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Kimiaki Sato
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EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.18-13 - Review of Preoperative Examination (Now Available) (ID 1351)
08:00 - 18:00 | Author(s): Kimiaki Sato
- Abstract
Background
Before lung resection, it is necessary to perform various preoperative examinations to determine the indication for surgery. In our department, lung blood flow scintigraphy is performed on all cases scheduled for lung resection, and predicted post operation (ppo)%FEV1 and ppo%DLCO, are calculated based on lung function tests and scheduled surgery. Both have a cut-off value of 40%, and if the case has less than 40%, change to surgery with less lung volume loss.
However, the large number of cases have no difference between left and right lung blood flow ratios. Even if the difference is large, almost all cases have organic lung abnormalities which are detected by CT easily. In addition, even if there is a large dissociation in the left-right difference in pulmonary blood flow, it is very rare that the predicted value after surgery is less than 40% in normal respiratory function patients. In recent years, most institutions do not perform pulmonary blood flow scintigraphy as preoperative examination, and it may be necessary to examine the significance of lung blood flow scintigraphy as preoperative examination.
Method
Of the cases in which lung blood flow scintigraphy was performed as a preoperative examination for lung resection in our department from January 2010 to December 2018, we selected the cases who has the blood flow ratio between the left and right lungs has more than doubled difference and doesn’t have detectable organic abnormality and history of lung resection.
Result
Nineteen out of 1570 cases were extracted. The blood flow of the right lung was more than twice that of the left lung in 18 cases. 19 cases have 12 men and the average age is 73.6 ± 6.9. There were 13 cases undergoing planned surgery, 3 cases that could not be resected due to the progress of the tumor, 1 case refusing the operation, and only 2 cases changed treatment based on the result of scintigraphy. One case treated by radiation therapy and another was treated by PDT.
Conclusion
It is suggested that lung blood flow scintigraphy may not be necessary in cases who have normal pulmonary function and have no organic abnormalities.
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MA18 - Advances in Diagnosis of Common Types of NSCLC (ID 145)
- Event: WCLC 2019
- Type: Mini Oral Session
- Track: Pathology
- Presentations: 1
- Now Available
- Moderators:Yuko Minami, Mary Beth Beasley
- Coordinates: 9/10/2019, 11:30 - 13:00, Tokyo (1982)
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MA18.02 - S100A10 Upregulation Associates with Poor Prognosis in Lung Squamous Cell Carcinoma (Now Available) (ID 2836)
11:30 - 13:00 | Presenting Author(s): Kimiaki Sato
- Abstract
- Presentation
Background
S100A10 is one of the members of S100 protein family. This molecule predominantly functions in a complex with annexin A2, and stimulates plasminogen activator (tPA)-dependent plasmin formation. Plasmin cleaves and activates metalloproteases (MMPs). Several studies have established that plasmin is an important protease involved in cancer cell migration and invasion. Expression of the S100 protein family is detected in many human cancers and has been related to a poorer prognosis, but relationship between S100A10 expression and progression of human lung cancer has not been clarified. In this study, we focused on S100A10 and aimed to clarify its effect to progression in lung adenocarcinomas and lung squamous cell carcinomas (SCCs).
Method
We investigated expressions of S100A10 and MMPs by immunohistochemistry in resected 98 primary lung adenocarcinomas and 120 primary lung SCCs, and its associations with clinicopathological parameters were evaluated. S100A10-positivity was defined when more than 10% tumor cells showed positive staining. In lung SCC cases, we particularly evaluated cancer cell surface at the invasive front. Kaplan-Meier analysis and Cox proportional hazard models were used to estimate the effect on survival. Next we observed the expression of S100A10 in 6 lung adenocarcinoma and 6 lung SCC cell lines, and performed siRNA-mediated knockdown against S100A10 in highly-expressing cell lines.
Result
Seventy-four (78.6%) of 98 adenocarcinomas were S100A10-positive cases, and correlations with poorer prognosis (p=0.0413), lymphatic invasion (p=0.0335), and expression of MMP2 (0.0081), were observed, although S100A10 expression was not an independent predictor of a poorer survival in the multivariable analysis (HR 1.7334, 95%CI 0.4340-11.523, p=0.4647). In the same way, 33 (27.5%) of 120 SCCs showed S100A10-positive staining and correlation with poorer prognosis (p=0.0094), p-TNM stage (p=0.0119), nodal involvement (p=0.0006), lymphatic invasion (p=0.0005), and tumor size (p=0.0003) were observed. As for lung SCCs, S100A10 expression was an independent predictor of a poorer survival in the multivariable analysis (HR 9.5916, 95%CI 1.0702-128.208, p=0.0434). Then we performed knockdown of S100A10 in lung cancer cell lines and found that knockdown of S100A10 suppressed cell proliferation in adenocarcinomas and SCCs, and invasion in adenocarcinomas.
Conclusion
In this study, we found that S100A10 expression associates with poorer survival in lung SCCs, but not in lung adenocarcinoma. Our present results suggest that S100A10 protein plays an important role in proliferation of lung cancer, possibly in association with invasion by MMPs. Future studies are necessary to further understanding of importance of S100A10 in progression of human lung cancer, including some differences between histological subtypes.
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-09 - EGFR Is Highly Mutated in Lung Adenocarcinoma Patients with History of Breast Cancer (ID 2210)
10:15 - 18:15 | Author(s): Kimiaki Sato
- Abstract
Background
EGFR gene mutation has been reported to be frequent in the patients with specific clinical features such as female, adenocarcinoma, and East-Asian ethnicity. The mutation rate in lung adenocarcinoma is approximately 50% in Japan. Currently, the molecular mechanism which cause EGFR mutation has not been clarified. If the EGFR mutation in lung adenocarcinoma correlates with specific type of malignancy in the other organ, it could be a clue to find a mechanism which promote carcinogenesis of lung adenocarcinoma. In the current study, we focused on breast cancer.
Method
Patients with lung adenocarcinoma who underwent pulmonary resection in our hospital from January 2011 to December 2018 were analyzed. We retrospectively reviewed clinical information such as past illness, radiological findings, pathological diagnosis, and EGFR mutation status. Correlation was tested by chi-square test and p value of less than 0.05 was regarded as statistically significant.
Result
A total of 21 patients of lung adenocarcinoma had history of treatment for breast cancer. All patients were female. Among them, EGFR mutation was detected in 20 patients (95%). One patient who were negative for EGFR mutation had history of not only breast cancer but also cervical cancer of uterus and gastrointestinal stromal tumor, and developed angiosarcoma of the skin. Detected EGFR mutation types in 20 patients were as follows; deletion in exon 19 for 9 patients, L858R for 7 patients G719X for two patients, and L861Q for one patient. One patient showed multiple mutation (G719X and L861). In the same period, among 203 lung adenocarcinoma patients without other organ malignancy, 115 showed EGFR mutation (56.7%). There was significant difference in EGFR mutation rate between breast cancer group and no malignancy group (p=0.00058).
Conclusion
Patients of lung adenocarcinoma with history of breast cancer showed extremely high positive rate for EGFR mutation in Japan, suggesting underlying common oncogenic molecular mechanism between lung adenocarcinoma and breast cancer. Elucidation of the mechanism may contribute to the diagnosis and treatment of carcinogenesis of breast cancer and lung cancer.
