG4-related sclerosing cholangitis and autoimmune pancreatitis type 1. Other typical organ manifestations of systemic IgG4-RD were diagnosed through a thorough medical review, which led to immunohistochemical reevaluation of past surgical specimens. Besides the IgG4-related organ manifestations, which can include periorbital xanthelasmas, our patient developed a pulmonary adenocarcinoma 6 years after the initial clinical onset of IgG4-RD. After immunosuppressive treatment with prednisolone alone and subsequently in combination with azathioprine, the patient's IgG4-RD resolved. CONCLUSIONS Interdisciplinary collaboration is required to diagnose IgG4-RD that involves multiple organs. Patient medical history remains crucial for diagnosis and attention should be paid to avoiding unnecessary surgery. Tumors (lung adenocarcinomas) and xanthelasmas can develop because of IgG4-RD. Glucocorticoids and additional azathioprine may be advisable for maintenance treatment.
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Affiliation(s)
- Benjamin P.M. Gummlich
- Department of Gastroenterology, Gastrointestinal Oncology, and Endocrinology, University Medical Center Goettingen, Goettingen, Germany
| | - Philipp Ströbel
- Institut of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Ali Seif Amir Hosseini
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
| | - Albrecht Neesse
- Department of Gastroenterology, Gastrointestinal Oncology, and Endocrinology, University Medical Center Goettingen, Goettingen, Germany
| | - Volker Ellenrieder
- Department of Gastroenterology, Gastrointestinal Oncology, and Endocrinology, University Medical Center Goettingen, Goettingen, Germany
| | - Harald Schwörer
- Department of Gastroenterology, Gastrointestinal Oncology, and Endocrinology, University Medical Center Goettingen, Goettingen, Germany
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25
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Hong D, Zhang L, Xu K, Wan X, Guo Y. Prognostic Value of Pre-Treatment CT Radiomics and Clinical Factors for the Overall Survival of Advanced (IIIB-IV) Lung Adenocarcinoma Patients. Front Oncol 2021; 11:628982. [PMID: 34123786 PMCID: PMC8193844 DOI: 10.3389/fonc.2021.628982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/13/2020] [Accepted: 05/04/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose The purpose of this study was to investigate the prognostic value of pre-treatment CT radiomics and clinical factors for the overall survival (OS) of advanced (IIIB–IV) lung adenocarcinoma patients. Methods This study involved 165 patients with advanced lung adenocarcinoma. The Lasso–Cox regression model was used for feature selection and radiomics signature building. Then a clinical model was built based on clinical factors; a combined model in the form of nomogram was constructed with both clinical factors and the radiomics signature. Harrell’s concordance index (C-Index) and Receiver operating characteristic (ROC) curves at cut-off time points of 1-, 2-, and 3- year were used to estimate and compare the predictive ability of all three models. Finally, the discriminatory ability and calibration of the nomogram were analyzed. Results Thirteen significant features were selected to build the radiomics signature whose C-indexes were 0.746 (95% CI, 0.699 to 0.792) in the training cohort and 0.677 (95% CI, 0.597 to 0.766) in the validation cohort. The C-indexes of combined model achieved 0.799 (95% CI, 0.757 to 0.84) in the training cohort and 0.733 (95% CI, 0.656 to 0.81) in the validation cohort, which outperformed the clinical model and radiomics signature. Moreover, the areas under the curve (AUCs) of the radiomic signature for 2-year prediction was superior to that of the clinical model. The combined model had the best AUCs for 2- and 3-year predictions. Conclusions Radiomic signatures and clinical factors have prognostic value for OS in advanced (IIIB–IV) lung adenocarcinoma patients. The optimal model should be selected according to different cut-off time points in clinical application.
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Affiliation(s)
- Duo Hong
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Lina Zhang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Ke Xu
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Xiaoting Wan
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yan Guo
- GE Healthcare, Beijing, China
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26
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Lee G, Park H, Lee HY, Ahn JH, Sohn I, Lee SH, Kim J. Tumor Margin Contains Prognostic Information: Radiomic Margin Characteristics Analysis in Lung Adenocarcinoma Patients. Cancers (Basel) 2021; 13:cancers13071676. [PMID: 33918164 PMCID: PMC8037340 DOI: 10.3390/cancers13071676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary The tumor microenvironment is a dynamic area, with continuous interaction between tumor cells and their surrounding environment. We aimed to investigate the relationship between tumor radiomic margin characteristics and prognosis in patients with lung cancer. When compared to the model with clinical variables only (C-index = 0.738), the model incorporating clinical variables and radiomic margin characteristics (C-index = 0.753) demonstrated a higher C-index for predicting overall survival. In the model integrating both clinical variables and radiomic margin characteristics, convexity, Laplace of Gaussian (LoG) kurtosis 3, and roundness factor were independent predictive factors of overall survival. Our study showed that radiomic margin characteristics helped predict overall survival in patients with lung adenocarcinomas, thus implying that the tumor margin contains prognostic information. Abstract We aimed to investigate the relationship between tumor radiomic margin characteristics and prognosis in patients with lung cancer. We enrolled 334 patients who underwent complete resection for lung adenocarcinoma. A quantitative computed tomography analysis was performed, and 76 radiomic margin characteristics were extracted. The radiomic margin characteristics were correlated with overall survival. The selected clinical variables and radiomic margin characteristics were used to calculate a prognostic model with subsequent internal and external validation. Nearly all of the radiomic margin characteristics showed excellent reproducibility. The least absolute shrinkage and selection operator (LASSO) method was used to select eight radiomic margin characteristics. When compared to the model with clinical variables only (C-index = 0.738), the model incorporating clinical variables and radiomic margin characteristics (C-index = 0.753) demonstrated a higher C-index for predicting overall survival. In the model integrating both clinical variables and radiomic margin characteristics, convexity, a Laplace of Gaussian (LoG) kurtosis of 3, and the roundness factor were each independently predictive of overall survival. In addition, radiomic margin characteristics were also correlated with the micropapillary subtype, and the sphericity value was able to predict the presence of the micropapillary subtype. In conclusion, our study showed that radiomic margin characteristics helped predict overall survival in patients with lung adenocarcinomas, thus implying that the tumor margin contains prognostic information.
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Affiliation(s)
- Geewon Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon 16419, Korea;
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
- Correspondence:
| | - Joong Hyun Ahn
- Biostatistics and Clinical Epidemiology Center, Samsung Biomedical Research Institute, Seoul 06351, Korea; (J.H.A.); (I.S.)
| | - Insuk Sohn
- Biostatistics and Clinical Epidemiology Center, Samsung Biomedical Research Institute, Seoul 06351, Korea; (J.H.A.); (I.S.)
| | - Seung-Hak Lee
- Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon 16419, Korea;
- Core Research and Development Center, Korean University Ansan Hospital, Ansan 15355, Korea
| | - Jhingook Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
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27
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Niu R, Wang Y, Shao X, Jiang Z, Wang J, Shao X. Association Between 18F-FDG PET/CT-Based SUV Index and Malignant Status of Persistent Ground-Glass Nodules. Front Oncol 2021; 11:594693. [PMID: 33842310 PMCID: PMC8024639 DOI: 10.3389/fonc.2021.594693] [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: 08/14/2020] [Accepted: 03/02/2021] [Indexed: 11/14/2022] Open
Abstract
To explore the association between 18F-FDG PET/CT-based SUV index and malignant risk of persistent ground-glass nodules (GGNs). We retrospectively analyzed a total of 166 patients with GGN who underwent PET/CT examination from January 2012 to October 2019. There were 113 women and 53 men, with an average age of 60.8 ± 9.1 years old. A total of 192 GGNs were resected and confirmed by pathology, including 22 in benign group and 170 in adenocarcinoma group. They were divided into three groups according to SUV index tertiles: Tertile 1 (0.14–0.54), Tertile 2 (0.55–1.17), and Tertile 3 (1.19–6.78), with 64 GGNs in each group. The clinical and imaging data of all patients were collected and analyzed. After adjusting for the potential confounding factors, we found that the malignancy risk of GGN significantly decreased as the SUV index increased (OR, 0.245; 95%CI, 0.119–0.504; P <0.001), the average probability of malignant GGN was 89.1% (95% CI, 53.1–98.3%), 80.5% (95% CI, 36.7–96.7%), and 34.3% (95%CI, 9.5–72.2%) for Tertile 1 to Tertile 3. And the increasing trend of SUV index was significantly correlated with the reduction of malignant risk (OR, 0.099; 95%CI, 0.025–0.394; P = 0.001), especially between Tertile 3 versus Tertile 1 (OR, 0.064; 95%CI, 0.012–0.356; P = 0.002). Curve fitting showed that the SUV index was linearly and negatively correlated with the malignant risk of GGN. SUV index is an independent correlation factor for malignancy risk of GGN, the higher the SUV index, the lower the probability of GGN malignancy.
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Affiliation(s)
- Rong Niu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Zhenxing Jiang
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiaonan Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China
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28
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Sereno M, He Z, Smith CR, Baena J, Das M, Hastings RK, Rake G, Fennell DA, Nakas A, Moore DA, Le Quesne J. Inclusion of multiple high-risk histopathological criteria improves the prediction of adjuvant chemotherapy efficacy in lung adenocarcinoma. Histopathology 2021; 78:838-848. [PMID: 33155719 PMCID: PMC8247971 DOI: 10.1111/his.14301] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/08/2020] [Accepted: 11/04/2020] [Indexed: 12/25/2022]
Abstract
Aims The decision to consider adjuvant chemotherapy (AC) for non‐small cell lung cancer is currently governed by clinical stage. This study aims to assess other routinely collected pathological variables related to metastasis and survival for their ability to predict the efficacy of AC in lung adenocarcinoma. Methods and results A retrospective single‐centre series of 620 resected lung non‐mucinous adenocarcinoma cases from 2005 to 2015 was used. Digital images of all slides were subjected to central review, and data on tumour histopathology, AC treatment and patient survival were compiled. A statistical case matching approach was used to counter selection bias. Several high‐risk pathological criteria predict both pathological nodal involvement and early death: positive vascular invasion status (VI+) (HR = 2.10, P < 0.001), positive visceral pleural invasion status (VPI+) (HR = 2.16, P < 0.001), and solid/micropapillary‐predominant WHO tumour type (SPA/MPPA) (HR = 3.29, P < 0.001). Crucially, these criteria also identify patient groups benefiting from AC (VI + HR = 0.69, P = 0.167, VPI + HR = 0.44, P = 0.004, SPA/MPPA HR = 0.36, P = 0.006). Cases showing VI+/VPI+/SPA/MPPA histology in the absence of AC stage criteria were common (170 of 620 total), and 8 had actually received AC. This group showed much better outcomes than equivalent untreated cases in matched analysis (3‐year OS 100.0% versus 31.3%). Inclusion of patients with VI+/VPI+/SPA/MPPA histology would increase AC‐eligible patients from 51.0% to 84.0% of non‐mucinous tumours in our cohort. Conclusions Our data provide preliminary evidence that the consideration of AC in patients with additional high‐risk pathological indicators may significantly improve outcomes in operable lung adenocarcinoma, and that AC may be currently underused.
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Affiliation(s)
- Marco Sereno
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Zhangyi He
- MRC Toxicology Unit, University of Cambridge, Leicester, UK
| | - Claire R Smith
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Juvenal Baena
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Madhumita Das
- MRC Toxicology Unit, University of Cambridge, Leicester, UK
| | - Robert K Hastings
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Grace Rake
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Dean A Fennell
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | | | - David A Moore
- UCL Cancer Institute, University College London, London, UK
| | - John Le Quesne
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.,MRC Toxicology Unit, University of Cambridge, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
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29
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Qi L, Xue K, Cai Y, Lu J, Li X, Li M. Predictors of CT Morphologic Features to Identify Spread Through Air Spaces Preoperatively in Small-Sized Lung Adenocarcinoma. Front Oncol 2021; 10:548430. [PMID: 33505903 PMCID: PMC7831277 DOI: 10.3389/fonc.2020.548430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/20/2020] [Accepted: 10/29/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to explore the predictive CT features of spread through air spaces (STAS) in patients with small-sized lung adenocarcinoma. Methods From January 2017 to May 2019, patients with confirmed pathology of small-sized lung adenocarcinoma (less than or equal to 2 cm) and who underwent surgery were retrospectively analyzed. The clinical, pathological, and surgical information and CT features were analyzed. Results A total of 47 patients with STAS (males, 61.7%; mean age, 56 ± 8years) and 143 patients without STAS (males, 58%; mean age, 53 ± 11 years) were included. Pathologically, papillary, micropapillary, solid predominant subtypes, and vascular and pleural invasion were most commonly observed features in the STAS group. Radiologically, higher consolidation tumor ratio (CTR), presence of spiculation, satellites, ground glass ribbon sign, pleural attachment, and unclear tumor–lung interface were more commonly observed features in the STAS group. CTR, presence of ground glass ribbons and pleural connection, and absence of cystic airspaces were considered as stable predictors of STAS in multivariate logistic models. The receiver operating characteristic curve (ROC) analysis for predicting STAS demonstrated higher area under the curve (AUC) in the model that used CTR (0.760, 95% confidence interval, 0.69–0.83) for predicting STAS than in the model that used long diameter of entire lesion (0.640). Conclusions CTR is the best CT sign for predicting STAS in small-sized lung adenocarcinoma. The ground glass ribbon is a newly found indicator and has the potential for predicting STAS.
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Affiliation(s)
- Lin Qi
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
| | - Ke Xue
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yongjun Cai
- Department of Pathology, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Jinjuan Lu
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
| | - Xiaohu Li
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ming Li
- Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China
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Miao H, Chen D, Li R, Hu J, Chen Y, Xu C, Wen Z. Identification of an immune-related six-long noncoding RNA signature as a novel prognosis biomarker for adenocarcinoma of lung. Biosci Rep 2021; 41:BSR20202444. [PMID: 33324975 DOI: 10.1042/BSR20202444] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lung adenocarcinoma (LUAD) is a heterogeneous disease with high mortality. Close attention has been paid to immunotherapy in LUAD treatment. However, immunotherapy has produced different therapeutic effects because of immune heterogeneity. Long noncoding RNAs (lncRNAs) are survival prognostic indicators with functions in the immune process. The present study was designed to examine the predictive power of immune-related lncRNAs in LUAD prognosis and investigated potential molecular mechanisms. METHODS Transcriptome profiling and LUAD sample clinical information were retrieved from online database. The immune-related lncRNAs signature was identified by Cox regression. Survival analysis was used to verify the validity of the prognosis model. Then, possible biological functions were predicted and the abundance of infiltrating immune cells in LUAD samples were further analyzed. RESULTS An immune-associated lncRNAs signature was established by combining six lncRNAs. Patients with LUAD were stratified into high- and low-risk groups using the six lncRNAs signature. Patients in different risk levels had significantly different prognoses (P<0.001), and the immune-associated lncRNAs signature was identified as an independent prognostic factor for LUAD. The functions of the lncRNA signature were confirmed as ubiquitin mediated proteolysis and signal sequence binding. The lncRNA signature negatively correlates with B-cell immune infiltration. CONCLUSION A reliable immune-related lncRNAs prognosis model for LUAD was identified. lncRNAs played a vital role in the tumor immune process and were associated with the LUAD prognosis. Research of lncRNAs in B-cell immune infiltration could provide new insight into the immunotherapy of LUAD.
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Yamada Y, Shirahase H, Fukiya M, Yoshizawa A, Minamiguchi S, Ozasa H, Haga H. Thyroid metastasis of pulmonary adenocarcinoma with EGFR G719A mutation: Genetic confirmation with liquid-based cytology specimens. Cytopathology 2020; 32:364-366. [PMID: 33184941 DOI: 10.1111/cyt.12940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Yosuke Yamada
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Hiroyuki Shirahase
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Mika Fukiya
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | | | - Hiroaki Ozasa
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
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Liu G, Xu Z, Ge Y, Jiang B, Groen H, Vliegenthart R, Xie X. 3D radiomics predicts EGFR mutation, exon-19 deletion and exon-21 L858R mutation in lung adenocarcinoma. Transl Lung Cancer Res 2020; 9:1212-1224. [PMID: 32953499 PMCID: PMC7481623 DOI: 10.21037/tlcr-20-122] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 12/11/2022]
Abstract
Background To establish a radiomic approach to identify epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma patients based on CT images, and to distinguish exon-19 deletion and exon-21 L858R mutation. Methods Two hundred sixty-three patients who underwent pre-surgical contrast-enhanced CT and molecular testing were included, and randomly divided into the training (80%) and test (20%) cohort. Tumor images were three-dimensionally segmented to extract 1,672 radiomic features. Clinical features (age, gender, and smoking history) were added to build classification models together with radiomic features. Subsequently, the top-10 most relevant features were used to establish classifiers. For the classifying tasks including EGFR mutation, exon-19 deletion, and exon-21 L858R mutation, four logistic regression models were established for each task. Results The training and test cohort consisted of 210 and 53 patients, respectively. Among the established models, the highest accuracy and sensitivity among the four models were 75.5% (61.7–86.2%) and 92.9% (76.5–99.1%) to classify EGFR mutation, respectively. The highest specificity values were 86.7% (69.3–96.2%) and 70.4% (49.8–86.3%) to classify exon-19 deletion and exon-21 L858R mutation, respectively. Conclusions CT radiomics can sensitively identify the presence of EGFR mutation, and increase the certainty of distinguishing exon-19 deletion and exon-21 L858R mutation in lung adenocarcinoma patients. CT radiomics may become a helpful non-invasive biomarker to select EGFR mutation patients for invasive sampling.
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Affiliation(s)
- Guixue Liu
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihan Xu
- Siemens Healthineers Ltd, Shanghai, China
| | | | - Beibei Jiang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Harry Groen
- Department of Lung Diseases, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
| | - Rozemarijn Vliegenthart
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
| | - Xueqian Xie
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Arenas AM, Cuadros M, Andrades A, García DJ, Coira IF, Rodríguez MI, Baliñas-Gavira C, Peinado P, Álvarez-Pérez JC, Medina PP. LncRNA DLG2-AS1 as a Novel Biomarker in Lung Adenocarcinoma. Cancers (Basel) 2020; 12:E2080. [PMID: 32731343 DOI: 10.3390/cancers12082080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) are a heterogeneous class of non-coding RNAs whose biological roles are still poorly understood. LncRNAs serve as gene expression regulators, frequently interacting with epigenetic factors to shape the outcomes of crucial biological processes, and playing roles in different pathologies including cancer. Over the last years, growing scientific evidence supports the key role of some lncRNAs in tumor development and proposes them as valuable biomarkers for the clinic. In this study, we aimed to characterize lncRNAs whose expression is altered in tumor samples from patients with lung adenocarcinoma (LUAD) compared to adjacent normal tissue samples. On an RT-qPCR survey of 90 cancer-related lncRNAs, we found one lncRNA, DLG2-AS1, which was consistently downregulated in 70 LUAD patients. To gain insight into its biological function, DLG2-AS1 was cloned and successfully re-expressed in LUAD cancer cell lines. We determined that DLG2-AS1 is not a cis-regulatory element of its overlapping gene DLG2, as their transcription levels were not correlated, nor did DLG2-AS1 restoration modify the expression of DLG2 protein. Furthermore, after generating a receiver operating curve (ROC) and calculating the area under curve (AUC), we found that DLG2-AS1 expression showed high sensitivity and specificity (AUC = 0.726) for the classification of LUAD and normal samples, determining its value as a potential lung cancer biomarker.
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Šťastná N, Jakubíková L, Brat K. Long-Term Effect of Erlotinib Therapy in the Third Line of Anticancer Treatment in a Patient with Non-Small-Cell Lung Cancer - a Case Report. Klin Onkol 2020; 33:226-229. [PMID: 32683880 DOI: 10.14735/amko2020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Malignant tumours of the trachea, the lungs, and the bronchus are the second most common type of tumour in the Czech Republic. Approximately three-quarters of cases are dia-gnosed in an advanced stage (IIIB-IV) and are one of the most common causes of death in all cancer groups. Targeted therapy brings a certain level of the improvement of prognostic outlook. In the Czech Republic, 1st and 2nd generation of tyrosine kinase inhibitors (gefitinib, erlotinib, afatinib) are indicated in the first-line anticancer treatment in non-small-cell lung cancer in locally advanced and metastatic stage, with proved activating mutation status of the epidermal growth factor receptor. Erlotinib is also indicated for use in the second or third line of anticancer treatment after a documented failure of previous chemotherapy. CASE A 70-year-old patient with lung adenocarcinoma, sensitive mutation in exon 19 of epidermal growth factor receptor gene, clinical-stage IV (according to the 7th edition of TNM classification), demonstrating long-term stable disease on erlotinib treatment after first-line gefitinib failure and second-line carboplatin-bevacizumab-paclitaxel combination chemotherapy failure. The disease treated with erlotinib has been stable for 48 months, although the dose has been reduced to 100mg per day due to side effects (rash). CONCLUSION While the efficacy of a gefitinib treatment in this case report was comparable to clinical trials results, the progression interval in this particular patient when treated with erlotinib is about 5 times longer compared to the progression observed in clinical trials. Another interesting fact is also a significant difference in the effect of these two tyrosine kinase inhibitors, which have shown comparable efficacy in clinical trials.
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Kao MW, Su YC, Liang PI, Wu YY, Hong TM. Low Galectin-3 Expression Level in Primary Tumors Is Associated with Metastasis in T1 Lung Adenocarcinoma. J Clin Med 2020; 9:jcm9061990. [PMID: 32630393 PMCID: PMC7355842 DOI: 10.3390/jcm9061990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/26/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Although nodal and distant metastasis is rare in T1 lung adenocarcinoma, it is related to poor clinical prognosis. Association between galectin-3 (Gal-3) expression level, and clinical outcome of T1 lung adenocarcinoma has not been clarified. METHODS From January 2009 to December 2014, 74 patients with surgically resected T1 lung adenocarcinoma were enrolled in this retrospective cohort study. Patient outcomes were followed up until December 2019. Gal-3 expression level in primary tumors was assessed immunohistochemically and evaluated based on the staining intensity and percentage. Patient characteristics and correlation between Gal-3 expression level and clinical outcomes were reviewed. RESULTS Low Gal-3 expression was associated with increased metastatic events (p = 0.03), especially distant metastasis (p = 0.007), and mortality rate (p = 0.04). Kaplan-Meier analysis revealed that high Gal-3 expression level was associated with favorable recurrence-free survival in T1 lung adenocarcinoma (log-rank p = 0.048) and T1a (≤ 2 cm, American Joint Committee on Cancer (AJCC) 7th edition) lung adenocarcinoma (log-rank p = 0.043). Gal-3 expression along with tumor size showed a larger area under curve (AUC) than tumor size alone for predicting metastatic events (AUC = 0.747 vs. 0.681) and recurrence (AUC = 0.813 vs. 0.766) in T1a lung adenocarcinoma in the receiver-operating characteristic curve. CONCLUSION Low Gal-3 expression level in primary tumors was remarkably associated with increased metastatic events and reduced recurrence-free survival in T1 lung adenocarcinoma. We suggest that Gal-3 expression level in addition to tumor size may potentially be stronger than tumor size alone in predicting metastasis in T1a lung adenocarcinoma patients.
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Affiliation(s)
- Ming-Wei Kao
- Division of Thoracic Surgery, Department of Surgery, E-Da Hospital, and College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Yue-Chiu Su
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (Y.-C.S.); (P.-I.L.)
| | - Peir-In Liang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (Y.-C.S.); (P.-I.L.)
| | - Yi-Ying Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Tse-Ming Hong
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 4259)
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Lim CG, Shin KM, Lim JK, Kim HJ, Kim WH, Cho SH, Kim GC, Lim J, Jeong JY, Cha SI. Emphysema is associated with the aggressiveness of COPD-related adenocarcinomas. Clin Respir J 2020; 14:405-412. [PMID: 31903685 DOI: 10.1111/crj.13146] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/09/2019] [Accepted: 01/02/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To compare the differences in radiologic and pathologic features of surgically resected chronic obstructive pulmonary disease (COPD)-related adenocarcinomas according to the presence of emphysema. METHODS A total of 216 smokers with surgically resected lung adenocarcinoma were included in this retrospective study, and 102 patients were diagnosed with COPD. We classified COPD patients as emphysematous or non-emphysematous group based on the emphysema severity on computed tomography (CT) and evaluated the differences in the CT and pathologic features between the two groups. The relationship between emphysema and disease-free survival was assessed using a Kaplan-Meier curve. RESULTS Lung adenocarcinomas in emphysema group presented a more aggressive pathologic grade and higher prevalence of solid lesions (vs subsolid lesions) on CT than those in non-emphysematous group (P = 0.006 and <0.001, respectively). After adjustment for age, sex, smoking pack-years and tumor size, emphysema group had a greater risk for higher histologic grade and higher prevalence of solid lesions than non-emphysema group (odds ratio, 3.445; 95% confidence interval, 1.124-10.564; P = 0.030, odds ratio, 6.192; 95% confidence interval, 1.804-21.254; P = 0.004, respectively). Kaplan-Meier survival curves showed that patients with emphysema had significantly impaired disease-free survival compared with those without emphysema (median disease-free survival = 37.0 vs 57.5 months, P = 0.038). CONCLUSION Adenocarcinomas in emphysema-present COPD had more aggressive features of pathology and CT findings, and worse disease-free survival than those without emphysema. These findings might provide an insight into the different pathobiology and prognostic implications of lung adenocarcinomas according to the presence of emphysema in patients with COPD.
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Affiliation(s)
- Chun Geun Lim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Kyung Min Shin
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jae Kwang Lim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Hye Jung Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Won Hwa Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Seung Hyun Cho
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Gab Chul Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jiseun Lim
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Ji Yun Jeong
- Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Seung-Ick Cha
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Yang Y, Li K, Sun D, Yu J, Cai Z, Cao Y, Wu J. Invasive Pulmonary Adenocarcinomas Versus Preinvasive Lesions Appearing as Pure Ground-Glass Nodules: Differentiation Using Enhanced Dual-Source Dual-Energy CT. AJR Am J Roentgenol 2019; 213:W114-22. [PMID: 31082273 DOI: 10.2214/AJR.19.21245] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE. The objective of our study was to investigate the potentials of enhanced dual-source dual-energy CT (DECT) and three-planar measurements for differentiating invasive pulmonary adenocarcinomas (IPAs) from preinvasive lesions appearing as pure ground-glass nodules (pGGNs). MATERIALS AND METHODS. Thirty-nine patients with 53 pGGNs who underwent enhanced dual-source DECT were included in this retrospective study. All pGGNs were pathologically confirmed and categorized into two groups: preinvasive lesions or IPAs. The traditional CT features of the pGGNs were evaluated on unenhanced images. Quantitative parameters were measured on iodine-enhanced images of dual-source DECT in three planes, and both intra- and interobserver reproducibility analyses were performed to assess the measurement reproducibility of quantitative parameters. To identify significant factors for differentiating IPAs from preinvasive lesions, we performed logistic regression analysis and ROC curve analysis. RESULTS. For traditional CT features, only lesion size and unenhanced CT attenuation value showed significant differences between preinvasive lesions and IPAs (p < 0.05). Preinvasive lesions and IPAs exhibited significant differences in attenuation on virtual images, so-called "virtual HU" or "VHU," and the modified normalized iodine concentration (NIC) (p < 0.05), and both intra- and interobserver agreement for the quantitative measurements were excellent. Multivariate logistic regression analysis revealed that larger lesion size (adjusted odds ratio [OR], 3.65) and higher modified NIC (adjusted OR, 19.01) were significant differentiators of IPAs from preinvasive lesions (p < 0.05). ROC curve analysis revealed that modified NIC showed excellent performance (AUC, 0.924) and significantly higher performance than lesion size (AUC, 0.711) for differentiating IPAs from preinvasive lesions. CONCLUSION. In pGGNs, a lesion with a modified NIC value of more than 0.29 can be a very specific discriminator of IPAs from preinvasive lesions, and IPAs can be accurately and reliably differentiated from preinvasive lesions using enhanced dual-source DECT and three-planar measurements.
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Koh YW, Lee D, Lee SJ. Intratumoral heterogeneity as measured using the tumor-stroma ratio and PET texture analyses in females with lung adenocarcinomas differs from that of males with lung adenocarcinomas or squamous cell carcinomas. Medicine (Baltimore) 2019; 98:e14876. [PMID: 30882693 PMCID: PMC6426613 DOI: 10.1097/md.0000000000014876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We compared intratumoral stromal proportions and positron emission tomography (PET) textural features between females and males with lung adenocarcinoma (ADC) or squamous cell carcinoma (SCC).We retrospectively evaluated 167 consecutive patients (male 122, female 45) who underwent pretreatment fluorodeoxyglucose PET/CT and surgical resection. The tumor-stroma ratios (TSRs) of primary tumors were estimated on hematoxylin-and-eosin-stained histological sections, and higher-order textural features were extracted on PET. We compared the histological and PET features between the sexes.More females than males had ADC. Age and pathological tumor size did not significantly differ between females and males. Females with ADC had more stroma-rich tumors than males with ADC (P = .016) or SCC (P = .047). In addition, some PET textural features significantly differed between females with ADC and males with ADC and SCC; short run emphasis, long run emphasis, coarseness, strength, short-zone emphasis, zone percentage and high-intensity large-zone percentage were the commonly differed textural features. However, the TSRs and PET textural features did not significantly differ between males with ADC or SCC.Intratumoral heterogeneity in females with lung ADC differs from that in males with lung ADC or SCC.
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Affiliation(s)
| | | | - Su Jin Lee
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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Kobayashi K, Watanabe N, Oka T, Tomita H, Suzui N, Oumi Y, Hara A, Miyazaki T. A case of lung adenocarcinoma complicated by pulmonary talcosis occurring in a patient employed in the confectionery industry. Pathol Int 2019; 69:229-234. [PMID: 30775827 DOI: 10.1111/pin.12772] [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: 09/02/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022]
Abstract
A 73-year-old Japanese man, who worked at a confectionery company for more than 20 years, was diagnosed with a 28 mm nodular lesion in the superior lobe of the right lung by whole-body computed tomography examination. A biopsy revealed the presence of adenocarcinoma. With a diagnosis of a primary lung cancer, a right upper lobectomy was performed. A nodular lesion, 25 × 23 mm in size, was observed in the upper right lobe lung field, and was diagnosed histopathologically as a papillary adenocarcinoma. In addition, fibrous scars in the central part of the tumor showed numerous Langhans and/or foreign body giant cells, and histiocytic cells that had phagocytized numerous small transparent crystals, together with coal powder deposition. The extracted crystals were observed with a scanning electron microscope, and although plate-like structures were observed, ferruginous bodies suggestive of asbestos were not found. The crystals were demonstrated to be talc by powder X-ray diffraction. Herein, we investigated a case of lung adenocarcinoma in a patient with talcosis, with discussions based on a literature search. This collision of talcosis and lung adenocarcinoma adds to an increasing body of knowledge on an apparent association between talc and cancer cases.
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Affiliation(s)
| | - Naoki Watanabe
- Division of Pathology, Gifu Municipal Hospital, Gifu-City, Japan
| | - Teruaki Oka
- Division of Pathology, Kanto Central Hospital, Tokyo, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu-City, Japan
| | - Natsuko Suzui
- Department of Pathology, Gifu University Hospital, Gifu-City, Japan
| | - Yasunori Oumi
- Division of Instrumental Analysis, Life Science Research Center, Gifu University, Gifu-City, Japan
| | - Akira Hara
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu-City, Japan
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Chen Y, Kang Y, Hong L, Yao H. Hypoglycemia caused by co-secretion of insulin from lung tumor and cardia cancer: first case report. SAO PAULO MED J 2019; 137:100-103. [PMID: 29166433 PMCID: PMC9721221 DOI: 10.1590/1516-3180.2017.0136060617] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 06/06/2017] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.
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Affiliation(s)
- Yaning Chen
- Attending Physician, Department of Endocrinology, General Navy Hospital of PLA, Beijing, China.
| | - Yi Kang
- Attending Physician, Department of Endocrinology, General Navy Hospital of PLA, Beijing, China.
| | - Liu Hong
- MD. Professor, Department of Endocrinology, General Navy Hospital of PLA, Beijing, China.
| | - Hebin Yao
- MD. Professor, Department of Pathology, General Navy Hospital of PLA, Beijing, China.
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Liao M, Liu Q, Li B, Liao W, Xie W, Zhang Y. A group of long noncoding RNAs identified by data mining can predict the prognosis of lung adenocarcinoma. Cancer Sci 2018; 109:4033-4044. [PMID: 30290038 PMCID: PMC6272079 DOI: 10.1111/cas.13822] [Citation(s) in RCA: 13] [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: 07/11/2018] [Revised: 09/23/2018] [Accepted: 10/02/2018] [Indexed: 12/25/2022] Open
Abstract
Long noncoding RNAs (lncRNA) are reported to be potential cancer biomarkers. This study aims to find new lncRNA biomarker relevant to lung adenocarcinoma. Gene expression profile and clinical data of lung adenocarcinoma and lung squamous cell carcinoma patients were downloaded from the UCSC Xena database. These data were analyzed to identify potential lncRNA prognostic biomarkers, and the candidate lncRNAs were analyzed and verified with association analysis, meta-analysis, survival analysis, gene ontology analysis, gene set enrichment analysis, and other statistical methods. A group of 5 lncRNAs was identified from the 1965 differentially expressed (fold-change >2) genes. Four of these 5 lncRNAs were expressed at a lower level in lung adenocarcinoma tissues and the other one at a higher level (P < .0001). A risk score model was constructed using a linear combination of the expression levels of these lncRNAs. High-risk patients showed poorer overall survival (hazard ratio [HR] = 2.14; 95% confidence interval [CI], 1.67-3.06, P < .0001), disease-free survival (HR = 1.84; 95% CI, 1.26-2.35, P = .0007), and recurrence-free survival (HR = 1.51; 95% CI, 1.02-2.40, P = .04). The 5-fold cross-validation and subsequent meta-analysis further verified that patients in the low-risk group had better survival (95% CI, 0.74-1.79, Z = 4.72, P < .00001). Furthermore, both univariate and multivariate Cox regression analyses revealed that the prognostic value of these 5 lncRNAs was independent of other clinical prognostic factors. Further analysis indicated that these 5 lncRNAs might be associated with tumor metastasis. Taken together, our study suggests new prognostic lncRNA biomarkers for lung adenocarcinoma.
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Affiliation(s)
- Meijian Liao
- School of Life Sciences, Tsinghua University, Beijing, China.,Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Qing Liu
- School of Life Sciences, Tsinghua University, Beijing, China.,Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Bing Li
- School of Life Sciences, Tsinghua University, Beijing, China.,Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Weijie Liao
- School of Life Sciences, Tsinghua University, Beijing, China.,Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Weidong Xie
- Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China.,Open FIESTA Center, Tsinghua University, Shenzhen, China
| | - Yaou Zhang
- Key Laboratory in Health Science and Technology, Division of Life Science and Health, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China.,Open FIESTA Center, Tsinghua University, Shenzhen, China
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42
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Bukhari S, Soomro R, Fawwad S, Alvarez C, Wallach S. Adenocarcinoma of Lung Presenting as Lambert-Eaton Myasthenic Syndrome. J Investig Med High Impact Case Rep 2017; 5:2324709617721251. [PMID: 28785598 PMCID: PMC5521354 DOI: 10.1177/2324709617721251] [Citation(s) in RCA: 2] [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: 03/19/2017] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 11/30/2022] Open
Abstract
Lambert-Eaton myasthenic syndrome (LEMS) is a paraneoplastic neuromuscular junction disorder. LEMS presents with muscular weakness and fatigability, mainly involving the proximal lower limbs. There are 2 types of LEMS depending on the etiology: paraneoplastic and idiopathic. The paraneoplastic form, which constitutes more than a half of the cases, is mostly associated with intrathoracic neoplasms. Most cases are seen in patients with small cell lung cancer; other subtypes of lung cancer are extremely rare. In this article, we report a case of LEMS as a rare association with adenocarcinoma of the lung.
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Affiliation(s)
- Sumera Bukhari
- St. Francis Medical Center, Seton Hall University, Trenton, NJ, USA
| | - Rabia Soomro
- St. Francis Medical Center, Seton Hall University, Trenton, NJ, USA
| | - Shaikh Fawwad
- St. Francis Medical Center, Seton Hall University, Trenton, NJ, USA
| | - Chikezie Alvarez
- St. Francis Medical Center, Seton Hall University, Trenton, NJ, USA
| | - Sara Wallach
- St. Francis Medical Center, Seton Hall University, Trenton, NJ, USA
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43
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Yuan M, Pu XH, Xu XQ, Zhang YD, Zhong Y, Li H, Wu JF, Yu TF. Lung adenocarcinoma: Assessment of epidermal growth factor receptor mutation status based on extended models of diffusion-weighted image. J Magn Reson Imaging 2017; 46:281-289. [PMID: 28054731 DOI: 10.1002/jmri.25572] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 09/29/2016] [Accepted: 11/15/2016] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To evaluate the diagnostic performance of extended models of diffusion-weighted (DW) imaging to help differentiate the epidermal growth factor receptor (EGFR) mutation status in stage IIIA-IV lung adenocarcinoma. MATERIALS AND METHODS This retrospective study had institutional research board approval and was HIPAA compliant. Preoperative extended DW imaging including intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) 3 Tesla MRI were retrospectively evaluated in 53 patients with pathologically confirmed non-early stage (IIIA-IV) lung adenocarcinoma. EGFR mutationsat exons 18-21 were determined by using polymerase chain reaction-based ARMS. Quantitative parameters (mean, kurtosis, skewness, 10th and 90th percentiles) of IVIM (true-diffusion coefficient D, pseudo-diffusion coefficient D*, and perfusion fraction f) and DKI (kurtosis value Kapp, kurtosis corrected diffusion coefficient Dapp) were calculated by outlining entire-volume histogram analysis. Receiver operating characteristic analysis was constructed to determine the diagnostic performance of each parameter. Multivariate logistic regression was used to differentiate the probability of EGFR mutation status. RESULTS Twenty-four of 53 patients with lung adenocarcinoma were EGFR mutations, which occurred most often in acinar (10 of 13 [76.9%]) and papillary predominant tumors (9 of 13 [69.2%]). Patients with EGFR mutation showed significant higher 10th percentile of D, lower D* value in terms of kurtosis, and lower Kapp value in terms of mean, skewness, 10th and 90th percentiles (all P values < 0.05). The 90th Kapp showed significantly higher sensitivity (97%; P < 0.05) and Az (0.817; P < 0.05) value. Multivariate logistic regression showed 90th Kapp was a independent factor for determining EGFR mutation with odds ratio -1.657. CONCLUSION Multiple IVIM and DKI parameters, especially the histogram 90th Kapp value, helped differentiate EGFR mutation status in stage IIIA-IV lung adenocarcinoma. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:281-289.
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Affiliation(s)
- Mei Yuan
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xue-Hui Pu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yu-Dong Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Zhong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | | - Tong-Fu Yu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Bashir ES, Kwan AKN, Chan CYW, Mun Keong K. Remarkable bone formation following gefitinib for extensive lytic bone metastasis: a report of two cases. J Orthop Surg (Hong Kong) 2016; 24:421-423. [PMID: 28031519 DOI: 10.1177/1602400330] [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] [Indexed: 11/15/2022] Open
Abstract
Gefitinib inhibits the epidermal growth factor receptor tyrosine kinase and improves survival in patients with non-small-cell lung cancer. We report 2 patients with extensive lytic bony metastasis in the spine and pelvis secondary to advanced pulmonary adenocarcinoma who were treated with gefitinib and had remarkable bone formation in the lytic bone lesions in the spine and pelvis. Surgery for stabilisation was avoided.
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Affiliation(s)
| | - Angel Khor Nee Kwan
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kwan Mun Keong
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Rau KM, Chen HK, Shiu LY, Chao TL, Lo YP, Wang CC, Lin MC, Huang CC. Discordance of Mutation Statuses of Epidermal Growth Factor Receptor and K-ras between Primary Adenocarcinoma of Lung and Brain Metastasis. Int J Mol Sci 2016; 17:524. [PMID: 27070580 DOI: 10.3390/ijms17040524] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 12/11/2022] Open
Abstract
Mutations on epidermal growth factor receptor (EGFR) of adenocarcinomas of lung have been found to be associated with increased sensitivity to EGFR tyrosine kinase inhibitors and K-ras mutations may correlate with primary resistance. We aimed to explore the discordant mutation statuses of EGFR and K-ras between primary tumors and matched brain metastases in adenocarcinomas of lung. We used a sensitive Scorpion ARMS method to analyze EGFR mutation, and Sanger sequencing followed by allele-specific real-time polymerase chain reaction to analyze K-ras mutation. Forty-nine paired tissues with both primary adenocarcinoma of lung and matched brain metastasis were collected. Thirteen patients (26.5%) were discordant for the status of EGFR between primary and metastatic sites. K-ras gene could be checked in paired specimens from 33 patients, thirteen patients (39.6%) were discordant for the status of K-ras. In primary lung adenocarcinoma, there were 14 patients of mutant EGFR had mutant K-ras synchronously. This study revealed that the status of EGFR mutation in lung adenocarcinomas is relatively consistent between primary and metastatic sites compared to K-ras mutation. However, there are still a few cases of adenocarcinoma of lung showing discordance for the status of EGFR mutation. Repeated analysis of EGFR mutation is highly recommended if tissue from metastatic or recurrent site is available for the evaluation of target therapy.
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Pineda AL, Ogoe HA, Balasubramanian JB, Rangel Escareño C, Visweswaran S, Herman JG, Gopalakrishnan V. On Predicting lung cancer subtypes using 'omic' data from tumor and tumor-adjacent histologically-normal tissue. BMC Cancer 2016; 16:184. [PMID: 26944944 PMCID: PMC4778315 DOI: 10.1186/s12885-016-2223-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/28/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adenocarcinoma (ADC) and squamous cell carcinoma (SCC) are the most prevalent histological types among lung cancers. Distinguishing between these subtypes is critically important because they have different implications for prognosis and treatment. Normally, histopathological analyses are used to distinguish between the two, where the tissue samples are collected based on small endoscopic samples or needle aspirations. However, the lack of cell architecture in these small tissue samples hampers the process of distinguishing between the two subtypes. Molecular profiling can also be used to discriminate between the two lung cancer subtypes, on condition that the biopsy is composed of at least 50 % of tumor cells. However, for some cases, the tissue composition of a biopsy might be a mix of tumor and tumor-adjacent histologically normal tissue (TAHN). When this happens, a new biopsy is required, with associated cost, risks and discomfort to the patient. To avoid this problem, we hypothesize that a computational method can distinguish between lung cancer subtypes given tumor and TAHN tissue. METHODS Using publicly available datasets for gene expression and DNA methylation, we applied four classification tasks, depending on the possible combinations of tumor and TAHN tissue. First, we used a feature selector (ReliefF/Limma) to select relevant variables, which were then used to build a simple naïve Bayes classification model. Then, we evaluated the classification performance of our models by measuring the area under the receiver operating characteristic curve (AUC). Finally, we analyzed the relevance of the selected genes using hierarchical clustering and IPA® software for gene functional analysis. RESULTS All Bayesian models achieved high classification performance (AUC > 0.94), which were confirmed by hierarchical cluster analysis. From the genes selected, 25 (93 %) were found to be related to cancer (19 were associated with ADC or SCC), confirming the biological relevance of our method. CONCLUSIONS The results from this study confirm that computational methods using tumor and TAHN tissue can serve as a prognostic tool for lung cancer subtype classification. Our study complements results from other studies where TAHN tissue has been used as prognostic tool for prostate cancer. The clinical implications of this finding could greatly benefit lung cancer patients.
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Affiliation(s)
- Arturo López Pineda
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Boulevard, 15206, Pittsburgh, PA, USA.
| | - Henry Ato Ogoe
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Boulevard, 15206, Pittsburgh, PA, USA.
| | - Jeya Balaji Balasubramanian
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Boulevard, 15206, Pittsburgh, PA, USA.
| | - Claudia Rangel Escareño
- Department of Computational Genomics, National Institute of Genomic Medicine, Periferico Sur No. 4809, Col. Arenal Tepepan, Tlalpan, 14610, Mexico City, Mexico.
| | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Boulevard, 15206, Pittsburgh, PA, USA.
| | - James Gordon Herman
- Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Cancer Pavilion, 5150 Centre Avenue, 15232, Pittsburgh, PA, USA.
| | - Vanathi Gopalakrishnan
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Boulevard, 15206, Pittsburgh, PA, USA.
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郑 少, 李 书, 王 红, 谢 晓, 张 雅. [Isolation and identification of CD133 positive and negative cells from human lung cancer and screening of the differential genes between the positive and negative cells]. Zhongguo Fei Ai Za Zhi 2015; 18:123-30. [PMID: 25800567 PMCID: PMC6000004 DOI: 10.3779/j.issn.1009-3419.2015.03.01] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/22/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE It has been proven that cancer stem cell existed in variety of cancer, which an significant difference of biological characteristics was observed between the cancer stem cells and non-cancer stem cells. And CD133 is considered to be cancer stem cell marker. So there may be significant differences in CD133- positive cells and CD133-negative cells. The aim of this study is to isolate CD133+ cells and CD133- cells from lung cancer cell line A549, explore their biological characteristics and screen the metastasis-related genes. METHODS MACS was applied to isolate CD133+ cells and CD133- cells from human lung cancer cell line A549. To observe the formation of sphere, CD133+ cells and CD133- cells were cultured in serum-free DMEM-F12 medium (containing EGF, bFGF) in vitro. The colony formatting efficiency of CD133+ cells, CD133- cells and cells without sorting was tested by colony-forming assay. The differentiation of sphere was induced by culturing in DMEM-F12 medium (containing serum). The metastasis-related genes (84 genes) of CD133+ cells and CD133- cells were detected by using DNA microarray. Immunohistochemistry was used to detect the expression of CD133 protein in Human lung cancer tissue. RESULTS CD133+ cells formed sphere in serum-free DMEM-F12 medium,while the CD133- cells failed to form sphere. The rates of CD133+ cell colony formation (57.1%) was significantly higher than that of CD133- cells (3.3%). Sphere (CD133+/CK7-) was induced to differentiate, and CK7 expression was found in differentiated cells. The expression levels of 19 metastasis-related genes from CD133+ cells and CD133- cells were significant different. Little CD133 positive cells which distributing around the cancer nests were found in lung cancer tissue. The expression of CD133 was not related to tumor types, cell differentiation or TNM stage. CONCLUSIONS CD133+ cells exhibit the characteristics of cancer stem cells. The difference of metastasis-related gene expression levels was discovered between CD133+ cells and CD133- cells. CD82 plays an important role in mechanism of tumor metastasis.
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Affiliation(s)
- 少秋 郑
- 514031 梅州,梅州市人民医院病理科Department of Pathology, Meizhou People's Hospital, Meizhou 514031, China
| | - 书华 李
- 510182 广州,广州医科大学病理教研室Department of Pathology, Guangzhou Medical University, Guangzhou 510182, China
| | - 红艳 王
- 510182 广州,广州医科大学病理教研室Department of Pathology, Guangzhou Medical University, Guangzhou 510182, China
| | - 晓斌 谢
- 510182 广州,广州医科大学病理教研室Department of Pathology, Guangzhou Medical University, Guangzhou 510182, China
| | - 雅洁 张
- 510182 广州,广州医科大学病理教研室Department of Pathology, Guangzhou Medical University, Guangzhou 510182, China
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Pan D, Wang B, Zhou X, Wang D. Clinical study on gefitinib combined with γ-ray stereotactic body radiation therapy as the first-line treatment regimen for senile patients with adenocarcinoma of the lung (final results of JLY20080085). Mol Clin Oncol 2014; 1:711-715. [PMID: 24649233 PMCID: PMC3915633 DOI: 10.3892/mco.2013.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 11/28/2012] [Accepted: 04/05/2013] [Indexed: 01/12/2023] Open
Abstract
Lung cancer is one of the most commonly encountered human malignancies. Due to the increase in life expectancy as well as the incidence of lung cancer, the incidence of senile lung cancer has increased significantly. We conducted a study to evaluate the efficacy and safety of gefitinib combined with γ-ray stereotactic body radiation therapy (SBRT) as the first-line treatment regimen for senile patients with adenocarcinoma of the lung. A total of 122 senile patients with adenocarcinoma of the lung were divided into 3 groups according to the treatment method. Group A included 35 patients treated with gefitinib combined with γ-ray SBRT, group B included 45 patients treated with γ-ray SBRT alone and group C included 42 patients treated with gefitinib alone. The patients received 250 mg of gefitinib per day, from the first day of the treatment until disease progression or discontinuation due to other causes. The patients were treated with γ-ray SBRT, initiated on the second day. The dose curve for this case group was 50–80%. The encircled dose was 4.0–6.5 Gy per fraction and the range of the total radiation dose was 36–48 Gy. The total number of treatments was 8–12, at a frequency of 5 times per week. All 122 patients were assessed by contrast-enhanced double helical computed tomography (CT) at 2 months. The tumor response rate (RR) of group A was 68.6% (24/35), the disease control rate (DCR) was 88.6% (31/35), the median overall survival (OS) was 15.5 months (range, 3–52 months) and the progression-free survival (PFS) was 7.8 months. The 1-year OS rate was 40.0% (14/35). The main side effects included skin rash and diarrhea. The RR of group B was 51.1% (23/45), the DCR was 71.1% (32/45), the OS was 9.6 months (range, 3–22 months) and the PFS was 5.3 months. The 1-year OS rate was 15.6% (7/45). The RR of group C was 40.5% (17/42), the DCR was 61.9% (26/42), the OS was 10.3 months (range, 3–26 months) and the PFS was 5.1 months. The 1-year OS rate was 35.7% (15/42). The main side effects included skin rash and diarrhea. The short-term therapeutic effect (RR) in group A was higher compared to that in group C (P=0.014, χ2=6.053); however, there was no significant difference compared to group B (P=0.116, χ2=2.477). The PFS of group A was higher compared with that of groups B and C (7.8 vs. 5.9, P=0.018 and 7.8 vs. 5.1, P=0.013, respectively). The OS of group A was higher compared with that of groups B and C (15.5 vs. 9.6, P=0.002 and 15.5 vs. 10.3, P=0.017, respectively). No significant differences were observed in PFS and OS between groups B and C. In conclusion, gefitinib combined with γ-ray SBRT appears to be feasible and effective as the first-line treatment in senile patients with adenocarcinoma of the lungs.
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Affiliation(s)
- Dejian Pan
- Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi, Jiangsu 214044
| | - Biao Wang
- Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi, Jiangsu 214044
| | - Xijian Zhou
- Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi, Jiangsu 214044
| | - Donglin Wang
- Department of Oncology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China
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