P1.02-018 Number of Cancer Cells in Lung Adenocarcinoma Specimen – Correlation with Noguchi's Classification, WHO Pathologic Type, and Prognosis

P1.02-018 Number of Cancer Cells in Lung Adenocarcinoma Specimen – Correlation with Noguchi's Classification, WHO Pathologic Type, and Prognosis

November 2017 also have potential as a useful marker foreseeing the recurrence. Keywords: Freely floating cancer cells, Hilar lymph node positive, lung...

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November 2017 also have potential as a useful marker foreseeing the recurrence. Keywords: Freely floating cancer cells, Hilar lymph node positive, lung cancer

P1.02-018 Number of Cancer Cells in Lung Adenocarcinoma Specimen e Correlation with Noguchi’s Classification, WHO Pathologic Type, and Prognosis T. Inoue,1 Y. Nakazato,2 M. Nishihira,1 O. Araki,1 Y. Karube,1 S. Maeda,1 S. Kobayashi,1 M. Chida1 1Department of General Thoracic Surgery, Dokkyo Medical University, Mibu Tochigi/JP, 2Department of Diagnostic Pathology, Dokkyo Medical University, Mibu/JP Background: Patients with completely resected lung adenocarcinomas smaller than 2 cm have a good prognosis, though some develop recurrence. It has been shown that Noguchi’s classification and WHO pathologic type are correlated with prognosis. We examined the correlation of number of cancer cells/mm2 in adenocarcinoma specimens with prognosis, Noguchi’s classification, and WHO pathologic type. Method: Primary tumors were obtained from 104 patients who underwent surgery from January 2006 through December 2010 and had pulmonary adenocarcinomas 2 cm in maximum diameter. This prognostic investigation was performed in November 2016. All specimens were stained with hematoxylin-eosin and evaluated using Noguchi’s classification and WHO pathologic type. We also determined the number of cancer cells/mm2 in the specimens, with those findings evaluated using receiver operator characteristic (ROC) curve analysis and tumor size. Overall survival curves were produced using the Kaplan-Meier method and analyzed using a log rank test according to number of cancer cells, Noguchi’s classification, and WHO pathologic type. The relationship among those 3 parameters was investigated with Pearson’s correlation coefficient. A p-value <0.05 was considered to indicate significance. Result: At the time of the examination, 90 patients were alive and 14 had died due to lung cancer. The average number of cancer cells/mm2 was 791.3 (range 129.4-1739.5) and that was strongly correlated with progression of Noguchi’s grade (correlation coefficient 0.519, p<0.001) and WHO pathologic type (correlation coefficient 0.436, p<0.001). ROC curve analysis established a cut-off of 992/mm2. In general, cases with cancer cells above the cut-off had worse prognosis (5-year survival 64.0% vs. 94.2%, p<0.001). Conclusion: The number of cancer cells/mm2 in lung adenocarcinoma specimens was found to be correlated with Noguchi’s classification and WHO pathologic type, and is considered useful for prognostic evaluation of affected patients. Keywords: Adenocarcinomas, Cancer cells, Prognosis

P1.02-019 Dual Role of Notch in Lung Cancer S. Sinicropi-Yao,1 J. Amann,1 K. Coombes,2 D. Carbone3 1 Internal Medicine, The Ohio State University, Columbus, OH/US, 2 Department of Biomedical Informatics, The Ohio State University, Columbus, OH/US, 3Medical Oncology, The Ohio State Wexner Medical Center, Columbus, OH/US

Abstracts

S1931

Background: Anomalies in the family of Notch receptors (1, 2, 3, and 4) have been implicated in a range of solid tumors, including lung cancer. There is growing evidence that Notch plays an oncogenic and tumor suppressor role in adenocarcinoma and lung squamous cell carcinoma, respectively. Gaining a complete understanding of the mechanisms underlying these opposing activities in lung cancer is key to the development of novel targeted therapy approaches. Method: The Cancer Genome Atlas (TCGA) datasets were used to look at gene co-expression patterns of Notch in lung adenocarcinoma and lung squamous cell carcinoma. Biological pathways implicated by gene families were assessed using functional annotation tools (DAVID, ToppGene, and IPA). In vitro and in vivo knockdown studies assessed the functional role of Notch in lung cancer. Result: Coexpression analysis supports the hypothesis that Notch is coexpressed with different genes in lung adenocarcinoma and squamous cell carcinoma. Knockdown of Notch in vitro and in vivo support our in silico finding of opposing effects of Notch. Our analysis implicates genes associated with metabolic pathways, angiogenesis and cell cycle that may underlie the differential role of Notch in lung adenocarcinoma and squamous cell carcinoma. Conclusion: These results support the hypothesis differences in the Notch co-expression may underlie its opposing roles in lung adenocarcinoma and squamous cell carcinoma. These finding help unravel the context dependent role of Notch as an oncogene and tumor suppressor in subtypes of lung cancer. Understanding the similarities and differences in coexpression patterns can improve our understanding of the regulatory mechanisms of Notch and strategies for its clinical development as single agent or in combination. Keywords: co-expression, NSCLC, NOTCH

P1.02-020 Acinar-Predominant Pattern Correlates with Poorer Prognosis in Invasive Mucinous Adenocarcinoma of the Lung G. Lin,1 H. Li,2 C. Xie1 1Respiratory Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou/CN, 2Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou/CN Background: Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma. Growth pattern such as lepidic, acinar, papillary and micropapillary can be seen in IMA. However, no study regarding prognostic and clinicopathologic aspects of IMAs with different growth pattern has been reported. Method: From January 1999 to July 2011, of 2236 patients with newly diagnosed primary lung adenocarcinoma, 16 patients were identified as lepidicpredominant IMA and 10 patients as acinar-predominant IMA. Data regarding the clinicopathological characteristics, CT features and prognosis was collected. Result: No statistically significant difference was noted in gender, age as well as smoker proportion between lepidic-predominant and acinar-predominant IMA. There was no statistically significant difference in T classification. The proportion of lymph node metastasis was significantly higher in acinar-predominant IMA (P¼0.046). Both the tumors shared many signs in CT findings. Air-bronchgram was a relatively specific sign for lepidic-predominant IMA. Survival analysis showed that lepidicpredominant IMA also have a more favorable outcome than acinar-predominant IMA (P¼0.0294). Conclusion: Lepidic-predominant and acinar-predominant IMA are two different subtypes of IMA. Acinar-predominant IMA is associated with lymph node metastasis and has a poorer prognosis than lepidic-predominant IMA. Keywords: invasive mucinous adenocarcinoma, Prognosis, pathological subtype