Showing papers on "Adenocarcinoma of the lung published in 2023"
TL;DR: In this article , an 81-year-old female with hypereosinophilia-associated lung adenocarcinoma was found to have significant right lower lobe mass enlargement since the previous study completed 5 months prior.
Abstract: It is well-documented that lung and bronchus cancers are the leading cause of cancer death in the United States in both male and female patients, with lung adenocarcinoma accounting for the highest prevalence of lung cancers. Significant eosinophilia in the setting of lung adenocarcinoma has been documented in a few reports, being described as a rare paraneoplastic syndrome. We report on an 81-year-old female with hypereosinophilia-associated lung adenocarcinoma. A chest film showed a right lung mass, which was not apparent on a chest film 1 year prior, in the setting of significant leukocytosis of 27.90 x 103/mm3 with eosinophilia of 6.40 x 103/mm3. A computed tomography (CT) chest, obtained during admission, demonstrated significant right lower lobe mass enlargement since the previous study completed 5 months prior, with new occlusion of bronchi and pulmonary vessels to the region of the mass. Our observations are consistent with prior reports showing that the presence of eosinophilia in lung cancers may indicate rapid disease progression.
TL;DR: In this article , the authors reported an unusual case of late and lethal Trousseau's syndrome during pembrolizumab maintenance therapy in a lung adenocarcinoma harboring tumor protein p53 (TP53) mutation.
Abstract: Trousseau's syndrome is a relatively rare reported event in immunotherapy-related clinical trials, mostly occurring in the early period of immune checkpoint inhibitor (ICI) therapy. Here, we report an unusual case of late and lethal Trousseau's syndrome during pembrolizumab maintenance therapy in a lung adenocarcinoma harboring tumor protein p53 (TP53) mutation. The patient has experienced severe coagulation abnormalities manifesting as cerebral infarction, partial infarction of both kidneys and spleen after 23 cycles of pembrolizumab use and was resistant to anticoagulants. The late occurrence of coagulation abnormalities in this case reveals a possible correlation between TP53 mutations and Trousseau's syndrome when patients are treated with ICIs.
TL;DR: In this paper , a 70-year-old female with a painful swollen right index finger was found to be a metastatic lesion from adenocarcinoma of the lung.
Abstract: Acrometastasis accounts for 0.1% of all cases of metastatic cancer, with the most common primary tumor being lung cancer. Since acrometastasis is extremely rare and it generally has a nonspecific clinical presentation, it provides a diagnostic dilemma. We present a case of a 70-year-old female with a painful swollen right index finger which was found to be a metastatic lesion from adenocarcinoma of the lung. The patient expired within one month of diagnosis due to complications from her rapidly progressive metastatic cancer.
TL;DR: Wang et al. as mentioned in this paper presented the immune infiltration characteristics of tumor cells in patients with lung adenocarcinoma (LUAD) and evaluated the predictive value and significance of tumor immune cells on the prognosis of LUAD patients.
Abstract: Background To depict the immune infiltration characteristics of tumor cells in patients with lung adenocarcinoma (LUAD) and evaluate the predictive value and significance of tumor immune cells on the prognosis of LUAD patients. Methods The clinical characteristics and transcriptome of LUAD patients were obtained from The Cancer Genome Atlas (TCGA), and the immune cell abundance in LUAD tissue was evaluated using the CIBERSORT algorithm. We created a simplified immune cell-based Cox regression model according to the survival status of patients and clarified the correlation between the survival status of patients and seven types of immune cells. An immune cell-based risk prediction model was created by Cox proportional hazards regression. Subsequently, the gene expression profile of LUAD patients was obtained from the Gene Expression Omnibus (GEO) database to validate the tumor immune infiltration and patient prognosis prediction model attained using the CIBERSORT algorithm. Results The abundance of 22 tumor-infiltrating immune cells in these patients was detected using the CIBERSORT algorithm. According to Pearson correlation analysis, the immune cells appeared to be closely related to each other. The immune cell composition was remarkably different between the LUAD tumor tissue and paracancerous tissue. The simplified COX model showed that seven kinds of immune cells have predictive value for the prognosis and survival status of LUAD. The receiver operating characteristic curve (ROC) curve confirmed that the prediction model performed well for 1-, 3-, and 5-year survival status. The calibration curve suggested that the prediction model was consistent with the clinical results. Correlation analysis revealed that the clinical features were significantly related to immune cell infiltration. A total of 246 LUAD specimens were from the GEO database, and the risk score model suggested that high risk scores were indicative of a poor prognosis. Finally, enzyme-linked immunosorbent assay (ELISA) revealed that the expressions of tumor necrosis factor-α (TNF-α), interleukin 8 (IL-8), IL-6, and interferon-γ (IFN-γ) in tumor tissues were remarkably higher compared with those in adjacent tissues. Conclusions There is a close correlation between the tumor-infiltrating immune cells and the prognosis and clinical characteristics of LUAD patients. The risk score model based on TCGA and GEO designed in this study can be applied in clinical practice.
TL;DR: In this article , the role of the secreted protein beta-1,3-N-acetylglucosaminyltransferase 3 (B3GNT3) in the development of lung adenocarcinoma and to evaluate its potential significance for early clinical biomarker screening was explored.
Abstract: Background Lung adenocarcinoma, as a common histological type in lung cancer, the overall survival is very low, and the prognosis is poor because it is difficult to find and easily recurs. Therefore, this study aimed to explore the role of the secreted protein beta-1,3-N-acetylglucosaminyltransferase 3 (B3GNT3) in the development of lung adenocarcinoma and to evaluate its potential significance for early clinical biomarker screening. Methods The mRNA expression profiles of patients with lung adenocarcinoma and normal controls were analyzed via The Cancer Genome Atlas (TCGA) database. Serum samples of clinical lung cancer patients and healthy people were obtained, and the differences in B3GNT3 expression in different stages of lung adenocarcinoma and in healthy tissues were compared. Kaplan-Meier (K-M) curves were drawn to clarify the influence of high and low expression of B3GNT3 on the prognosis of patients. Peripheral blood samples from patients with lung adenocarcinoma and healthy people were obtained clinically, and receiver operating characteristic (ROC) curves were drawn to clarify the sensitivity and specificity of B3GNT3 expression for the diagnosis of lung adenocarcinoma. Lung adenocarcinoma cells were cultured in vitro, the expression of B3GNT3 was knocked down by lentivirus infection. The expression of the apoptosis-associated genes was detected by reverse transcription-polymerase chain reaction (RT-PCR). Results The secreted protein B3GNT3 is significantly differentially expressed in the serum of patients with lung adenocarcinoma versus normal controls. Subgroup analysis according to lung adenocarcinoma clinical stage showed that the higher the clinical stage of lung adenocarcinoma was, the higher the B3GNT3 expression. Enzyme-linked immunosorbent assay (ELISA) revealed that B3GNT3 expression was significantly increased in the serum of patients with lung adenocarcinoma and significantly decreased after surgery. By inhibiting programmed cell death-ligand 1 (PD-L1), the level of apoptosis was significantly increased and the proliferative capacity was significantly inhibited. In contrast, the level of apoptosis was significantly increased and the proliferation ability was significantly inhibited after simultaneous overexpression of B3GNT3 and inhibition of PD-L1. Conclusions High expression of the secreted protein B3GNT3 in lung adenocarcinoma is closely related to prognosis and can serve as a potential biological marker for the early screening of lung adenocarcinoma.
TL;DR: The use of osilodrostat in paraneoplastic CS has been previously reported in only 3 patients as mentioned in this paper , while lung cancer was treated with osimertinib, which is more commonly seen in small cell lung cancer but never before reported in epidermal growth factor receptor mutated adenocarcinoma of the lung.
Abstract: Abstract Cushing’s syndrome (CS), secondary to paraneoplastic syndrome, is more commonly seen in small cell lung cancer but never before reported in epidermal growth factor receptor-mutated adenocarcinoma of the lung. Here, we present a case of a patient whose symptoms of hypokalemia, hypertension, and progressive abnormal glucose levels led to further workup that revealed adrenocorticotropic hormone-dependent hypercortisolism. Her cortisol levels dropped after 1 month of osilodrostat treatment, while lung cancer was treated with osimertinib. The use of osilodrostat in paraneoplastic CS has been previously reported in only 3 patients.
05 Apr 2023
TL;DR: Wang et al. as discussed by the authors investigated the predictive value of serum D-dimer levels combined with tumor markers for venous thromboembolism (VTE) in elderly patients with stage III-IV lung adenocarcinomas.
Abstract: Abstract Objective To investigate the predictive value of serum D-dimer levels combined with tumor markers for venous thromboembolism (VTE) in elderly patients with stage III-IV lung adenocarcinomas. Methods A retrospective analysis was conducted involving elderly patients with inoperable stage III-IV lung adenocarcinoma admitted to the Department of Geriatrics and Department of Respiratory and Critical Care Medicine at Henan Provincial People's Hospital between January 2019 and January 2021. Patients were divided into VTE (n = 129) and non-VTE groups (n = 192). Serum D-dimer, carcinoembryonic antigen (CEA), lung cancer antigen (CYFRA21-1), carbohydrate antigen 125 (CA-125), carbohydrate antigen 199 (CA19-9), and neuron-specific enolase (NSE) levels were compared between the two groups. The risk factors for serum D-dimer and tumor markers in elderly patients with stage III-IV lung adenocarcinoma complicated by VTE were analyzed using binary logistic regression. The ROC curve was used to evaluate the predictive value of serum D-dimer and tumor markers in elderly patients with stage III-IV lung adenocarcinoma complicated by VTE. Results Compared to the non-VTE group, the serum D-dimer, CEA, CYFRA21-1, CA-125, and CA19-9 levels in elderly patients with stage III-IV lung adenocarcinoma and VTE were significantly different (P < 0.05). Further logistic regression analysis showed that D-dimer, CEA, and CYFRA21-1 levels were risk factors for VTE in elderly patients with stage III-IV lung adenocarcinoma. The area under the curve (AUC) of D-dimer, CEA, and CYFRA21-1 levels for the prediction of stage III-IV lung adenocarcinoma combined with VTE in the elderly were 0.839, 0.720, and 0.676, respectively (P < 0.05).The predicted AUC of D-dimer combined with CEA for stage III-IV lung adenocarcinoma complicated with VTE in elderly patients was 0.861, sensitivity was 0.868, specificity was 0.671, and cut-off value was 0.771. Conclusion: Serum D-dimer levels combined with the tumor marker CEA can improve the clinical diagnosis of VTE in elderly patients with stage III-IV lung adenocarcinoma.
TL;DR: Wang et al. as discussed by the authors used unsupervised consensus clustering based on the expression of SUMOylation regulatory genes to identify the tumor microenvironment features of lung adenocarcinoma, especially the immune cell infiltration status.
Abstract: Background: Recent studies have revealed that SUMOylation modifications are involved in various biological processes, including cancer development and progression. However, the precise role of SUMOylation in lung adenocarcinoma (LUAD), especially in the tumor immune microenvironment, is not yet clear. Methods: We identified SUMOylation patterns by unsupervised consensus clustering based on the expression of SUMOylation regulatory genes. The tumor microenvironment in lung adenocarcinoma was analyzed using algorithms such as GSVA and ssGSEA. Key genes of SUMOylation patterns were screened for developing a SUMOylation scoring model to assess immunotherapy and chemotherapy responses in lung adenocarcinoma patients. Experiments were conducted to validate the differential expression of model genes in lung adenocarcinoma. Finally, we constructed a nomogram based on the SUMOylation score to assess the prognosis of individual lung adenocarcinoma patients. Results: Two patterns of SUMOylation were identified, namely, SUMO-C1, which showed anti-tumor immune phenotype, and SUMO-C2, which showed immunosuppressive phenotype. Different genomic subtypes were also identified; subtype gene-T1 exhibited a reciprocal restriction between the immune microenvironment and stromal microenvironment. High SUMOylation scores were indicative of poor lung adenocarcinoma prognosis. SUMOylation score was remarkably negatively correlated with the infiltration of anti-tumor immune cells, and significantly positively correlated with immune cells promoting immune escape and immune suppression. In addition, patients with low scores responded better to immunotherapy. Therefore, the developed nomogram has a high prognostic predictive value. Conclusion: The SUMOylation patterns can well discriminate the tumor microenvironment features of lung adenocarcinoma, especially the immune cell infiltration status. The SUMOylation score can further assess the relationship between SUMOylation and immune cell crosstalk and has significant prognostic value and can be used to predict immunotherapy and chemotherapy response in patients with lung adenocarcinoma.
TL;DR: Wang et al. as discussed by the authors explored the clinical features, prognostic factors, and optimal treatments for lung squamous cell cancer in situ (LSCIS) patients and found that the patients with LSCIS had significantly worse survival than those with LAIS.
Abstract: Background Lung squamous cell cancer in situ (LSCIS) is preinvasive squamous tumor and generally overlooked as a potential subtype of pathological and clinical significance, which has seldom been investigated systematically. This study sought to explore the clinical features, prognostic factors, and optimal treatments for LSCIS patients. Methods Patients diagnosed with LSCIS (n=449), lung adenocarcinoma in situ (LAIS; n=1,132), stage IA lung squamous cell cancer (LSQCC; n=22,289) and stage IA lung adenocarcinoma (LUAD; n=68,523) were identified in the Surveillance Epidemiology and End Results (SEER) database. Additionally, 512 patients from the Shanghai Pulmonary Hospital diagnosed with LSCIS (n=34), LAIS (n=248), stage IA LSQCC (n=118) and stage IA LUAD (n=112) were included in the study. Kaplan-Meier survival curves were constructed, and Cox proportional hazards regression analyses were performed to examine the overall survival (OS), lung cancer-specific survival (LCSS), and progression-free survival (PFS) of the patients. Results The univariate and multivariate analyses showed the patients with LSCIS had significantly worse survival than those with LAIS. Although, the univariate analysis revealed that the LSCIS patients had significantly worse OS and LCSS than the stage IA LSQCC patients, the multivariate analyses showed that the prognosis of the LSCIS was similar to that of the stage IA LSQCC in the SEER cohort. The prognosis of the LSCIS was similar to that of the stage IA LSQCC in the Shanghai Pulmonary Hospital cohort. The univariate and multivariate analyses showed that age (>70 years) and chemotherapy were negative prognostic factors, and surgery was a favorable prognostic factor for the LSCIS patients. The survival of the LSCIS patients who underwent local tumor destruction or excision was similar to that of those who did not receive surgery. Lobectomy was the surgical procedure associated with the highest OS and LCSS in LSCIS patients. Conclusions The survivals of the LSCIS were similar to those of the stage IA LSQCC, but significantly worse than those of the LAIS. Surgery was an independent favorable prognostic factor for the LSCIS patients. Lobectomy was a superior choice of surgical procedure, and significantly improved the current outcomes of the LSCIS patients.
TL;DR: In this article , the authors reported the first case of a patient with Sweet's syndrome and lung adenocarcinoma with a decrease in peripheral whole blood cells, the patient was treated with a variety of antibiotics, but his symptoms did not improve significantly.
Abstract: Background Sweet’s syndrome is a rare inflammatory disease of unknown etiology, and its relationship with tumors is unknown at present. Sweet’s syndrome in patients with solid tumors, especially adenocarcinoma of the lung, is extremely rare. At present, only 1 case of an operative patient has been reported in the literature. Diagnosing lung cancer with Sweet’s syndrome is not easy, when there is a fever with an unknown cause and erythemas, especially when the erythemas do not disappear after antibiotic treatment, a skin biopsy is much important. Although the exact mechanism of the disease and its link to lung cancer are unknown, our case shows that the active surgical treatment of the primary disease and appropriate glucocorticoid therapy are effective means. Case Description We report the first case of a patient with Sweet’s syndrome and lung adenocarcinoma with a decrease in peripheral whole blood cells. A 66-year-old male patient presented, who had been suffering from a fever for >10 days and had multiple tender erythemas, erythemas were mainly on the limbs and upper chest. He was treated with a variety of antibiotics, but his symptoms did not improve significantly. The routine blood tests results show a decline in peripheral blood cells, a chest computed tomography (CT) examination showed a space occupying lesion in the middle lobe of the right lung, which was considered peripheral lung cancer. Sweet’s syndrome was diagnosed after a skin biopsy, a pathological examination showed that a large number of neutrophils were infiltrating. The patient then underwent video-assisted thoracoscopic lobectomy associated with the systematic dissection of the mediastinal lymph node, and glucocorticoids were administered. After the operation, the tender erythemas and fever disappeared, at the 1-month follow-up, the chest CT showed no obvious tumor recurrence or metastasis. Conclusions To the best of our knowledge, this is the first report of Sweet’s syndrome in a patient with lung adenocarcinoma with 3 cell lines reduced. The active surgical treatment of the primary disease and appropriate glucocorticoid therapy proved to be an effective treatment for this syndrome.
TL;DR: In this paper , the authors evaluated the expression of NHLRC2 in lung cell and tissue samples from patients with lung adenocarcinoma (ADC) and squamous cell carcinoma (SCC).
Abstract: Background Certain variants of NHL repeat (named after NCL-1, HT2A and LIN-41)-containing protein 2 (NHLRC2) gene have been linked to severe fibrotic interstitial lung disease in children. The aim of the current study was to evaluate the expression of NHLRC2 in lung cell and tissue samples from patients with lung adenocarcinoma (ADC) and squamous cell carcinoma (SCC). Methods The expression of NHLRC2 in lung tissue samples was studied by immunohistochemistry (102 ADC, 111 SCC), mRNA in situ hybridization (4 ADC, 3 SCC), and Western blot analysis (3 ADC, 2 SCC). The immunohistochemical NHLRC2 expression was measured by image analysis software and the percentage of NHLRC2-positive cancer cells was evaluated by semiquantitative analysis. The immunohistochemical results of NHLRC2 were compared with the clinical and histological characteristics of the patients. NHLRC2 protein levels in primary stromal and epithelial lung cancer cell lines were measured by Western blot analysis. Results NHLRC2 was mainly expressed in cancer cells and inflammatory cells within the tumor. The NHLRC2 expression evaluated by image analysis method was significantly higher in ADC compared with that in SCC (P<0.001). High NHLRC2 expression was associated with reduced disease specific survival (P=0.002), overall survival (P=0.001), and high mitotic activity (P=0.042) in ADC. Additionally, the proportion of NHLRC2-positive cancer cells analyzed by the semiquantitative method was significantly higher in ADC than in SCC (P<0.001). Conclusions NHLRC2 expression was higher in lung ADC than in SCC and its expression was associated with poor survival in ADC patients. Further studies are required to clarify the pathogenetic role of NHLRC2 in lung cancer.
TL;DR: In this article , the authors examined recurrence patterns and associations with outcomes in patients with resected lung adnocarcinoma according to ground-glass opacity (GGO) at CT.
Abstract: Background Although lung adenocarcinoma with ground-glass opacity (GGO) is known to have distinct characteristics, limited data exist on whether the recurrence pattern and outcomes in patients with resected lung adenocarcinoma differ according to GGO presence at CT. Purpose To examine recurrence patterns and associations with outcomes in patients with resected lung adenocarcinoma according to GGO at CT. Materials and Methods Patients who underwent CT followed by lobectomy or pneumonectomy for lung adenocarcinoma between July 2010 and December 2017 were retrospectively included. Patients were divided into two groups based on the presence of GGO: GGO adenocarcinoma and solid adenocarcinoma. Recurrence patterns at follow-up CT examinations were investigated and compared between the two groups. The effects of patient grouping on time to recurrence, postrecurrence survival (PRS), and overall survival (OS) were evaluated using Cox regression. Results Of 1019 patients (mean age, 62 years ± 9 [SD]; 520 women), 487 had GGO adenocarcinoma and 532 had solid adenocarcinoma. Recurrences occurred more frequently in patients with solid adenocarcinoma (36.1% [192 of 532 patients]) than in those with GGO adenocarcinoma (16.2% [79 of 487 patients]). Distant metastasis was the most common mode of recurrence in the group with solid adenocarcinoma and all clinical stages. In clinical stage I GGO adenocarcinoma, all regional recurrences appeared as ipsilateral lung metastasis (39.2% [20 of 51]) without regional lymph node metastasis. Brain metastasis was more frequent in patients with clinical stage I solid adenocarcinoma (16.5% [16 of 97 patients]). The presence of GGO was associated with time to recurrence and OS (adjusted hazard ratio [HR], 0.6 [P < .001] for both). Recurrence pattern was an independent risk factor for PRS (adjusted HR, 2.1 for distant metastasis [P < .001] and 3.9 for brain metastasis [P < .001], with local-regional recurrence as the reference). Conclusion Recurrence patterns, time to recurrence, and overall survival differed between patients with and without ground-glass opacity at CT, and recurrence patterns were associated with postrecurrence survival. © RSNA, 2023 Supplemental material is available for this article.
TL;DR: Wang et al. as mentioned in this paper presented a case of an Asian female who was diagnosed with lung adenocarcinoma, where she was treated with chemotherapy alone, combination of chemotherapy and targeted therapy and immunotherapy.
Abstract: Human epidermal growth factor receptor 2 (HER2) mutations occur in 2% of lung cancers.In this report, we presented a case of an Asian female who was diagnosed with lung adenocarcinoma. NGS results indicated HER2 exon 20 insertion mutation and PET/CT results showed multiple metastases in lower lobes of both lungs. Thereafter, she was treated with chemotherapy alone, combination of chemotherapy and targeted therapy and immunotherapy. Due to progressive disease, she was then received DS-8201. Imaging data indicated partial response to DS-8201 and tumor marker values decreased significantly, suggesting good efficacy. Nevertheless, DS-8201 was discontinued because of the development of myelosuppression (grade 3). Finally, she died at home due to platelet deficiency, white blood cell (grade 4), granulocytopenia, intracranial hemorrhage and gastrointestinal hemorrhage.This was an important case since it exerted effective response to DS-8201. Meanwhile, myelosuppression is also found in the patient, which requires attention to pulmonary symptoms and careful monitoring.
TL;DR: In this article , the authors evaluated the pathologic and genetic changes of tumors in patients with advanced lung adenocarcinoma treated with EGFR tyrosine kinase inhibitor (TKI) therapy and salvage surgery.
TL;DR: In this article , the first case of anti-CV2 paraneoplastic polyneuropathy associated with lung adenocarcinoma was described, where the patient presented with progressive unsteadiness and numbness involving bilateral upper and lower limbs.
Abstract: We describe the first case of anti-CV2 paraneoplastic polyneuropathy associated with lung adenocarcinoma. Our patient presented with progressive unsteadiness and numbness involving bilateral upper and lower limbs. He had symmetrical length-dependent lower motor neuron pattern of weakness and numbness involving both small and large fibres with prominent sensory ataxia. An extended workup for the polyneuropathy involving a serum paraneoplastic antineuronal antibody panel showed a positive reaction for anti-CV2 antibody. CT scan of the thorax, abdomen and pelvis revealed a right upper lung nodule and histopathological examination of the nodule revealed lung adenocarcinoma. He was scheduled for chemotherapy following his discharge and there was improvement of his sensorimotor polyneuropathy following his chemotherapy.