Different NKD1 expression in histologic subtypes of small adenocarcinoma of lung : Retrospective review applying new classification of IASLC/ATS/ERS system
- 주제(키워드) lung , lepidic , minimally invasive adenocarcinoma , NKD1
- 발행기관 고려대학교 대학원
- 지도교수 김철환
- 발행년도 2013
- 학위수여년월 2013. 2
- 학위구분 석사
- 학과 일반대학원 의학과
- 세부전공 병리학전공
- 원문페이지 34 p
- 실제URI http://www.dcollection.net/handler/korea/000000038149
- 본문언어 영어
- 제출원본 000045743231
초록/요약
BACKGROUND Lung cancer is the leading cause of cancer-related death in Korea. NKD1(Naked Cuticle Drosophila), functioning as a negative regulator of the canonical Wnt/ ß-catenin, was reported to be reduced in non-small cell lung cancer, asserting that decreased this protein might not only associate with poor prognosis but also be related with the invasive ability of lung cancer cells. However, association of NKD1 expression with small lung adenocarcinoma have not yet been elucidated to date. METHODS In surgically resected lung cancers from 2000 to 2011, 40 cases of lung adenocarcinomas less than 2cm in dimension, being staged as Tis and T1a, were selected. Clinicopathologic parameters were reviewed, including age, sex, smoking history, tumor size, pathologic stage, operative mode, and died of disease. Through histologic analysis, all the cases were subclassified into adenocarcinoma in situ(AIS), minimally invasive adenocarcinoma(MIA), and small adenocarcinoma(SAD). SAD included lepidic predominant adenocarcinoma(LPA) and non-LPA. Immunohistochemical study for NKD1 was performed on 40 cases. RESULTS Forty cases were composed of 5 cases(12.5%) of AIS, 8 cases(20.0%) of MIA and 27 cases (67.5%) of SAD. Cases of AIS and MIA showed no lymph node metastasis and 100% disease free survival whereas among 27 patients with SAD, 2 patients(7.4%) showed lymph node metastasis and 3 patients(11.1%) were died of disease. In 40 cases, NKD1-reduced expression was detected in 8(20%), normal expression in 15(37.5%) and overexpression in 17(42.5%). Loss of NKD1 expression was significantly associated with lymph node metastasis (p=0.001). All the cases with predominant papillary pattern showed overexpression of NKD1(p=0.026). Factors statistically influencing worse survival at univariate analysis were lymph node metastasis(p=0.001) and presence of micropapillary pattern (p=0.001). CONCLUSIONS Though the same stage T1a of MIA and SAD, MIA have better outcomes than SAD. Down-regulated NKD1 expression was closely associated with nodal metastasis, implying unfavorable marker, and showed a overexpression in the papillary predominant adenocarcinoma.
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Abstract i
I.Introduction 1
II.Material and Methods 4
III.Results 8
IV.Discussion 11
V.Reference 16
Tables and Figures 20
