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Yojiro Yutaka



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    P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)

    • 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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      P1.05-05 - Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Suspected Malignancy; Current Status and Issues (ID 13209)

      16:45 - 18:00  |  Author(s): Yojiro Yutaka

      • Abstract
      • Slides

      Background

      The number of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is now increasing, since it is less invasive and useful for the pathological diagnosis of lung cancer or thoracic and hilar lymph node enlargement. However, there are some problems to be solved, such as diagnostic accuracy and complications. Here, we retrospectively reviewed our experiences of EBUS-TBNA performed for diagnosis of malignant diseases.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between July 2009 and December 2017, 489 patients underwent EBUS-TBNA. Among them, the subject of this study was 424 cases underwent EBUS-TBNA for diagnosis of malignancy. We retrospectively analyzed the completion rate, the complication rate, the adequate sample collection rate and the diagnostic accuracy of EBUS-TBNA among these 424 patients.

      4c3880bb027f159e801041b1021e88e8 Result

      Among all 424 cases, the target lesions of EBUS-TBNA consisted of mediastinal lesions (n=303), hilar lesions (n=69) and both mediastinal and hilar lesions (n=52). Almost all EBUS-TBNAs were performed under conscious anesthesia, while 9 EBUS-TBNAs were performed under general anesthesia. Among 424 cases, EBUS-TBNA was completed in 408 cases (96.2%) and the collection of adequate sample was performed in 382 cases (90.1%). There were four complications (0.94%); they consisted of mediastinal infection (n=2), obstructive pneumonia (n=1) and airway obstruction (n=1). All 4 cases were treated medically and fully recovered. Among 16 incomplete cases, 10 cases were histologically diagnosed with having malignancy; 5 cases were surgically diagnosed, and other 5 cases were diagnosed by EBUS-TBNA under general anesthesia. Other 3 cases were clinically diagnosed with having malignant diseases. Among 26 patients in whom adequate samples were not collected, 14 patients were finally diagnosed with having malignancy. On the other hand, among 382 patients in whom adequate samples were collected, the sensitivity, specificity, positive predictive value and negative predictive value were 90.0%, 100.0%, 100.0% and 76.0%, respectively. Furthermore, the diagnostic accuracy of EBUS-TBNA for hilar lesions was the least among the three lesions (mediastinal: 94.2%, hilar: 83.9%, both mediastinal and hilar: 91.8%, p=0.029).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Among the patients in whom adequate samples were collected, the outcome of EBUS-TBNA was favorable. Since complications are rare but can happen, early recognition and treatment for complication are important. When EBUS-TBNA under conscious sedation is not completed, EBUS-TBNA under general anesthesia or other diagnostic approaches such as mediastinoscopy and video-assisted thoracoscopic surgery are to be considered.

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    P2.03 - Biology (Not CME Accredited Session) (ID 952)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.03-29 - Prognostic Significance of Phosphorylated Fyn in Patients with Lung Adenocarcinoma (ID 12824)

      16:45 - 18:00  |  Author(s): Yojiro Yutaka

      • Abstract

      Background

      Src family tyrosine kinases, including Fyn, are non-receptor tyrosine kinases and they are known to drive malignancy in various kinds of cancers. Some papers have reported that Fyn is an effector of EGFR signaling. Additionally, Fyn is recognized as an additional therapeutic target. However, little is known about the clinical importance of phosphorylated Fyn (pFyn) in lung adenocarcinoma. The purpose of the present study is to clarify the prognostic significance of pFyn in lung adenocarcinoma.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 251 lung adenocarcinoma specimens were collected from patients who underwent surgery in our institute. Tissue microarrays (TMA) were assembled from paraffin-embedded tumor blocks. We analyzed pFyn expression through immunostaining of TMA and classified them as 0, +1, +2, +3. The association between pFyn expression as well as the patients’ clinical information was statistically analyzed. Correlations were compared using Pearson's chi-square test and overall survival (OS) were compared using the log-rank test after propensity score matching (age, gender, smoking history, pathological stage, EGFR mutation status, and p53 mutation status). The Institutional Review Board approved this study and informed consent for tumor tissue usage was obtained pre-operatively.

      4c3880bb027f159e801041b1021e88e8 Result

      Unadjusted pathologic stage distributions by TNM classification (WHO, 7th edition) were as follows: Stage 1A: 128 patients, Stage 1B: 73, Stage 2A: 23, Stage 2B: 4, Stage 3A: 23. pFyn was positive in 118 cases (47.6%). There was a significant correlation between pFyn expression and gender, pathological stage, p53 mutation status, and poor OS. The propensity score adjusted analysis revealed that the prognosis of pFyn positive group was significantly worse compared to the pFyn negative group (p=0.046), which was observed only in the patients with mutant EGFR.

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      8eea62084ca7e541d918e823422bd82e Conclusion

      pFyn expression may affect the prognosis of patients with lung adenocarcinoma in a EGFR mutation dependent manner.

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