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Akif Turna



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    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.04-10 - The Importance of Suppressor and Cytotoxic T Lymphocyte Subsets and Cytotoxic Mechanisms in Non-Small Cell Lung Cancer (ID 14413)

      16:45 - 18:00  |  Presenting Author(s): Akif Turna

      • Abstract
      • Slides

      Background

      Lung cancer represents the second most frequent cause of death worldwide, and most common subtype of lung cancer is non-small cell lung cancer (NSCLC). Recent trials showed that deficiencies in anti-tumor immunity play a major role in carcinogenesis of NSCLC. CD8+CD28 cytotoxic T (Tc) cells and CD4+CD25+FoxP3+ regulatory T (Treg) cells known as suppresor CD4+ T cells, have been shown to exist in tumor tissues and inhibits the anti-tumoral immune responses. Natural killer (NK) cells are cytokine producing innate lymphoid cells having cytotoxic capacity to kill tumor cells. In this study the prevalence of Treg cells and CD28 expressing Tc cells and cytotoxic functions were analyzed.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The study groups comprised patients with newly-diagnosed non-small cell lung cancer (NSCLC) (n=46) with T1-3N0M0 NSCLC, none of whom had received preoperative chemotherapy and/or radiotherapy, and healthy subjects (n=46). The prevalence of CD3-CD16+CD56+ NK cells, CD4+CD25+Foxp3+ regulatory (Treg) and CD8+CD28T cells were analyzed by flow cytometry. Cytotoxic capacity of NK and CD8+ T cells were analyzed by CD107a degranulation assay.

      4c3880bb027f159e801041b1021e88e8 Result

      NK and CD8+CD28- suppressor T cells were increased however percentage of activator CD8+CD28+T lymphocytes were significantly decreased in patients with NSCLC compared to healthy subjects (p=0.002, p=0.005, p=0.000, p=0.001, p=0.001, p=0.02 and p=0.02, respectively). Although the cytotoxic activity of NK cells did not differ between the groups, CD107a expression was found increased in total CD8+ T cells in unstimulated and K562 stimulation (p=0.001). Although the number of Treg cells are decreased in the NSCLC group but this is not statistically significant. No statistically signficant difference was found in terms of lymphocyte subsets and NK cells between the patients with early(T1) and late stages(T2-3).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our findings showed that suppressor CD8+CD28- T cell subset as well as NK cells were increased in patients with operable NSCLC. Increased CD8+CD28- T cells might cause supression of antitumour immunity and their prevalence might be useful to assess immunotherapy outcomes in patients. Although the number of NK cells increased significantly, the activity of NK cells did not show difference. Functional evaluation of cells has been found to be more important than cell populations.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.16-42 - Standard Mediastinoscopy Versus Video-Assisted Mediastinoscopic Lymphadectomy in Clinical N1 Non-Small Cell Lung Cancer (ID 14399)

      16:45 - 18:00  |  Presenting Author(s): Akif Turna

      • Abstract
      • Slides

      Background

      A considerable number of patients with clinical N1 (cN1) non-small cell lung cancer (NSCLC) based on positron emission tomography–computed tomography (PET-CT) imaging have occult mediastinal nodal involvement (N2 disease). We aimed to compare the role of video-assisted mediastinoscopy lymphadenectomy(VAMLA) and standard mediastinoscopy in pre-resectional mediastinal staging in patients with cN1 disease.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 821 patients with potentially resectable NSCLC seen between January 2004 and November 2016 were included in the study. The preoperative mediastinal staging was accomplished by standard cervical mediastinoscopy or VAMLA in all patients except those with peripheral cT1N0 tumors. Resection via thoracotomy or video-assisted thoracoscopic surgery was performed in patients with no mediastinal lymph node metastasis. A systematic lymph node sampling or systematic lymph node dissection was performed during resectional surgery. Surgical-pathological results were compared with the pathological findings. Primary aim was to compare the sensitivities and accuracies to detect N2 by two methods.

      4c3880bb027f159e801041b1021e88e8 Result

      Out of 85 patients with cN1 on PET-CT, a mediastinal metastasis was disclosed in 29 patients (34.1%). Of 56 patients who underwent VAMLA 24(42.9%) were found to have N2/3 disease, whereas standard mediastinoscopy revealed N2/N3 disease in 7 patients(24.1%)(p=0.029) VAMLA and standard mediastinoscopy had both sensitivities of 85.7% to detect N2 disease(p=1). The NPVs were 87.5% and 85.7% by VAMLA and standard mediastinoscopy respectively(p=0.821).

      8eea62084ca7e541d918e823422bd82e Conclusion

      VAMLA is more accurate to detect mediastinal nodal disease in operable cN1 lung cancer, and could be used in patients with cN1 NSCLC patients since it discloses N2 disease in an important fraction of patients.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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      P2.16-43 - Diabetes is a Negative Prognostic Factor in Non-Small Cell Lung Cancer Patients Undergoing Resectional Surgery (ID 14409)

      16:45 - 18:00  |  Presenting Author(s): Akif Turna

      • Abstract
      • Slides

      Background

      During the last decades, lung cancer has been a major health problem as it is one of the leading causes of cancer death among both genders all over the world other than subsaharan Africa. Diabetes mellitus(DM) can also be a possible prognostic factor because it effects similar age groups with non small cell lung cancer(NSCLC).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 634 patients with resected NSCLC seen between January 2004 and June 2017 were included in the study. The preoperative mediastinal staging was performed by video-assisted cervical mediastinoscopy or video-assisted mediastinoscopic lymphadenectomy in all patients except those with peripheral cT1N0 non-adenocarcinoma tumors. Possible prognostic factors such as presence of diabetes mellitus(DM), gender, age, smoking history, clinical stage, histology and laboratory parameters were recorded.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 84 patients (13.2%) were found to have DM. The median survival time of patients with or without DM were 33.0 months(95% confidence interval: 26.5-39.5 months) and 127.0 months respectively(p<0.001). T and N factors were found to be prognostic parameters (p<0.001, p=0.01 respectively). When we analyzed only male patients(n=544), DM was found to be highly significantly associated with worse survival (p<0.001). Multivariate Cox analysis showed that absence of DM(p<0.001), absence of nodal metastasis(p=0.007), and lower T factor (p=0.04) were independently good prognostic elements in resected patients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      We concluded that, presence DM was independently associated with worse survival in lung cancer patients who underwent resectional surgery.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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