WCIM 2014 SEOUL KOREA 453
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 1583 Lung Cancer
Mimicking Metastatic Lung Tumor: A Case of Primary Squamous Cell Lung Carcinoma with a Literature Review
Bomi Park1, Kwang In Park1, Sung Min Kim1, Jin Whan Kim1, Chung Sik Lee1, Jae Wook Jeong1, Dong Il Park1, Jae Young Moon1, Jeong Eun Lee1, Sung Soo Jeong1, Ju Ock Kim1, Sun Young Kim1, Hee Sun Park1
Chungnam National University Hospital, Korea1
A 84-year-old man presented with chronic cough lasted for a year. Posterior-anterior upright methods of chest roentgenography showed multiple metastatic lung nodules in both lung fi eld. And bronchoscopy showed masses in the accessory bronchus in right distal trachea side and anterior basal trunk in right lower lobe. Therefore, he was underwent histological examination for each lesion. The results of histology had been reported in the necrotic tissue and aspergillosis, respectively. However, we thought it’s a result of the contamination, he was underwent further evaluation. A percutaneous needle biopsy revealed poorly differentiated carcinoma of unknown origin. In PET-CT and brain MRI, we found a single cerebellar metastatic lesion and multiple metastatic muscle lesions. Strangely, SUV values of lung nodules were not high but there was in- creased uptake in paraesophageal area in the PET-CT. Additional duodenoscopic exam- ination proved no abnormality. In order to fi nd the origin site of cancer, we conducted additional immunohistochemial studies, and as a result, p63 and CK5/6 were positive, TTF-1 and napsin-A were negative, respectively. At last, we defi nitely diagnosed as squamous lung cancer and he had underwent chemotherapy. We experienced a case discovered in multiple metastatic lung nodules that is different from the characteris- tics of universal squamous lung cancer of central invasion. So we would like to discuss differential diagnosis from metastatic cancer and sarcoidosis which can have similar image fi nding.
PS 1584 Lung Cancer
Feasibility Trial of Weekly Divided Irinotecan and Carboplatin for Patients with Small Cell Lung Cancer
Choonhee Son1, Soo-Jung Um1, Mee Sook Roh1 Dong-A University Medical Center, Korea1
Background: Lung cancer is the most common cause of cancer-related death world- wide and in Korea, and small cell lung cancer(SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study.
Methods: Patients with histologically or cytologically confi rmed extensive stage(ED) SCLC were included. Patients with limited stage(LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irrinotecan 60mg/m2, carboplatin 2 AUC at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occured. No more than 6 cy- cles of chemotherapy were given.
Results: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5%(complete response, 14.9%: partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocy- topenia (8.5%), sepsis (4.3%), pancytopenia (2.1%). There was no treatment related death.
Conclusions: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a fi rst line therapy for both stage of SCLC. Large scaled, controlled study is feasible.
PS 1585 Lung Cancer
Immunohistochemistry with EGFR Mutation-Specifi c Antibodies in Biopsy and Resection Specimens with Pulmonary Adenocarcinoma
Chi Hong Kim1, Seung Hoon Kim1, Sonya Youngju Pak2, Jinyoung Yoo1, Sung-Kyoung Kim1, Hoon Kyo Kim1
The Catholic University of Korea, St. Vincent’s Hospital, Korea1, The Catholic University of Korea, St.
Mary’s Hospital, Korea2
Background: Recently, mutation-specifi c antibodies have been developed for detect- ing epidermal growth factor receptor (EGFR) mutations by immunohistochemistry (IHC). This study was designed to determine the signifi cance of the type of specimen used for analysis (biopsy vs. resection), and to evaluate any correlation between muta- tion-specifi c antibodies and total EGFR protein (tEGFR) expressions.
Methods: IHC using mutation-specifi c antibodies for E746-A750 deletion (DEL) and L858R point mutation (L858R) was performed in biopsies or tissue microarrays (TMA) of resected tumors from a total of 154 patients with lung adenocarcinoma. tEGFR was also investigated by IHC. Results were then compared with DNA sequencing data.
Results: Molecular-based assays detected EGFR mutations in 62 (40.3%) patients, in- cluding 14 (9.1%) with DEL, and 31 (20.1%) with L858R. IHC with two mutation-spe- cifi c antibodies demonstrated a homogeneous staining pattern, and showed overall (biopsy/resection) sensitivity, specifi city, positive predictive value (PPV), and negative predictive value (NPV) of 75.6% (78.3%/72.7%), 94.5 % (90.9%/96.3%), 85%
(78.3%/88.9%), and 90.4% (90.9%/89.7%), respectively. tEGFR showed low sensitivity, specifi city, PPV, and NPV, with no correlation with either DEL-specifi c or L858R-spe- cifi c antibodies.
Conclusions: IHC using EGFR mutation-specific antibodies proved to be a reliable screening tool for identifying EGFR mutations in both biopsied and resected specimens with pulmonary adenocarcinoma, especially when the tumor cells in biopsy samples are not suffi cient for molecular biology techniques.
PS 1586 Lung Cancer
Promoter Methylation of MIR137 and Its Clinical Signifi cance in Surgically Resected Lung Cancer
Nahyeon Kang2, Su Yeon Choi2, Young Kyoon Kim1, Ie Ryung Yoo1, Dae Hee Han1, Dong Soo Lee1, Yeon Sil Kim1, Sook Hee Hong1, Jin Hyoung Kang1, Kyo Young Lee1, Jae Gil Park1, Sook Whan Sung1, Seung Joon Kim1
Multidisciplinary Team of Lung Cancer in Seoul St.Mary’s Hospital, Korea1, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Korea2
Background: Recent studies suggest that miR-137 functions as tumor suppressor in various tumors including colorectal cancer, glioblastoma multiforme, oral cancer, and squamous cell carcinoma of the head and neck. The silencing of miR-137 could be re- lated with its abnormal promoter hypermethylation. The purpose of this study was to investigate the signifi cance of MIR137 promoter methylation in lung cancer.
Methods: Lung cancer cell lines were treated with DNA methyltransferase inhibitor (5’-Aza) and/or HDAC inhibitor (Trichostatin A) whether miR-137 could be reactivated.
From paired tumor and adjacent non-tumor lung tissues (n=50), real-time RT-PCR for miR-137 expression and cyclin dependent kinase 6 (CDK6), quantitative methylation specifi c PCR for methylation analysis, and bisulfi te modifi ed DNA sequencing for vali- dation were used for the study.
Results: miR-137 was reactivated by treatment with 5’-Aza and/or Trichostatin A in lung cancer cell lines. miR-137 was signifi cantly downregulated and CDK6 was signif- icantly upregulated in lung tumor tissues compared with adjacent non-tumor tissues.
Quantitative methylation specifi c PCR showed increased MIR137 promoter methyl- ation in lung tumor tissues compared with adjacent non-tumor tissues, which was further validated with bisulfi te sequencing.
Conclusions: These results suggest that miR-137 has a role of tumor suppressor and its expression is regulated by promoter methylation. The decreased expression of miR- 137 combined with increased expression of CDK6 could be associated with lung can- cer carcinogenesis.
