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Young Wha Koh



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    P1.02 - Biology/Pathology (ID 614)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P1.02-021 - Can <sup>18</sup>F-FDG PET/CT Predict the Pathological Necrosis and Microvessel Density in Lung Adenocarcinomas (ID 7987)

      09:30 - 16:00  |  Presenting Author(s): Young Wha Koh

      • Abstract

      Background:
      Tumor hypoxia is characterized by necrosis and a low microvessel density (MVD). Necrosis and MVD are invaluable tools for predicting survival outcomes in non-small-cell lung cancer (NSCLC). Furthermore, hypoxia increases the extent of resistance to gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in lung adenocarcinomas. However, the invasive nature of tumor sampling remains a major clinical obstacle. [18]F-fluorodeoxyglucose positron emission tomography ([18]F-FDG PET) accumulation is a well-validated in vivo measure of tissue glucose metabolism and hypoxia. We hypothesized that [18]F-FDG PET could identify tumor necrosis of, and quantify the MVD in lung adenocarcinoma. Therefore, we investigated the relationship between preoperative [18]F-FDG PET parameters and tumor necrosis and MVD. Hypoxia biomarkers including glucose transporter type 1 (GLUT1), carbonic anhydrase IX and vascular endothelial growth factor were also evaluated.

      Method:
      Data on 164 patients who underwent the surgical resection of pulmonary adenocarcinomas were retrospectively reviewed. Preoperative [18]F-FDG-PET data, the extent of tumor necrosis, and immunohistochemical measures of the expression of GLUT1, carbonic anhydrase IX, vascular endothelial growth factor, and CD31 for detecting MVD were evaluated. The associations between PET parameters and the levels of pathological markers, and the prognostic significance of necrosis, were evaluated.

      Result:
      The standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) level were significantly lower in patients exhibiting no necrosis compared to those with partial or diffuse necrosis. When we divided the patients into two groups based on high vs. low PET parameter values, elevated SUVmax, MTV, and TLG values were significantly more associated with partial or diffuse necrosis than were lower values (p<0.001). A negative correlation was evident between the MVD and SUVmax (p=0.002), MVD and MTV (p=0.038), and MVD and TLG (p=0.019). GLUT1 expression correlated with high PET parameter values, a low MVD, and the presence of necrosis. Patients without necrosis exhibited better 5-year recurrence-free survival and overall survival than patients with necrosis (p<0.001 and p=0.007, respectively). However, a multivariate analysis revealed that necrosis was not of prognostic significance.

      Conclusion:
      High-level FDG accumulation predicted tumor necrosis. Clinicians can thus predict prognosis and improve treatment policies by reference to PET parameters.

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    P2.02 - Biology/Pathology (ID 616)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P2.02-060 - Prognostic Significance of EDIL3 Expression and Correlation with Mesenchymal Phenotype and Microvessel Density in Lung Adenocarcinoma (ID 9109)

      09:30 - 16:00  |  Presenting Author(s): Young Wha Koh

      • Abstract

      Background:
      Epidermal Growth Factor-like repeats and Discoidin I-Like Domains 3 (EDIL3), is a secreted glycoprotein associated with endothelial cell surface and extracellular matrix. Overexpressed EDIL3 can contribute to carcinogenesis by promoting cancer vascularization and epithelial–mesenchymal transition. Therefore, EDIL3 might be a good candidate target for developing novel cancer anti-angiogenic therapy. Although the associations among EDIL3, mesenchymal phenotype, and angiogenesis have been observed in several malignancies, no study has examined the relationships among EDIL3, mesenchymal phenotype, and angiogenesis or the prognostic significance of EDIL3 expression in non-small cell lung carcinoma (NSCLC) patients. We examined the prognostic significance of EDIL3 expression and its correlations with mesenchymal phenotype and microvessel density in NSCLC.

      Method:
      A total of 268 NSCLC specimens were evaluated retrospectively by immunohistochemical staining for EDIL3, epithelial–mesenchymal transition (EMT) markers (e-cadherin, β-catenin, and vimentin), and CD31 to measure microvessel density. we performed real-time qRT PCR for EDIL3 expression

      Result:
      EDIL3, e-cadherin, β-catenin, and vimentin were expressed in 16%, 22.8%, 3.7%, and 10.1% of the specimens, respectively. The mRNA level of EDIL3 in tumor was correlated with the level of EDIL3 protein expression using immunohistochemistry. In lung adenocarcinoma patients, EDIL3 expression was significantly correlated with mesenchymal phenotype (low e-cadherin expression and high vimentin expression) and increased microvessel density (P < 0.001, P = 0.001, and P = 0.023, respectively). In lung squamous cell carcinoma patients, EDIL3 expression was significantly correlated with mesenchymal phenotype (low e-cadherin expression and high vimentin expression) (P = 0.021 and P = 0.002, respectively). In lung adenocarcinoma patients, EDIL3 was an independent prognostic factor for overall survival in a multivariate analysis (hazard ratio: 2.552, P = 0.004).

      Conclusion:
      EDIL3 is significantly correlated with mesenchymal phenotype, angiogenesis, and tumor progression in lung adenocarcinoma.