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K. Miwa



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    P1.02 - Biology/Pathology (ID 614)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 2
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      P1.02-060 - Podoplanin Expression in Cancer-associated Fibroblasts Predicts Poor Prognosis in Patients with Squamous Cell Carcinoma of the Lung (ID 8104)

      09:30 - 16:00  |  Author(s): K. Miwa

      • Abstract
      • Slides

      Background:
      Podoplanin is a candidate cancer stem cell marker in squamous cell carcinoma (SCC). Several studies have reported the prognostic value of podoplanin expression in tumor cells in lung SCC but few have focused on its expression in cancer-associated fibroblasts (CAFs). The aim of this study was to analyze the prognostic significance of podoplanin expression, with special reference to the expression pattern in both tumor cells and CAFs.

      Method:
      Immunohistochemical analyses using anti-podoplanin antibody were performed on 126 resected specimens of lung SCC. When more than 10% of tumor cells or CAFs showed immunoreactivity with podoplanin levels as strong as those of the positive controls, the specimens were classified as a podoplanin-positive.

      Result:
      Podoplanin-positive status in tumor cells (n=54) was correlated with a lower incidence of lymphatic invasion (p=0.031) but there were no significant differences in diseasefree survival (DFS) and disease-specific survival (DSS) by the log-rank test. Podoplanin-positive status in CAFs (n=41) was correlated with more advanced stage (p=0.008), higher frequency of pleural invasion (p=0.002) and both shorter DFS (p=0.006) and DSS (p=0.006). In Cox’s multivariate analysis, podoplanin-positive status in CAFs was an independent negative prognostic factor for DFS (p=0.027) and DSS (p=0.027). Figure 1



      Conclusion:
      Podoplanin expression in CAFs might be an independent unfavorable prognostic indicator in patients with lung SCC, irrespective of the expression status of tumor cells.

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      P1.02-061 - Podoplanin Expression in Cancer-Associated Fibroblasts Predicts Unfavourable Prognosis in Patients with Stage IA Adenocarcinoma (ID 8140)

      09:30 - 16:00  |  Author(s): K. Miwa

      • Abstract
      • Slides

      Background:
      Podoplanin expression in cancer-associated fibroblasts (CAFs) has been proposed as an unfavourable indicator in squamous cell carcinoma of the lung, but little is known about its clinical significance in early-stage lung adenocarcinoma. The aim of the present study was to evaluate the prognostic impact of podoplanin expression in patients with pathological stage IA lung adenocarcinoma classified by the new tumour-node-metastasis (TNM) system.

      Method:
      Paraffin-embedded tissue samples from 148 curatively resected patients with pathological stage IA1-3 lung adenocarcinoma were analyzed immunohistochemically using an antibody for podoplanin. When more than 10% of cancer cells or CAFs showed immunoreactivity with podoplanin, the specimens were classified as podoplanin-positive. The association between podoplanin expression status and clinicopathological factors was evaluated by the performing non-parametric tests. For the survival analysis, two different endopoints, cancer relapse and cancer-related death, were used to calculate disease-free survival (DFS) and disease-specific survival (DSS), respectively.

      Result:
      Podoplanin-positive status in cancer cells (n = 8) correlated with neither clinicopathological factors nor patients’ prognosis. Podoplanin-positive status in CAFs (n = 43) was significantly correlated with poorer differentiation (P = 0.003), the presence of lymphatic invasion (P < 0.001) and high-grade (solid and/or micropapillary) component (P = 0.005). The log-rank test showed that podoplanin expression in CAFs was significantly associated with both shorter disease-free survival (DFS) (P < 0.001) and disease-specific survival (DSS) (P = 0.002). According to Cox’s multivariate analysis, podoplanin-positive status in CAFs had the most significant effect on shorter DFS (hazard ratio [HR] = 6.037, P = 0.001) followed by the presence of high-grade component (HR = 3.82, P = 0.009).

      Conclusion:
      Podoplanin expression in CAFs could be an independent predictor of increased risk of recurrence in patients with pathological stage IA1-3 lung adenocarcinoma. Our result suggested that immunohistochemical analysis using antibodies to podoplanin, which has been routinely performed, could be useful not only for the detection of lymphatic vessel invasion but also for predicting an aggressive tumour phenotype in patients with lung adenocarcinoma.

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    P1.13 - Radiology/Staging/Screening (ID 699)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.13-008 - Evaluation of Clinical Associated Factors for Lung Adenocarcinoma by TNM 8th Edition with Unexpected N2 disease (ID 8918)

      09:30 - 16:00  |  Author(s): K. Miwa

      • Abstract
      • Slides

      Background:
      Among patients with lung adenocarcinoma, some of them diagnosed as clinical N0 (cN0) are staged as pathological N2(pN2 ; unexpected N2 disease). The aim of this study is to analyze preoperative factors of unexpected N2 disease.

      Method:
      We retrospectively reviewed 361 cN0 lung adenocarcinoma patients who underwent curative resection between January 2005 to December 2016 in our institution. Patients were staged according to findings of computer tomography (CT), positron emission tomography (PET), and/or transbronchial needle aspiration (TBNA). We analyzed their clinical features, comparing pN0 group with pN2 group. Especially, we focused on the diameter of solid component by TNM classification 8[th] edition.

      Result:
      There were 37 patients (10.2%) with unexpected N2 disease. Of the 37 patients, 10 patients (27.0%) had metastasis in Single-station N2 without N1 involvement (skip N2 disease), 14 patients (37.8%) had in Single-station N2 and 13 patients (35.1%) had in Multiple-station N2. There was no difference in the tumor size between pN0 and pN2 (p=0.100). However, the diameter of solid component was larger in pN2 than in pN0 (p<0.001), C/T ratio (p<0.001), maximum standard uptake value (p<0.001), and CEA (p=0.005) were higher in pN2 than in pN0. Multivariate logistic regression analysis identified the diameter of solid component and CEA as significant associated factors for unexpected N2 disease (p=0.006, p=0.01).

      Conclusion:
      The possibility of unexpected N2 disease increases with the larger diameter of solid component or higher CEA. Particularly, in order to discover unexpected N2 disease in lung adenocarcinoma, it is reasonable to evaluate T-factor by TNM classification 8[th] edition.

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