• Title/Summary/Keyword: Adenocarcinoma of the lung

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Prognostic Value of CD44 Variant exon 6 Expression in Non-Small Cell Lung Cancer: a Meta-analysis

  • Zhao, Shuang;He, Jin-Lan;Qiu, Zhi-Xin;Chen, Nian-Yong;Luo, Zhuang;Chen, Bo-Jiang;Li, Wei-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6761-6766
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    • 2014
  • Background: CD44v6 (CD44 variant exon 6) is the chief CD44 variant isoform regulating tumor invasion, progression, and metastasis. The prognostic value of CD44v6 expression in non small cell lung cancer (NSCLC) has been evaluated in many studies, but the results have remained controversial. Thus, we performed a meta-analysis of currently available studies to investigate the prognostic value of CD44v6 expression in NSCLC patients and the relationship between the expression of CD44v6 and clinicopathological features. Materials and Methods: Two independent reviewers searched the relevant literature in Pubmed, Medline and Embase from 1946 to January 2014. Overall survival (OS) and various clinicopathological features were collected from included studies. This meta-analysis was accomplished using STATA 12.0 and Revman 5.2 software. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated to estimate the effects. Results: A total of 921 NSCLC patients from ten studies met the inclusion criteria. The results showed that CD44v6 high expression was a prognostic factor for poor survival (HR=1.91, 95%CI=1.12-3.26, p<0.05). With respect to clinicopathological features, CD44v6 high expression was related to histopathologic type (squamous cell carcinoma versus adenocarcinoma: OR=2.72, 95%CI=1.38-5.38, p=0.004), and lymph node metastasis (OR=3.02, 95%CI=1.93-4.72, p<0.00001). Conclusions: Our results suggested CD44v6 high expression as a poor prognostic factor for NSCLC, and CD44v6 expression is associated with lymph node metastasis and histopathologic type. Therefore, CD44v6 expression can be used as a novel prognostic marker in NSCLC cases.

Efficacy of First-line Chemotherapy Affects the Second-Line Setting Response in Patients with Advanced Non-Small Cell Lung Cancer

  • Cao, Wa;Li, Ai-Wu;Ren, Sheng-Xiang;Chen, Xiao-Xia;Li, Wei;Gao, Guang-Hui;He, Ya-Yi;Zhou, Cai-Cun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6799-6804
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    • 2014
  • Background: Chemotherapy is the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC) without driver mutations and many receive therapies beyond first-line. Second-line chemotherapy has been disappointing both in terms of response rate and survival and we know relatively little about the prognostic factors. Materials and Methods: One thousand and eight patients with advanced NSCLC who received second-line chemotherapy after progression were reviewed in Shanghai Pulmonary Hospital, China, from September 2005 to July 2010. We analyzed the effects of potential prognostic factors on the outcomes of second-line chemotherapy (overall response rate, ORR; progression free survival, PFS; overall survival, OS). Results: The response and progression free survival of first-line chemotherapy affects the ORR, PFS and OS of second-line chemotherapy (ORR: CR/PR 15.4%, SD 10.1%, PD2.3%, p<0.001; PFS: CR/PR 3.80 months, SD 2.77 months, PD 2.03 months, p<0.001; OS: CR/PR 11.60 months, SD 10.33 months, PD 6.57 months, p=0.578, p<0.001, p<0.001, respectively). On multivariate analysis, better response to first-line therapy (CR/PR: HR=0.751, p=0.002; SD: HR=0.781, p=0.021) and progression within 3-6 months (HR=0.626, p<0.001), together with adenocarcinoma (HR=0.815, p=0.017), without liver metastasis (HR=0.541, p=0.001), never-smoker (HR=0.772, p=0.001), and ECOG PS 0-1 (HR=0.745, p=0.021) were predictors for good OS following second-line chemotherapy. Conclusions: Patients who responded to first-line chemotherapy had a better outcome after second-line therapy for advanced NSCLC, and the efficacy of first-line chemotherapy, period of progression, histology, liver metastasis, smoking status and ECOG PS were independent prognostic factors for OS.

Clinical Evaluation of Lung Cancer Confirmed to be Dead in the Post-operative Follow-up Periods (사망이 확인되었던 폐암환지의 임상적 고찰)

  • 이두연
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.86-95
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    • 1992
  • We have performed surgical operations for 184 primary lung carcinomas over a 10 year period from December, 1979 to December, 1990 at the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea. We have reviewed 77 cases confirmed to be dead in the post-operative follow-up period among 184 cases. There were 68 males and 9 females [M: F=7.56: 1], with 76.62% ranging between 50 to 70 years old There were 50 cases[64.94%] of squamous cell carcinoma, 15[19.48%] of adenocarcinoma, 4[5.19%] of large cell carcinoma, 4[5.19%] of mixed cell carcinoma 3 [3.90%] of small cell carcinoma % 1 case of bronchoalveolar cell carcinoma. There were 25 cases[32.47%] in stage I, 12 [15.58%] in stage II 32 [41.56%] in stage IIIa and 8 [10.39%] in stage IIIb according to the new international staging system for lung cancer. The operative methods were left pneumonectomy in 38 cases, right pneumonectomy in 21, bilobectomy in 5, lobectomy in 12, and wedge resection in one case.ase. There were 9 operative mortalities; one case by bleeding, 5 cases by respiratory failure, one case by bleeding & renal failure, one case by empyema thoracis with BPF and one case by brain metastases. The actuarial mean survival length was 14.636$\pm$18.188months overall and 16.441$\pm$18. 627months in 68 cases excluding 9 operative deaths. The actuarial mean survival length was 18.568$\pm$11.057 months in 43 squamous cell carcinomas, 14.385$\pm$11.057 months in 14 adenocarcinomas, 10.250$\pm$8.884months in 4 large cell carcinomas and 12.250$\pm$17.193months in 4 mixed cell carcinomas. The actuarial mean survival length was 14.051$\pm$16.963months in 59 pneumonectomy cases, 15.200$\pm$12.478 months in 5 bilobectomy cases, 18.417$\pm$26.026months in 12 lobectomy cases. The actuarial mean survival length was 28.952$\pm$25.738months in 22 stage I cases, 19. 455$\pm$16.723months in ll stage II cases, 8.633$\pm$6.584months in 29 stage IIIa cases and 6. 167$\pm$4.355months in 6 stage IIIb cases. The differences of actuarial mean survival length according to the stages were statistically significant [a=0.003]

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Aberrant Methylation of p16 Tumor Suppressor Gene and Death-Associated Protein Kinase in Non-Small Cell Lung Carcinoma (비소세포폐암 조직에서 p16 종양억제유전자와 Death-Associated Protein Kinase의 Aberrant Methylation의 양상)

  • Kim, Yun-Seong;Lee, Min-Ki;Jung, Kyung-Sik;Kim, Ki-Uk;Kim, Young-Dae;Lee, Hyung-Ryul;Lee, Chang-Hoon;Seok, Ju-Won;Kim, Yong-Ki;Jun, Eun-Sook;Choi, Young-Min;Rha, Seo-Hee;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.108-121
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    • 2001
  • Background : The $p16^{INK4a}$ (p16) twnor suppressor gene is frequently inactivated in hwnan non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon $\gamma$-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. Methods : This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. Results : Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57. $8{\pm}10.5$ years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I (1 IA, 10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III (9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. Conclusion: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.

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Prognostic Impact of Elevation of Vascular Endothelial Growth Factor Family Expression in Patients with Non-small Cell lung Cancer: an Updated Meta-analysis

  • Zheng, Chun-Long;Qiu, Chen;Shen, Mei-Xiao;Qu, Xiao;Zhang, Tie-Hong;Zhang, Ji-Hong;Du, Jia-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1881-1895
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    • 2015
  • Background: The vascular endothelial growth factor family has been implicated in tumorigenesis and metastasis. The prognostic value of each vascular endothelial growth factor family member, particular VEGF/VEGFR co-expression, in patients with non-small lung cancer remains controversial. Materials and Methods: Relevant literature was identified by searching PubMed, EMBASE and Web of Science. Studies evaluating expression of VEGFs and/or VEGFRs by immunohistochemistry or ELISA in lung cancer tissue were eligible for inclusion. Hazard ratios (HRs) and 95% confidence intervals (CIs) from individual study were pooled by using a fixed- or random-effect model, heterogeneity and publication bias analyses were also performed. Results: 74 studies covering 7,631 patients were included in the meta-analysis. Regarding pro-angiogenesis factors, the expression of VEGFA (HR=1.633, 95%CI: 1.490-1.791) and VEGFR1 (HR=1.924, 95%CI: 1.220-3.034) was associated separately with poor survival. Especially, VEGFA over-expression was an independent prognostic factor in adenocarcinoma (ADC) (HR=1.775, 95%CI: 1.384-2.275) and SCC (HR=2.919, 95%CI: 2.060-4.137). Co-expression of VEGFA/VEGFR2 (HR=2.011, 95%CI: 1.405-2.876) was also significantly associated with worse survival. For lymphangiogenesis factors, the expression of VEGFC (HR=1.611, 95%CI: 1.407-1.844) predicted a poor prognosis. Co-expression of VEGFC/VEGFR3 (HR=2.436, 95%CI: 1.468-4.043) emerged as a preferable prognostic marker. Conclusions: The expression of VEGFA (particularly in SCC and early stage NSCLC), VEGFC, VEGFR1 indicates separately an unfavorable prognosis in patients with NSCLC. Co-expression VEGFA/VEGFR2 is comparable with VEGFC/VEGFR3, both featuring sufficient discrimination value as preferable as prognostic biologic markers.

A Case of Patient with Non-Small Cell Lung Carcinoma Treated with Samchilchoongcho-Jung in Conjunction with Crizotinib (비소세포성 폐암환자의 Crizotinib과 삼칠충초정 병용투여 경과관찰 1례)

  • Ha, Su jeong;Song, Si yeon;Park, So-jung;Jeon, Hyung-joon;Lee, Yeon-weol;Cho, Chong-kwan;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.23 no.1
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    • pp.23-32
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    • 2018
  • Objective: The purpose of this study is to report the case of a patient with non-small cell lung adenocarcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) mutation treated by Samchilchoongcho-Jung in conjunction with Crizotinib. Methods: An NSCLC patient diagnosed with multiple pleural and lymph nodes metastasis has been taking Crizotinib (500 mg/day) since January 2014. The patient has been treated with Samchilchoongcho-Jung (1,500 mg/day) since June 2014. The tumor size was measured by computed tomography (CT) and laboratory analysis was conducted. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combining treatment, stable disease was shown on CT. The tumor marker (CEA, Cyfra 21-1) levels were maintained. NCI-CTCAE 5.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may contribute to tumor response, in conjunction with Crizotinib on the treatment of patients with NSCLC.

Pulmonary Mucinous Cystic Tumor of Borderline Malignancy -A case of report- (폐의 저악성 점액성 낭종)

  • Kang, Kyung-Min;Lim, Yong-Taek;Kim, Chul-Hwan;Lee, Seob;Hur, Yong;Kim, Byung-Ryul;Lee, Jung-Ho
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.212-215
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    • 1998
  • Pulmonary mucinous cystic tumor of borderline malignancy is very rare and distinguished from bronchogenic cyst or adenocarcinoma of bronchoalveolar type. We present the case of a 63-year-old woman with a right lower lobe mass, found by chest radiographs. The preoperative diagnosis was made as bronchoalveolar cancer by percutaneous needle aspiration of mass. Right lower lobectomy and lymph node dissections were performed. The lobectomy specimen contained variable sized multilocular cystic mucous masses, filled with mucus. Microscopically, the cystic masses are lined with tall columnar mucinous epithelium but some area contains focal cellular atypism and bronchoalveolar cancer like foci. This foci are lack of cellular atypism consistent with bronchoalveolar cancer cell. After lobectomy the patient has remained free from recurrence and distant metastasis for following 12 months period. Pulmonary mucinous cystic tumor of borderline malignancy appears to have a favorable prognosis and should be distinguished from other lung neoplasms.

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Association of p53 Expression with Metabolic Features of Stage I Non-Small Cell Lung Cancer

  • Kang, Shin-Myung;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Han, Joung-Ho;Kim, Ho-Joong;Kwon, O-Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.417-424
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    • 2011
  • Background: Recent evidences have revealed metabolic functions of p53 in cancer cells; adaptation or survival to metabolic stress and metabolic shift toward oxidative phosphorylation. However, further studies in clinical setting are needed. We investigated whether p53 protein expression, as a surrogate marker for loss of p53 function, is associated with metabolic features of stage I non-small cell lung cancer (NSCLC), focusing on tumor necrosis and maximal standardized uptake value (SUVmax) on $^{18}F$-fluorodeoxyglucose positron emission tomography. Methods: Clinical information was obtained from retrospective review of medical records. p53 expression was assessed by immunohistochemical staining. Results: p53 protein expression was detected in 112 (46%) of 241 NSCLC cases included in this study. p53 expression was independently associated with the presence of necrosis (odds ratio [OR], 2.316; 95% confidence interval [CI], 1.215~4.416; p=0.011). Non-adenocarcinoma histology (OR, 8.049; 95% CI, 4.072~15.911; p<0.001) and poorly differentiation (OR, 6.474; 95% CI, 2.998~13.979; p<0.001) were also independently associated with the presence of necrosis. However, p53 expression was not a significant factor for SUVmax. Conclusion: p53 protein expression is independently associated with the presence of necrosis, but not SUVmax.

Long Term Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암 환자에서의 기관지 소매 절제술의 장기 성적)

  • Cho, Suk-Ki;Sung, Ki-Ick;Lee, Cheul;Lee, Jae-Ik;Kim, Joo-Hyun;Kim, Young-Tae;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.917-923
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    • 2001
  • Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

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Effect of Korean Rice-Wine (Yakju) on in vitro and in vivo Progression of B16BL6 Mouse Melanoma and HRT18 Human Colon Adenocarcinoma Cells (한국 전통 약주의 B16BL6 mouse melanoma 및 HRT18 human colon adenocarcinoma 세포 성장 억제 효과)

  • Chung, Kun-Sub;Oh, Won-Taek;Nam, Sang-Min;Son, Byoung-Soo;Park, Yong-Serk
    • Korean Journal of Food Science and Technology
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    • v.30 no.6
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    • pp.1470-1475
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    • 1998
  • Two kinds of Korean rice-wine (Yakju) with different process and ingredients, and Japanese rice-wine (Sake) were chosen for this study, and throughly dried and solubilized in water or cell culture medium. In vitro cytotoxicity assays of the solubilized wine solids exhibited that maximum dilution factors for inhibition of B 16BL6 mouse melanoma cell growth were 16X for herbal medicine-added rice-wine (Korean rice-wine I) and typical Korean rice-wine (Korean rice-wine II), and 8X for Japanese rice-wine. Their cytotoxic effects on HRT18 human colon adenocarcinoma cells were even lower than those on B16BL6 cells. The morphology of the tumor cells were changed by addition of the solubilized wine solids. Inhibitory effect of the rice-wine on in vivo tumor growth and metastasis were monitored after implantation of B16BL6 cells into C57BL/6 mice with daily feeding the solubilized wine solids. Compared to non-fed control groups, B16BL6 tumor growth and metastasis to lung were clearly inhibited by feeding the wine solids, in order of Korean rice-wine I > Korean rice-wine II > Japanese rice-wine. The data of in vitro cytotoxicity and the cell shape changes indicate that the inhibitory effect of tumor progression may be attributed to tumor cell differentiation or immune stimulation induced by certain components in the rice-wine, rather than direct cytotoxicity of the components.

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