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Jang YJ, Jeong HK, Kong CB, Song WS, Cho WH, Jeon DG, Kim H, Yang SH, Na II, Lee HR, Kang HJ. Secondary hematological malignancies in patients with sarcoma: A single‑center retrospective study. Oncol Lett 2024; 27:211. [PMID: 38572064 PMCID: PMC10988193 DOI: 10.3892/ol.2024.14344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
The present retrospective study investigated the clinical features and prognosis of secondary hematological malignancies (SHMs) in patients with sarcoma at Korea Cancer Center Hospital (Seoul, South Korea). Patients who had been diagnosed with SHMs after having received treatment for sarcoma between January 2000 and May 2023 were enrolled. Clinical data were collected from the patients' medical records. Clinical characteristics were analyzed, including SHM incidence, type and prognosis. Of 2,953 patients with sarcoma, 18 (0.6%) were diagnosed with SHMs. Their median age at the time of sarcoma diagnosis was 39.5 (range, 9-72) years, and 74% (n=14) of these patients were male. The histological features of sarcoma varied, with osteosarcoma diagnosed in nine patients (50%). All patients with sarcoma underwent surgical treatment, and 16 (88.8%) received chemotherapy. The most common type of SHMs was acute myeloid leukemia (n=6; 33.3%), followed by myelodysplastic syndrome (n=5; 27.7%). The median latency period between the sarcoma diagnosis and SHM identification was 30 (range, 11-121) months. A total of 13 (72.2%) patients received treatment for the SHM. The median overall survival after SHM diagnosis was 15.7 (range, 0.4-154.9) months. The incidence of SHMs in sarcoma in the present study was consistent with that reported previously. The presence of SHMs was associated with a poor patient prognosis, especially if treatment for SHMs was not administered.
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Affiliation(s)
- Yoon Jung Jang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Hong Kyu Jeong
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
- Department of Hematology and Oncology, Hallym Hospital, Incheon 21079, Republic of Korea
| | - Chang-Bae Kong
- Department of Orthopedic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Won Seok Song
- Department of Orthopedic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Wan Hyeong Cho
- Department of Orthopedic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Dae Geun Jeon
- Department of Orthopedic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Heyjin Kim
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Sung Hyun Yang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Im Il Na
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Hyo-Rak Lee
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Hye Jin Kang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
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Jang YJ, Lim SM, Lee I, Byun BH, Lim I, Kim BI, Choi CW, Lee SS, Suh C, Yoon DH, Kim I, Nam SH, Lee MH, Won JH, Kong JH, Jeong SH, Oh SJ, Park KW, Han JJ, Song MK, Yang SH, Na II, Lee HR, Shin DY, Kang HJ. Radioimmunotherapy with 131 I-rituximab for patients with relapsed or refractory follicular or mantle cell lymphoma. Asia Pac J Clin Oncol 2023; 19:690-696. [PMID: 36915956 DOI: 10.1111/ajco.13932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 03/15/2023]
Abstract
AIM This study aimed to evaluate the safety and efficacy of 131 I-rituximab in patients with relapsed or refractory follicular or mantle cell lymphoma. METHODS Twenty-four patients with relapsed or refractory follicular or mantle cell lymphoma were administered unlabeled rituximab (70 mg) immediately before receiving a therapeutic dose of 131 I-rituximab. Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography was used a month later to assess tumor response. RESULTS This study enrolled 24 patients between June 2012 and 2022. Depending on how they responded to radioimmunotherapy (RIT), 131 I-rituximab was administered one to five times. Of the 24 patients, 9 achieved complete response after RIT and 8 achieved partial response. The median progression-free and overall survival was 5.9 and 37.9 months, respectively. During the follow-up period of 64.2 months, three patients were diagnosed with a secondary malignancy. Among treatment-related adverse events, hematologic toxicities were common, and grade 3-4 thrombocytopenia and neutropenia were reported in 66.6% of cases. CONCLUSION 131 I-rituximab has an effective and favorable safety profile in patients with relapsed or refractory follicular lymphoma and mantle cell lymphoma. This suggests that RIT may also be considered a treatment option for patients with relapsed or refractory follicular lymphoma and mantle cell lymphoma.
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Affiliation(s)
- Yoon Jung Jang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Inki Lee
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Byung Hyun Byun
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Chang Woon Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Seung-Sook Lee
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Inho Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Hyun Nam
- Division of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University at Gangdong, Seoul, Republic of Korea
| | - Mark Hong Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jong Ho Won
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Jee Hyun Kong
- Division of Oncology and Hematology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seong Hyun Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Suk Joong Oh
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Keon Woo Park
- Department of Internal Medicine, Dankook University, College of Medicine, Cheonan, Republic of Korea
| | - Jae Joon Han
- Division of Medical Oncology-Hematology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Moo-Kon Song
- Division of Hematology-Oncology, Department of Medicine, Hanyang University Changwon Hanmaeum Hospital, Changwon, Republic of Korea
| | - Sung Hyun Yang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Im Il Na
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hyo-Rak Lee
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Dong-Yeop Shin
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hye Jin Kang
- Department of Hematology and Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Jang YJ, Kim SY, Jung HK, Kim HR, Kim CH, Lee HR, Kang HJ, Yang SH, Seol H, Na II. Association of EGFR mutations in second primary lung cancer and HER2 expression in breast cancer survivors. Transl Cancer Res 2022; 10:5204-5211. [PMID: 35116370 PMCID: PMC8799167 DOI: 10.21037/tcr-21-1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/04/2021] [Indexed: 11/06/2022]
Abstract
Background The incidence of second primary lung cancer (SPLC) is increasing with longer survival rates from breast cancer. Despite of studies to suggest the mutual exclusivity of epidermal growth factor receptor (EGFR) and human epidermal growth receptor 2 (HER2) in several cancers, the effect of HER2 expression in breast cancer on EGFR mutations in SPLC is unclear. Therefore, this study aimed to determine the association between HER2 expression and EGFR mutations. Methods We conducted a retrospective cohort study of breast cancer survivors diagnosed with SPLC after breast cancer treatment between 1997 and 2018. We investigated the association between HER2 expression in breast cancer and EGFR mutations in SPLC, specifically focusing on negative correlations by using logistic regression analysis. Results EGFR mutations in SPLC were detected in 19 of 38 patients. Analysis for HER2 revealed a statistically significant difference in the proportion of EGFR mutations between patients with SPLC and previous HER2 positive breast cancer (43.5%) and those with SPLC and previous HER2 negative breast cancer (90.0%; P=0.021). The ratio of EGFR mutations decreased with the degree of HER2 expression in patients with previous breast cancer (90.0%: for no HER2 expression, 62.5% for HER2 1+, 0.0% for HER2 2+, and 41.7% for HER2 3+; P=0.018). Multivariate logistic analyses revealed that EGFR mutations in SPLC were significantly associated with age [odds ratio (OR): 1.11, 95% confidence interval (CI): 1.01-0.23, P=0.039] and HER2 positive status (OR: 0.04, 95% CI: 0.01-0.56, P=0.017). Conclusions This study suggests that the frequency of EGFR mutations in SPLC may be associated with low HER2 expression in previous breast cancer.
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Affiliation(s)
- Yoon Jung Jang
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Seo Yun Kim
- Division of Pulmonary and Critical Care Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hong Kyu Jung
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hye-Ryoun Kim
- Division of Pulmonary and Critical Care Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Cheol Hyeon Kim
- Division of Pulmonary and Critical Care Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hyo-Rak Lee
- Division of Hematology and Medical Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hye Jin Kang
- Division of Hematology and Medical Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Sung Hyun Yang
- Division of Hematology and Medical Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hyesil Seol
- Division of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Im Il Na
- Division of Hematology and Medical Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
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Kim SY, Myung JK, Kim HR, Na II, Koh JS, Baek HJ, Kim CH. Factors that Predict Clinical Benefit of EGFR TKI Therapy in Patients with EGFR Wild-Type Lung Adenocarcinoma. Tuberc Respir Dis (Seoul) 2018; 82:62-70. [PMID: 29926551 PMCID: PMC6304331 DOI: 10.4046/trd.2018.0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/19/2018] [Accepted: 03/24/2018] [Indexed: 01/10/2023] Open
Abstract
Background Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancers have emerged as key predictive biomarkers in EGFR tyrosine kinase inhibitor (TKI) treatment. However, a few patients with wild-type EGFR also respond to EGFR TKIs. This study investigated the factors predicting successful EGFR TKI treatment in lung adenocarcinoma patients with wild-type EGFR. Methods We examined 66 patients diagnosed with lung adenocarcinoma carrying wide-type EGFR who were treated with EGFR TKIs. The EGFR gene copy number was assessed by silver in situ hybridization (SISH). We evaluated the clinical factors and EGFR gene copy numbers that are associated with a favorable clinical response to EGFR TKIs. Results The objective response rate was 12.1%, while the disease control rate was 40.9%. EGFR SISH analysis was feasible in 23 cases. Twelve patients tested EGFR SISH-positive, and 11 were EGFR SISH-negative, with no significant difference in tumor response and survival between EGFR SISH-positive and -negative patients. The overall median progression-free survival (PFS) and overall survival (OS) of 66 patients were 2.1 months and 9.7 months, respectively. Female sex and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0–1 were independent predictors of PFS. ECOG PS 0–1 and a low tumor burden of extrathoracic metastasis were independent predictors of good OS. Conclusion Factors such as good PS, female sex, and low tumor burden may predict favorable outcomes following EGFR TKI therapy in patients with EGFR wild-type lung adenocarcinoma. However, EGFR gene copy number was not predictive of survival.
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Affiliation(s)
- Seo Yun Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jae Kyung Myung
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hye Ryoun Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Im Il Na
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hee Jong Baek
- Department of Thoracic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Cheol Hyeon Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
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Lee DW, Im SA, Kim YJ, Yang Y, Rhee J, Na II, Lee KH, Kim TY, Han SW, Choi IS, Oh DY, Kim JH, Kim TY, Bang YJ. CA19-9 or CEA Decline after the First Cycle of Treatment Predicts Survival in Advanced Biliary Tract Cancer Patients Treated with S-1 and Cisplatin Chemotherapy. Cancer Res Treat 2017; 49:807-815. [PMID: 28111425 PMCID: PMC5512384 DOI: 10.4143/crt.2016.326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/24/2016] [Indexed: 12/17/2022] Open
Abstract
Purpose While tumor markers (carbohydrate antigen 19-9 [CA 19-9] and carcinoembryonic antigen [CEA]) can aid in the diagnosis of biliary tract cancer, their prognostic role has not been clearly elucidated. Therefore, this study was conducted to evaluate the prognostic role of tumor markers and tumor marker change in patients with advanced biliary tract cancer. Materials and Methods Patients with pathologically proven metastatic or relapsed biliary tract cancer who were treated in a phase II trial of first-line S-1 and cisplatin chemotherapy were enrolled. Serum tumor markers were measured at baseline and after the first cycle of chemotherapy. Results Among a total of 104 patients, 80 (77%) had elevated baseline tumor markers (69 with CA 19-9 elevation and 40 with CEA). A decline ≥ 30% of the elevated tumor marker level after the first cycle of chemotherapy conferred an improved time to progression (TTP), overall survival (OS), and better chemotherapy response. Multivariate analysis revealed tumor marker decline as an independent positive prognostic factor of TTP (adjusted hazard ratio [HR], 0.44; p=0.003) and OS (adjusted HR, 0.37; p < 0.001). Subgroup analysis revealed similar results in each group of patients with CA 19-9 elevation and CEA elevation. In addition, elevated baseline CEA was associated with poor survival in both univariate and multivariate analysis. Conclusion Tumor marker decline was associated with improved survival in biliary tract cancer. Measuring tumor marker after the first cycle of chemotherapy can be used as an early assessment of treatment outcome.
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Affiliation(s)
- Dae-Won Lee
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Jung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yaewon Yang
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jiyoung Rhee
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sae-Won Han
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - In Sil Choi
- Department of Internal Medicine, Seoul Municipal Boramae Hospital, Seoul, Korea
| | - Do-Youn Oh
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jee Hyun Kim
- Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-You Kim
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Translational Medicine Major, Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yung-Jue Bang
- Department of Internal Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Shin DY, Lee HR, Kang HJ, Na II, Chang YH, Yang SH. Prevalent factor XII deficiency in cancer patients with isolated aPTT prolongation. Blood Res 2015; 50:114-7. [PMID: 26157783 PMCID: PMC4486155 DOI: 10.5045/br.2015.50.2.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 11/25/2014] [Accepted: 05/18/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- Dong-Yeop Shin
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hyo-Rak Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Hye Jin Kang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Im Il Na
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Yoon Hwan Chang
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
| | - Sung Hyun Yang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea
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Shin DY, Kim S, Park S, Koh JS, Kim CH, Baek H, Yang SH, Na II. Serum 25-hydroxyvitamin D levels correlate with EGFR mutational status in pulmonary adenocarcinoma. Endocr Relat Cancer 2014; 21:715-21. [PMID: 25030993 DOI: 10.1530/erc-14-0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
There have been several epidemiological studies of the association between 25-hydroxyvitamin D (25(OH)D) level and lung cancer risk. We explored the potential association between serum 25(OH)D levels and mutations in epidermal growth factor receptor (EGFR) in patients with pulmonary adenocarcinoma. We analyzed clinical data from 135 patients whose serum 25(OH)D levels were measured and EGFR mutational status was tested at the time of diagnosis. The relationship between 25(OH)D and clinical factors such as EGFR mutational status and sex was examined. The median serum 25(OH)D level in patients with pulmonary adenocarcinoma was 16.8 ng/ml (range: 3.0-84.3 ng/ml). The level of 25(OH)D was lower in female patients than in male patients (P=0.03). Interestingly, 25(OH)D levels of patients with EGFR-mutated tumors were low compared with those with wild-type tumors (median 18.2 vs 14.7 ng/ml, P=0.011). After a dose-response relationship between EGFR mutations and 25(OH)D levels (as a continuous variable) was observed (OR=0.96, P=0.036), we categorized 25(OH)D levels as low (≤16.8 ng/ml) and high (>16.8 ng/ml). Multivariate analysis revealed the association between low 25(OH)D levels and a high incidence of EGFR mutations (adjusted OR=2.42, 95% CI: 1.11-5.26, P=0.026). The results from this study indicate that low 25(OH)D levels are associated with EGFR mutations in pulmonary adenocarcinoma.
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Affiliation(s)
- Dong-Yeop Shin
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Soyeun Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sunhoo Park
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Jae Soo Koh
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Cheol Hyeon Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - HeeJong Baek
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sung Hyun Yang
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Im Il Na
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Shin DY, Kim S, Park S, Koh JS, Kim CH, Baek H, Yang SH, Na II. Serum 25-hydroxyvitamin D levels correlation with EGFR mutational status in pulmonary adenocarcinoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e19100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Dong-Yeop Shin
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - Soyeun Kim
- Department of Family Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - Sunhoo Park
- Department of Pathology, Korea Cancer Center Hospital, Seoul, South Korea
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Seoul, South Korea
| | - Cheol Hyeon Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - HeeJong Baek
- Department of Thoracic Surgery, Korea Cancer Center Hospital, Seoul, South Korea
| | - Sung Hyun Yang
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - Im Il Na
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, South Korea
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Kim S, Ko Y, Kwon S, Shin DY, Kim CH, Yang SH, Cho SJ, Na II. Family caregivers' awareness of illness and attitude toward disclosure during chemotherapy for advanced cancer. Psychooncology 2014; 23:1300-6. [DOI: 10.1002/pon.3565] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Soyeun Kim
- Department of Family Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Youngjin Ko
- Department of Family Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Sinyoung Kwon
- Hospice Center, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Dong-Yeop Shin
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Cheol Hyeon Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Sung Hyun Yang
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
| | - Im Il Na
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital; Korea Institute of Radiological and Medical Sciences; Seoul Korea
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10
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Choi HS, Kim MJ, Moon CH, Yoon JH, Ku HR, Kang GW, Na II, Lee SS, Lee BC, Park YJ, Kim HI, Ku YH. Medullary thyroid carcinoma with ectopic adrenocorticotropic hormone syndrome. Endocrinol Metab (Seoul) 2014; 29:96-100. [PMID: 24741461 PMCID: PMC3970275 DOI: 10.3803/enm.2014.29.1.96] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 05/07/2013] [Indexed: 11/11/2022] Open
Abstract
Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea.
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Affiliation(s)
- Hong Seok Choi
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Min Joo Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Chae Ho Moon
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jong Ho Yoon
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Ha Ra Ku
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Geon Wook Kang
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Seung-Sook Lee
- Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea
| | - Byung-Chul Lee
- Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Il Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Yun Hyi Ku
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
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11
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Lim SM, Chang H, Yoon MJ, Hong YK, Kim H, Chung WY, Park CS, Nam KH, Kang SW, Kim MK, Kim SB, Lee SH, Kim HG, Na II, Kim YS, Choi MY, Kim JG, Park KU, Yun HJ, Kim JH, Cho BC. A multicenter, phase II trial of everolimus in locally advanced or metastatic thyroid cancer of all histologic subtypes. Ann Oncol 2013; 24:3089-94. [PMID: 24050953 DOI: 10.1093/annonc/mdt379] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- S M Lim
- Department of Internal Medicine, Division of Medical Oncology, Yonsei University College of Medicine, Seoul
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12
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Yi EJ, Park JH, Lee HW, Cho SY, Na II, Kang MC. BRCA1 gene mutation in thymic malignant melanoma. Ann Thorac Surg 2013; 96:677-80. [PMID: 23910109 DOI: 10.1016/j.athoracsur.2012.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 11/21/2012] [Accepted: 12/07/2012] [Indexed: 01/07/2023]
Abstract
We present a patient with triple primary malignancies: thyroid cancer, ovarian cancer, and thymic malignant melanoma. We suspected that gene mutations were involved in the occurrence of these multiple primary cancers, and blood analysis revealed the presence of BRCA1 gene mutations.
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Affiliation(s)
- Eun Jue Yi
- Department of Thoracic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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13
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Na II, Kim HR, Lee JK, Park SH, Kim CH, Koh JS, Baek HJ, Choe DH. Epidermal growth factor receptor mutations in female patients with postoperative recurrent non-small-cell lung cancer. J Cancer Res Ther 2013; 8:373-8. [PMID: 23174717 DOI: 10.4103/0973-1482.103515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE We did this retrospective study to explore the association between epidermal growth factor receptor (EGFR) mutation and clinical features in postoperative recurrent female non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS We reviewed clinical data on 86 female patients who had postoperative recurrent disease between December 1992 and July 2007. The start of tyrosine kinase inhibitor therapy was treated as a censoring event. Corresponding surgical specimens of primary tumors were used to test for EGFR mutations. RESULTS Thirty patients presented with local recurrence and distant recurrence was identified in 56. Thirty-four of the 86 patients (40%) harbored EGFR mutations. Patients with distant recurrence were more likely to have EGFR mutations than patients with local recurrence (48% versus 23%; P = 0.024). On multivariate analysis, distant recurrence was associated with a high frequency of EGFR mutations (OR, 3.3; P = 0.028). Survival analysis showed poor survival of patients with mutated EGFR (HR, 2.3; P = 0.017) or with non-adenocarcinoma histology (HR, 3.3; P = 0.001). CONCLUSION The association between recurrence pattern and EGFR mutation status was suggested in recurrent female NSCLC patients. In addition, our data indicate unfavorable disease process of EGFR mutated tumors. Further studies need to be conducted to validate these findings.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Korea.
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14
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Rho JK, Choi YJ, Choi YR, Kim SY, Choi SJ, Choi CM, Na II, Lee JC. The effect of acquired cisplatin resistance on sensitivity to EGFR tyrosine kinase inhibitors in EGFR mutant lung cancer cells. Oncol Res 2012; 19:471-8. [PMID: 22715590 DOI: 10.3727/096504012x13285365944337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are used as first-line agents for treating nonsquamous cell lung cancer with EGFR mutation, there are many patients who have to receive these drugs following platinum-based chemotherapy. This study was designed to define whether exposure to cisplatin could affect the sensitivity to EGFR TKIs because conflicting results have been presented. We established sublines that are resistant to cisplatin from EGFR wild-type cells (A549 and H460) and EGFR mutant cells (PC-9 and HCC827). The EGFR-related signals were examined by Western blotting. MTT assay and the trypan blue exclusion method were used for the in vitro study, while tumor size and the SUV of the 18FDG-PET scans were measured in animal models. The IC50 value and apoptotic fractions after exposure to EGFR TKIs, such as gefitinib, erlotinib, and BIBW 2992, were almost the same in the cisplatin-resistant sublines compared to that of the parent cells. Although the baseline PTEN expression was reduced in the resistant cells, as was indicated in a previous study, the EGFR-related signals similarly responded to the EGFR TKIs. Furthermore, the reduced tumor size and SUV of the 18FDG-PET of the implanted tumor in nude mice according to erlotinib treatment were not different between the resistant sublines and the parent cells. In conclusion, the acquired resistance to cisplatin did not affect the sensitivity to EGFR TKIs in the EGFR mutant lung cancer cells, and this should abrogate any concerns about the use of EGFR TKIs following platinum-based chemotherapy.
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Affiliation(s)
- Jin Kyung Rho
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
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15
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Il Na I, Kim C, Park J, Choe D, Park S, Lee J. CT findings in non-small-cell lung cancer patients treated with gefitinib or erlotinib. J Cancer Res Ther 2012; 8:247-53. [DOI: 10.4103/0973-1482.98979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Na II, Park JH, Choe DH, Lee JK, Koh JS. Association of epidermal growth factor receptor mutations with metastatic presentations in non-small cell lung cancer. ISRN Oncol 2011; 2011:756265. [PMID: 22091430 PMCID: PMC3195961 DOI: 10.5402/2011/756265] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 03/24/2011] [Indexed: 12/18/2022]
Abstract
We performed this retrospective study to assess the association of epidermal growth factor receptor (EGFR) with metastatic presentations in advanced non-small cell lung cancer (NSCLC). The data from 125 patients with stage III or IV NSCLC were analyzed. We detected EGFR mutations in 36 NSCLC patients. EGFR mutations were predominant in never-smokers (P < .001), patients with adenocarcinomas (P < .001), and female patients (P < .001). When the metastatic sites were analyzed, pleural metastases were associated with a high incidence of EGFR mutations (P = .028). Particularly, pleural metastases with minimal effusion (PMME) were associated with EGFR mutational status (P = .001). Patients with N3 lesions were less likely to harbor EGFR mutations (P = .033). On multivariate analysis, N3 lesions (P = .017) and PMME (P < .001) remained significant factors for EGFR mutations. EGFR mutations may be associated with different presentations of pleural and N3 nodal metastases.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, 215-4, Gongneung-dong, Nowon-gu, Seoul 139-706, Republic of Korea
| | - Jong Heon Park
- Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Republic of Korea
| | - Du Hwan Choe
- Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Republic of Korea
| | - Jin Kyung Lee
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Republic of Korea
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 139-706, Republic of Korea
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17
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Na II, Park JY, Kim KM, Cheon GJ, Choe DH, Koh JS, Baek HJ, Lee JC. Significance of smoking history and FDG uptake for pathological N2 staging in clinical N2-negative non-small-cell lung cancer. Ann Oncol 2011; 22:2068-2072. [PMID: 21257671 DOI: 10.1093/annonc/mdq693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate whether smoking history and the standardized uptake value (SUV) of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) uptake are associated with unexpected pathological N2 status (pN2) in non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS We analyzed the data of 220 patients who underwent surgical resection with clinical N2-negative status on computed tomography (CT) and positron emission tomography (PET)-CT. The maximum SUV of primary tumor was chosen for logistic analysis. RESULTS Seventy-two patients (33%) had never smoked. The SUV ranged from 1.0 to 29.0 (median 9.1). In univariate analysis, adenocarcinomas (P = 0.019), female gender (P = 0.010), N1 on CT (P = 0.025), and N1 PET-CT (P = 0.001) were associated with a high probability of pN2. The proportion of pN2 in never smokers was higher than in ever smokers (26% versus 10% respectively; P = 0.002). The SUV remained on a multivariate logistic model (odds ratio 1.1; 95% confidence interval 1.0-1.2; P = 0.010) and it had a better predictive value in never smokers than in ever smokers (P = 0.017). CONCLUSIONS This study indicates an association between smoking history and pN2 in clinically negative N2 NSCLC. The different roles of FDG uptake were also suggested based on smoking history.
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Affiliation(s)
- I I Na
- Department of Internal Medicine.
| | - J Y Park
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - K M Kim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - G J Cheon
- Department of Nuclear Medicine, Korea University Medical Center Anam Hospital, Seoul
| | | | | | - H J Baek
- Thoracic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - J C Lee
- Department of Internal Medicine
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18
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Cho AR, Lim I, Na II, Choe DH, Park JY, Kim BI, Cheon GJ, Choi CW, Lim SM. Evaluation of Adrenal Masses in Lung Cancer Patients Using F-18 FDG PET/CT. Nucl Med Mol Imaging 2010; 45:52-8. [PMID: 24899978 DOI: 10.1007/s13139-010-0064-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/19/2010] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The aim of this study was to assess the diagnostic efficacy of PET/CT using various parameters for the characterization of adrenal nodules in lung cancer patients. METHODS Sixty-one adrenal nodules in 51 lung cancer patients were evaluated. The final diagnosis was based on histology (n = 2) or imaging follow-up (n = 59, range of follow-up: 7-57 months, median 27 months). Each adrenal nodule was analyzed using four parameters of PET/CT: the maximum standardized uptake value (SUVmax), the adrenal nodule/liver ratio of the SUV (SUV ratio), Hounsfield units (HU) and size. The optimal cutoff of each parameter for the identification of metastatic nodule was determined by ROC analysis and then the diagnostic efficacy was compared among the parameters. RESULTS Of the 61 adrenal nodules, 45 (73%) were considered metastasis. The optimal cutoff values of the parameters were SUVmax >2.7, SUV ratio >1.3, HU >18 and size >20 mm, respectively. The sensitivity, specificity and accuracy by SUVmax >2.7 were 88.9%, 87.5% and 88.5%, and those by SUV ratio >1.3 were 84.4%, 100% and 88.5%, respectively. The combination of SUV ratio >1.3 and HU >18 had sensitivity of 97.7%, specificity of 81.2% and accuracy of 93.4% to predict adrenal metastasis in patients with lung cancer. CONCLUSION SUV ratio from F-18 FDG PET/CT could identify the adrenal metastasis in lung cancer patients. The combination of SUV ratio and HU can improve the accuracy of differentiating benign and metastatic adrenal lesions in lung cancer patients.
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Affiliation(s)
- A Ra Cho
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea ; Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Du Hwan Choe
- Department of Radiology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Joon Yeun Park
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea ; Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea ; Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Chang Woon Choi
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea ; Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, Nowon-Gu, Seoul, 139-706 Korea ; Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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19
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Na II, Choe DH, Kim CH, Koh JS, Ryoo BY, Lee JC, Yang SH. Age at diagnosis predicts outcomes in gefitinib-treated female patients with non-small-cell lung cancer. Lung Cancer 2010; 68:295-8. [DOI: 10.1016/j.lungcan.2009.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 05/23/2009] [Accepted: 06/07/2009] [Indexed: 10/20/2022]
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20
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Na II, Byun BH, Kim KM, Cheon GJ, Choe DH, Koh JS, Lee DY, Ryoo BY, Baek H, Lim SM, Yang SH, Kim CH, Lee JC. 18F-FDG uptake and EGFR mutations in patients with non-small cell lung cancer: a single-institution retrospective analysis. Lung Cancer 2010; 67:76-80. [PMID: 19371962 DOI: 10.1016/j.lungcan.2009.03.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 03/11/2009] [Accepted: 03/13/2009] [Indexed: 11/30/2022]
Abstract
This retrospective study was performed to evaluate a possible association between the presence of epidermal growth factor receptor (EGFR) mutations and the standardized uptake value (SUV) of (18)F-fluoro-2-deoxy-glucose ((18)F-FDG) uptake in patients with non-small cell lung cancer (NSCLC). We included 100 patients who were tested for EGFR mutations by direct sequencing of resected tissues and who underwent preoperative positron emission tomography/computed tomography at the time of diagnosis. The maximum SUV by the primary tumor was chosen for further analysis. EGFR mutations in exons 19 and 21 were detected in 21 NSCLC patients (21%). EGFR mutations were more frequent in never-smokers than ever-smokers (35% versus 11%; P=0.003), in adenocarcinomas than non-adenocarcinomas (34% versus 6%; P=0.001), and in females than males (41% versus 12%; P=0.001). The SUV ranged from 1.3 to 33.0 (median 10.6). Area under receiver operating characteristic curve for SUVs in respect to the presence of EGFR mutations was 0.74 (95% CI: 0.62-0.85). When a cut off value was used, patients with low SUVs were more likely to have EGFR mutations than those with high SUVs (40% versus 11%; P=0.001). On multivariate analysis, a low SUV remained a significant predictors for EGFR mutations (P=0.025). (18)F-FDG uptake was associated with the presence of EGFR mutation. These results extrapolate that (18)F-FDG uptake might be helpful to discriminate patients who harbor EGFR mutations, especially when a genetic test is not feasible.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Republic of Korea.
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21
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No HS, Lee JH, Ahn Y, Na II, Kim HR, Kim CH, Koh JS, Lee JC. Prostatic Cancer Presenting as an Isolated Large Lung Mass. Tuberc Respir Dis (Seoul) 2010. [DOI: 10.4046/trd.2010.68.5.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hee Sun No
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jong Hwan Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Young Ahn
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Hye-Ryoun Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Cheol Hyeon Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea
| | - Jae Cheol Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
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Rho JK, Choi YJ, Lee JK, Ryoo BY, Na II, Yang SH, Lee SS, Kim CH, Yoo YD, Lee JC. The Role of MET Activation in Determining the Sensitivity to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors. Mol Cancer Res 2009; 7:1736-43. [DOI: 10.1158/1541-7786.mcr-08-0504] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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23
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Cho JH, Park YH, Kim WS, Oh SY, Cho SI, Kang HJ, Na II, Ryoo BY, Yang SH, Kim K, Jung CW, Park K, Ko YH, Lee SS. High incidence of mucosa-associated lymphoid tissue in primary thyroid lymphoma: A clinicopathologic study of 18 casesin the Korean population. Leuk Lymphoma 2009; 47:2128-31. [PMID: 17071486 DOI: 10.1080/10428190600783395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study aimed to evaluate the clinicopathologic features and treatment outcomes of patients with primary thyroid lymphoma (PTL). The patients included 14 women and four men with a median age of 50 years (range 31 - 82 years). Thirteen cases involved the thyroid alone (stage IE) and five cases involved the regional lymph nodes (stage IIE). Histopathologic studies revealed marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) in 13 patients and diffuse large B-cell lymphoma (DLBCL) in three patients. The other two patients showed features of both MALT and DLBCL. Surgery and chemotherapy with or without radiotherapy were performed. All patients achieved complete remission. All 18 patients were alive with a median follow-up period of 55 months. The prognosis of patients with primary thyroid lymphoma appears to be favourable.
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Affiliation(s)
- Jang Hyun Cho
- Department of Internal Medicine, Korea Institute of Radiological & Medical Science, Nowon-Ku, Seoul, Korea
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Im M, Lee JK, Hong YJ, Hong SI, Kang HJ, Na II, Ryoo BY, Cheon GJ, Lee HN, Chang YH. Four Cases of Hematologic Malignancy Following Radioactive Iodine Therapy for Thyroid Cancer. Ann Lab Med 2008; 28:425-9. [DOI: 10.3343/kjlm.2008.28.6.425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Mijeong Im
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jin Kyung Lee
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
- University of Science and Technology, Daejeon, Korea
| | - Young Joon Hong
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
- University of Science and Technology, Daejeon, Korea
| | - Seok Il Hong
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
- University of Science and Technology, Daejeon, Korea
| | - Hye Jin Kang
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Baek-Yeol Ryoo
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Ha Na Lee
- University of Science and Technology, Daejeon, Korea
| | - Yoon Hwan Chang
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
- University of Science and Technology, Daejeon, Korea
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Yoon JH, Kim MS, Kook EH, Ahn SH, Jeong SY, Han MS, Huh JK, Kang HJ, Na II, Cho SY, Kim SB, Ryoo BY, Yang SH. Primary gastric choriocarcinoma: two case reports and review of the literatures. Cancer Res Treat 2008; 40:145-50. [PMID: 19688122 DOI: 10.4143/crt.2008.40.3.145] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2008] [Accepted: 07/13/2008] [Indexed: 01/18/2023] Open
Abstract
Primary gastric choriocarcinoma (PGC) is a rare tumor, and its pathogenesis is still uncertain. Most PGCs have been reported to possess an adenocarcinoma component of variable extent, and pure PGC is especially rare. The diagnosis of PGC is confirmed by exhibition of choriocarcinomatous components on biopsy and exhibition of beta-hCG positive cell on immunohistochemical stain and elevation of the serum beta-hCG. Moreover it must be confirmed that no other site including gonads displays any tumor masses. The PGC tends to be more invasive and to have early metastasis. The median survival is known to be less than several months. We report two cases. The first case was a 62 year-old man who was diagnosed as advanced gastric cancer (AGC) by endoscopic biopsy with hepatic metastasis and received palliative chemotherapy with modified FOLFOX regimen and Genexol plus cisplatin regimen. He underwent subtotal gastrectomy due to perforation of the stomach during chemotherapy. On post-operative biopsy, He was re-diagnosed as PGC and received another palliative chemotherapy modified FOLFIRI, BEP, EMACO, VIP. However, multiple liver metastases were aggravated, and also serum AFP level increased. Ultimately, the patient died 10 months after initial diagnosis. Another case was a 45 year-old man. On endoscopic biopsy, he was diagnosed as AGC of adenocarcinoma. On Chest and Abdomen CT, multiple pulmonary and hepatic metastasis were also confirmed. On liver biopsy, He was diagnosed as PGC. The immunohistochemical stains were performed and the results were cytokeratin positive, EMA negative and beta-hCG weak positive. The serum beta-hCG level was highly elevated. BEP, VIP and EMA/CO combination therapy were administered, but he died at 12th months after the initial diagnosis.
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Affiliation(s)
- Jung Ho Yoon
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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Na II, Lee TH, Choe DH, Cheon GJ, Kim CH, Koh JS, Baek H, Ryoo BY, Yang SH, Lee JC. A diagnostic model to detect silent brain metastases in patients with non-small cell lung cancer. Eur J Cancer 2008; 44:2411-7. [PMID: 18707868 DOI: 10.1016/j.ejca.2008.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 06/27/2008] [Accepted: 07/01/2008] [Indexed: 11/19/2022]
Abstract
We aimed to discriminate subgroups according to the risk of brain metastases in patients with non-small cell lung cancer (NSCLC) lacking neurological symptoms. We performed a retrospective review of 433 patients with NSCLC who underwent chest computed tomography (CT), brain magnetic resonance imaging (MRI) and bone scans at an initial staging work-up between April 2003 and April 2007. Brain metastases were determined by MRI. Patients were stratified into groups according to the number of risk factors (0-3) identified by multivariate analysis. In multivariate analysis, histopathology with non-squamous cell carcinoma, nodal stage 2 on CT and presence of bone metastases were three risk factors for brain metastases. Patients were divided into four groups according to the number (0-3) of these predictive factors. The proportions of patients with brain metastases in the four groups were 2%, 3%, 17% and 35%, respectively, and these differences were significant (P<0.001). When analysis was performed in patients with localised disease, the number of risk factors was correlated with the prevalence of brain metastases (P=0.013) but stage was not (P=0.153). Although this diagnostic model should be validated through further studies, our data suggest that the number of risk factors might be a useful tool to identify silent brain metastases in patients with NSCLC.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-Gu, Seoul, Republic of Korea.
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Rho JK, Choi YJ, Lee JK, Ryoo BY, Na II, Yang SH, Kim CH, Lee JC. Epithelial to mesenchymal transition derived from repeated exposure to gefitinib determines the sensitivity to EGFR inhibitors in A549, a non-small cell lung cancer cell line. Lung Cancer 2008; 63:219-26. [PMID: 18599154 DOI: 10.1016/j.lungcan.2008.05.017] [Citation(s) in RCA: 175] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 05/13/2008] [Accepted: 05/13/2008] [Indexed: 11/24/2022]
Abstract
Epithelial to mesenchymal transition (EMT) has been reported to be related with reduced sensitivity to EGFR tyrosine kinase (EGFR-TK) inhibitors. We performed this study to investigate whether this phenomenon would play a role in acquired resistance to gefitinib. In this study, we established a gefitinib-resistant subline (A549/GR), which was derived from the parental A549 cell line by chronic, repeated exposure to gefitinib. Compared with the A549 cells, the A549/GR cells were approximately 7.7-fold more resistant to gefitinib and they showed the cross-resistance against other EGFR-TK inhibitors, including CL-387,758, erlotinib and ZD6478. Phenotypic changes such as a spindle-cell shape and increased pseudopodia formation suggesting EMT was present in the A549/GR cells. These changes were accompanied by a decrease of E-cadherin and an increase of vimentin, which is a mesenchymal marker. In addition, the ability of invasion and migration was increased in the A549/GR cells. TGF-beta1 treatment for 72 h also induced EMT in the A549 cells and this transition led to resistance to gefitinib. Conversely, this was reversed through the removal of TGF-beta1. In conclusion, induction of EMT may contribute to the decreased efficacy of therapy in primary and acquired resistance to gefitinib.
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Affiliation(s)
- Jin Kyung Rho
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Science, Seoul 139-706, Republic of Korea
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Na II, Cheon GJ, Choe DH, Byun BH, Kang HJ, Koh JS, Park JH, Baek H, Ryoo BY, Lee JC, Yang SH. Clinical significance of 18F-FDG uptake by N2 lymph nodes in patients with resected stage IIIA N2 non-small-cell lung cancer: A retrospective study. Lung Cancer 2008; 60:69-74. [DOI: 10.1016/j.lungcan.2007.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Revised: 09/18/2007] [Accepted: 09/19/2007] [Indexed: 10/22/2022]
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Na II, Byun BH, Kang HJ, Cheon GJ, Koh JS, Kim CH, Choe DH, Ryoo BY, Lee JC, Lim SM, Yang SH. 18F-Fluoro-2-Deoxy-Glucose Uptake Predicts Clinical Outcome in Patients with Gefitinib-Treated Non–Small Cell Lung Cancer. Clin Cancer Res 2008; 14:2036-41. [DOI: 10.1158/1078-0432.ccr-07-4074] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Choi YH, Kim HS, Nam SB, Kang HJ, Na II, Yang SH, Ryoo BY. A Case of Epstein-Barr Virus-positive Diffuse, Large B-cell Lymphoma after Angioimmunoblastic T-cell Lymphoma. Korean J Hematol 2008. [DOI: 10.5045/kjh.2008.43.3.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yoon Hee Choi
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyo Seog Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Seung Bum Nam
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Hye Jin Kang
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Sung Hyun Yang
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Baek-Yeol Ryoo
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
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Na II, Rho JK, Choi YJ, Kim CH, Park JH, Koh JS, Ryoo BY, Yang SH, Lee JC. The survival outcomes of patients with resected non-small cell lung cancer differ according to EGFR mutations and the P21 expression. Lung Cancer 2007; 57:96-102. [PMID: 17337084 DOI: 10.1016/j.lungcan.2007.01.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Revised: 12/07/2006] [Accepted: 01/30/2007] [Indexed: 10/23/2022]
Abstract
The aims of this study were to evaluate the prognostic implications of patients with epidermal growth factor receptor (EGFR) mutations and a p21 expression, and to determine their associations in resected non-small cell lung cancer (NSCLC) patients. We sequenced exons 18-21 of the EGFR tyrosine kinase domain by performing mutation analysis of tissues from patients that suffered with NSCLC and who also had undergone surgical resection. The expressions of p21 and p53 were analyzed using immunohistochemistry. We detected EGFR mutations in 24 of 97 patients (25%). EGFR mutations were more frequent in the people who had never smoked than in the smokers (33% versus 14%, respectively; P=.028). The presence of EGFR mutations had no effect on survival. The expression of p21 in the patients with wild-type EGFR tended to be associated with better survival. However, the expression of p21 in the patients with EGFR mutations was associated with poor overall survival (P=.006). The five-year survival rates were 17% for the patients with EGFR mutations and p21 positivity (Group I), 44% for the patients with wild type EGFR (Group II), and 75% for the patients with EGFR mutation and no p21 positivity (Group III) (P=.036). Multivariate analysis that was corrected for age, gender and cancer stage revealed different overall survival outcomes according to the three groups (P=.004). There was no significant correlation between the expressions of p21 and p53. Survival outcomes in the patients with resected NSCLC may be correlated with the presence of a p21 expression and EGFR mutations.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, South Korea
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Na II, Kang HJ, Cho SY, Koh JS, Lee JK, Lee BC, Lee GH, Lee YS, Yoo HJ, Ryoo BY, Yang SH, Shim YS. EGFR mutations and human papillomavirus in squamous cell carcinoma of tongue and tonsil. Eur J Cancer 2007; 43:520-6. [PMID: 17224267 DOI: 10.1016/j.ejca.2006.09.025] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Revised: 09/01/2006] [Accepted: 09/07/2006] [Indexed: 11/19/2022]
Abstract
This study was performed to determine the clinical significance of mutations in the EGFR (epidermal growth factor receptor) along with their association with human papillomavirus (HPV) infections in patients with squamous cell carcinoma of the head and neck (HNSCC). Exons 18-21 of the EGFR tyrosine kinase domain were sequenced and HPV typing was carried out using the HPV DNA chip in tissues obtained from patients with tongue and tonsil cancer. Univariate and multivariate analyses were used to identify the significant factors. One hundred and eight patients were enrolled. Ten patients (9%) were HPV positive and 17 (16%) had EGFR mutations. None of the patients with EGFR mutations were HPV positive. Gender, age (<60 years versus 60 years), and smoking history were not associated with EGFR mutations. A higher percentage of patients with tonsillar cancer were HPV positive than those with tongue cancer (26% and 0%, respectively; P<0.001). EGFR mutations were not a significant prognostic factor (P=0.746). HPV-positive patients had prolonged survival (P=0.025). Multivariate analysis revealed a longer overall survival in HPV-positive patients (P=0.007). EGFR mutations are not associated with the HPV-positive status, which may confer a better survival outcome. Clinical features of lung cancer patients with EGFR mutations were not observed in HNSCC. A further study will be needed to confirm these results.
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Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Centre Hospital, Korea Institute of Radiological and Medical Sciences, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Korea.
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Lee HJ, Nam SB, Jung JW, Na II, Kim CH, Ryoo BY, Choe DW, Kang JH, Lee JC. Gefitinib-Related Interstitial Pneumonia. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.62.2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ho Jin Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Seung Bum Nam
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jae Wook Jung
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Cheol Hyeon Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Baek-Yeol Ryoo
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Du Whan Choe
- Department of Radiology, Korea Cancer Center Hospital, Seoul, Korea
| | - Jin Hyung Kang
- Department of Internal Medicine, Kangnam St. Mary's Hospital, Seoul, Korea
| | - Jae Cheol Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
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Ryoo BY, Na II, Yang SH, Koh JS, Kim CH, Lee JC. Synchronous multiple primary lung cancers with different response to gefitinib. Lung Cancer 2006; 53:245-8. [PMID: 16787685 DOI: 10.1016/j.lungcan.2006.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Revised: 05/06/2006] [Accepted: 05/11/2006] [Indexed: 10/24/2022]
Abstract
Synchronous bronchiolo-alveolar cell carcinoma (BAC) in both lungs and squamous cell carcinoma in left lung were found in a 66-year-old male smoker. After two courses of chemotherapy with gemcitabine and carboplatin, the left lung mass had partially resolved, however, the extent of BAC had been increased. When gefitinib was used as a second-line chemotherapy, the consolidation lesions of BAC was improved while the mass of squamous cell carcinoma was aggravated. The analysis of epidermal growth factor receptor-tyrosine kinase (EGFR-TK) mutations showed that BAC had the deletion, delE746-A750 in exon 19, however, squamous cell carcinoma had no mutations. These synchronous tumors with different location, histology, status of EGFR-TK mutations and response to chemotherapy might be caused by different molecular pathogenesis.
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Affiliation(s)
- Baek-Yeol Ryoo
- Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Republic of Korea
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Park YH, Kim WS, Bang SM, Lee SI, Kang HJ, Na II, Yang SH, Lee SS, Uhm JE, Kwon JM, Kim K, Jung CW, Park K, Ko YH, Ryoo BY. Primary gastric lymphoma of T-cell origin: clinicopathologic features and treatment outcome. Leuk Res 2006; 30:1253-8. [PMID: 16529813 DOI: 10.1016/j.leukres.2006.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 12/27/2005] [Accepted: 01/26/2006] [Indexed: 12/19/2022]
Abstract
We conducted a retrospective analysis to investigate the natural history and the clinical outcome after treatment of primary gastric lymphoma of T-cell origin. Seventeen cases of T-cell origin among 444 primary gastric lymphoma patients were analyzed. The median age of the 14 male and 3 female patients was 49 years (range 22-76 years). The median progression-free survival (PFS) and overall survival (OS) were only 10 months (95% CI; 0-20 months), and 12 months (95% CI; 4-21 months), respectively. This study showed that the incidence of this subtype of T-cell gastric lymphoma was very rare, and had poor prognosis.
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Affiliation(s)
- Yeon Hee Park
- Department of Hematology-Oncology, Korea Institute of Radiological & Medical Sciences, Nowon-ku, Seoul, Republic of Korea.
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Park YH, Kim WS, Kang HJ, Na II, Ryoo BY, Yang SH, Lee SS, Uhm JE, Kim K, Jung CW, Park K, Ko YH. Gastric Burkitt lymphoma is a distinct subtype that has superior outcomes to other types of Burkitt lymphoma/leukemia. Ann Hematol 2006; 85:285-90. [PMID: 16518604 DOI: 10.1007/s00277-005-0050-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 11/12/2005] [Indexed: 11/30/2022]
Abstract
Burkitt lymphoma/leukemia (BL) is a highly aggressive non-Hodgkin's lymphoma (NHL) often presenting in extranodal sites or as an acute leukemia. Because of the shared molecular and genetic features, the World Health Organization classification of lymphoid diseases recognizes the lymphomatous and leukemic phases of BL as a single entity: a mature B cell neoplasm, subtype Burkitt lymphoma/Burkitt cell leukemia. Because BL frequently appears in the stomach, we investigated the clinical presentation and outcome of gastric BL. We discovered 21 patients with gastric BL through a survey of our NHL registry, and retrospectively analyzed the distinct features of BL, including the St Jude/Murphy staging, other extranodal involvement, morphology and immunophenotype, response to treatment, and clinical outcome. The patients' median age was 48 years (range, 7-75), and the male-to-female ratio was 2.5. Stage 1 was found in five patients, stage 2 in five patients, and stage 4 in 11 patients. The stomach body and antrum were most frequently involved. All 21 patients were treated with systemic intensive chemotherapy, producing a 71% (15/21) rate of complete response (CR) to chemotherapy. Both the 2-year disease-free and overall survival rates were 55%. All ten patients in BL stages 1 and 2 showed outstanding outcomes, and nine of the ten patients exhibited CR and long-term survival. These data show that a high proportion of patients with gastric BL have a localized disease that is limited to stage 1 and 2, and that these localized BLs have outstanding outcomes. These findings suggest that these BLs could represent a distinct subtype that might have a different biology, which needs to be defined.
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Affiliation(s)
- Yeon Hee Park
- Division of Hematology-Oncology, Department of Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, 215-4, Gongneung-Dong, Nowon-Gu, 139-706, Seoul, South Korea
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Na II, Shin H, Song EK, Lee KW, Yun T, Kim JH, Yoon SS, Lee JS, Park S, Kim BK. Graft-Versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation with Non-Myeloablative Conditioning: Experiences at a Single Center. Korean J Hematol 2006. [DOI: 10.5045/kjh.2006.41.2.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Im Il Na
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Hyunchoon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Kee Song
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang, Korea
| | - Tak Yun
- Department of Internal Medicine, National Cancer Center, Goyang, Korea
| | - Jee Hyun Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang, Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Seok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang, Korea
| | - Seonyang Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Byoung Kook Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Joh YH, Kim TY, Na II, Oh DY, Kim BS, Kim JH, Kim DY, Lee SH, Yoo CG, Lee CT, Kim YW, Heo DS, Bang YJ, Han SK, Shim YS, Kim NK. Phase II Trial of Vinorelbine and Cisplatin Chemotherapy in Advanced Non-Small Cell Lung Cancer. Cancer Res Treat 2001; 33:373-6. [PMID: 26680810 DOI: 10.4143/crt.2001.33.5.373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Platinum-based chemotherapy has conferred a modest but significant survival benefit and the introduction of newer drugs has led to achieve higher response rate in patients with advanced non-small cell lung cancer (NSCLC). We performed a phase II trial in order to evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine (Navelbine) and cisplatin in advanced NSCLC. MATERIALS AND METHODS Patients with previously untreated, unresectable stage IIIB or IV NSCLC with measurable lesion (s) were eligible for entry into the study. NP chemotherapy consisted of intravenous vinorelbine 25 mg/m2, on day 1 and 8, and intravenous cisplatin 80 mg/m2 on day 1; this cycle was repeated every three weeks. RESULTS A total of 33 patients were enrolled in the study between July 1999 and Feb 2000. Of the 30 patients deemed eligible for analysis, thirteen patients achieved a partial response and thirteen showed a stable disease. The overall response rate was 43.3%. The median duration of response was 5.7 months (95% CI: 2.8~8.5 months). The median time to progression was 7.6 months (95% CI: 5.5~9.7 months) and the overall median survival time was 15.1 months (95% CI: 9.8~20.4 months) in the intent-to-treat analysis. Chemotherapy-related grade 3 or 4 toxicities were anemia in 1.5%, leukopenia in 4.5%, nausea/vomiting in 2.3%, alopecia in 13.3%, and neurotoxicity in 3.3%. CONCLUSION The combination of vinorelbine and cisplatin chemotherapy seems to be active and fairly tolerable in patients with advanced NSCLC.
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