Author of

• 20039

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  Poster Display Session (ID 63)

  • Event: ELCC 2017
  • Type: Poster Display Session
  • Track:
  • Presentations: 2
  • Moderators:
  • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1

  • 19885

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    129P - Procathepsin D as a novel diagnostic marker for malignant pleural effusion of lung cancer (ID 341)

    12:30 - 13:00  |  Author(s): S.H. Jang
    • Abstract

    Background:
    Approximately 20% of pleural effusions are due to malignancy, and 50% of these are due to primary lung cancer. However, the etiology of the effusions is often obscure and various diagnostic procedures may be required in order to find their cause. Cathepsin D (CD) as a lysosomal aspartic protease is one of the most important intracellular enzymes considered to be substantially involved in tumor invasion. Procathespin D (pCD) is overexpressed and secreted by cells of various tumor types. The aim of this study is to evaluate the serum and pleural fluid levels of CD and pCD as a differential diagnostic tool in patients with pleural effusion caused by malignant or benign process.
    
    Methods:
    Patients and pleural fluid collection: The present study included 85 patients (40 patients with lung cancer, 30 patients with tuberculosis, 10 patients with parapneumonic effusion, 5 patients with transudate effusion) who underwent thoracentesis and pleural biopsy. Clinical and pathology data, including tumor type were acquired for all patients. Analysis of CD and pCD: Amounts of CD in the pleural fluid and serum were determined with a cathepsin D ELISA kit and pCD with a sandwich ELISA method.
    
    Results:
    Concentration of pleural CD was not significantly different in patients with malignant pleural effusion compared with non malignant effusion (mean 13.34 vs. 16.72 ng/ml; p > 0.05), and also the concentration of serum CD was not significantly different (mean 41.34 vs. 36.52 ng/ml; p > 0.05). Plasma pCD of malignant pleural effusion and non malignant effusion were 42.03 ng/ml and 38.59 ng/ml, respectively (p > 0.05) but pleural pCD of malignant pleural effusion and non malignant effusion were 84.24 ng/ml and 33.82 ng/ml, respectively with significance (p < 0.05).
    
    Conclusions:
    In this small cohort, the pleural pCD of lung cancer patients showed elevated levels compared with that of non malignant effusion. The pleural fluid levels of pCD could be a diagnostic marker of malignant effusion with lung cancer and further prospective studies might shed more light on the value of CD and pCD in the diagnostics of pleural effusion.
    
    Clinical trial identification:
    
    
    Legal entity responsible for the study:
    Chang Youl Lee
    
    Funding:
    Hallym University Medical Center
    
    Disclosure:
    All authors have declared no conflicts of interest.
    
    

  • 19793

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    12P - Thyroid transcription factor-1 as a prognosticator in patients with metastatic lung adenocarcinoma without EGFR sensitizing mutations (ID 335)

    12:30 - 13:00  |  Author(s): S.H. Jang
    • Abstract

    Background:
    Thyroid transcription factor-1 (TTF-1) expression is known not only as a diagnostic marker but also a good prognosticator among patients with lung adenocarcinoma. However, good prognosis of TTF-1 expression might be due to epidermal growth factor receptor (EGFR) sensitizing mutations because of the positive correlation between TTF-1 expression and EGFR mutations. The purpose of this study was to explore prognostic impact of TTF-1 expression according to EGFR sensitizing mutation status in lung adenocarcinoma.
    
    Methods:
    This is a retrospective analysis of patients with 1) stage IV lung adenocarcinoma having available TTF-1 immunohistochemistry result, 2) ECOG performance status 0-2, and 3) receiving systemic anti-cancer treatment. The data were extracted from the registry of Hallym University Sacred Heart Hospital in Korea, between March 2006 and March 2016.
    
    Results:
    Of the 697 patients with lung adenocarcinoma, 144 patients were included for analysis. The mean age was 65.2 ± 11.6 years (female; 42.4%). EGFR sensitizing mutations were detected in 72/144 (50.0%) patients. TTF-1 was positive in 116/144 (80.6%) patients, and it had a significant correlation with EGFR sensitizing mutations (p < 0.001). Patients with TTF-1 positive lung adenocarcinoma had longer overall survival (OS) than TTF-1 negative (21.4 vs. 6.5 months, p < 0.001). In Cox regression analysis, TTF-1 positivity (hazard ratio [HR] 0.50; 95% CI: 0.31-0.83; p = 0.007), Stage IV, M1a (HR 0.62; 95% CI, 0.40–0.97; p = 0.034), good performance status (ECOG=0; HR 0.52; 95% CI, 0.33–0.82; p = 0.005) and EGFR sensitizing mutations (HR 0.62; 95% CI, 0.39–0.97; p = 0.038) were independently associated with prolonged OS. In the subgroup of patients with wild type EGFR adenocarcinoma, TTF-1 positivity was also good prognosticator for OS (HR 0.58; 95% CI: 0.33-0.99; p = 0.046), and for progression-free survival (PFS) of the first-line cytotoxic chemotherapy (HR 0.43; 95% CI, 0.24–0.78; p = 0.006). (Table).rnTable: 12PCox proportional hazard model of overall survival for 72 patients with lung adenocarcinoma harboring wild type EGFRrn

    rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn

    Covariate	Univariate analysis		Multivariate analysis
    	P value	HR (95% CI)	P value	HR (95% CI)
    Age < 70 vs. ≥ 70	0.986	0.995 (0.607-1.633)	0.563	1.175 (0.680-2.030)
    Female vs. male	0.006	0.425 (0.231-0.780)	0.470	0.563 (0.119-2.676)
    Never smoker vs. ever smoker	<0.001	0.443 (0.248-0.790)	0.980	0.981 (0.222-4.330)
    Stage IV, M1a vs. M1b	0.062	0.602 (0.353-1.027)	0.046	0.569 (0.327-0.991)
    ECOG 0 vs. 1-2	0.016	0.529 (0.316-0.887)	0.076	0.587 (0.325-1.057)
    TTF-1 positive vs. negative	0.060	0.607 (0.360-1.022)	0.046	0.575 (0.334-0.991)
    Pemetrexed, 1[st] line vs. non-pemetrexed containing regimen	0.862	0.956 (0.576-1.587)	0.480	0.829 (0.492-1.395)

    rnHR=Hazard ratio; CI=confidence intervals, ECOG = Eastern Cooperative Oncology Group; EGFR = epidermal growth factor receptor; TTF-1 = thyroid transcription factor 1.rn
    
    Conclusions:
    TTF-1 expression was a good prognosticator for OS and PFS in patients with stage IV lung adenocarcinoma without EGFR sensitizing mutations.
    
    Clinical trial identification:
    
    
    Legal entity responsible for the study:
    Hallym University Sacred Heart Hospital Institutional Ethics Committee
    
    Funding:
    N/A
    
    Disclosure:
    All authors have declared no conflicts of interest.