Author of

• 10923

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  P1.18 - Poster Session 1 - Pathology (ID 175)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10931

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    P1.18-008 - Clinical impact of the two types of mucin in the mucinous adenocarcinoma of the lung - Clinical differences between the bronchogenic-type and the gastric-type mucinous adenocarcinomas (ID 1372)

    09:30 - 09:30  |  Author(s): M. Kurai
    • Abstract

    Background
    Mucinous adenocarcinoma is one histological-subtype of the lung cancer. The mucin produced by the tumor cell is usually acidic like as the bronchial gland-type mucin. However, there is one subtype of pulmonary mucinous adenocarcinoma designated as the gastric type, which differentiated into gastric pyloric mucosa and possessed neutral mucin (i.e. class III mucins). It is unclear whether dividing these two mucinous types of the pulmonary mucinous adenocarcinoma has a clinical meaning. This study was aimed for clarify the presence of clinical meaning between two types of the mucinous adenocarcinoma.

    Methods
    69 cases of the mucinous adenocarcinoma of the lung were performed curative operation in Matsumoto Medical Center between 2001 and 2012. HIK1083, designed as specific monoclonal antibodies against gastric pyloric mucin, and TTF-1 were used for judge whether the mucin of the tumor was gastric-type. We divided the mucinous adenocarcinoma into B-type which had the bronchial gland-type mucin (HIK1083 negative and TTF-1 positive), and G-type which had the gastric-type mucin (HIK1083 positive and TTF-1 negative). Then, we compared clinical features and prognoses of these two groups.

    Results
    In the mucinous adenocarcinoma, 34 cases were B-type and 35 cases were G-type. The clinical backgrounds of the two groups were similar including gender, age and smoking status. The locations of the tumor were different between B-type (24 on upper-middle lobes, 10 on lower lobes) and G-type (8 on upper-middle lobes, 27 on lower lobes). Histological-subtypes in B-type were 15 of pure- or mixed-BAC, 12 of papillary, 2 of aciner and 5 of solid. Those in G-type were all 35 of pure- or mixed-BAC. Lymph invasion has often seen in B-type (16 cases), and rarely seen in G-type (2 cases). The number of the cases of each pathological-stage of IA, IB, IIA, IIB, IIIA, IIIB and IV were 12, 5, 1, 4, 8, 3 and 1 in B-type, and were 17, 4, 2, 8, 0, 3 and 1 in G-type, respectively. Analysis of the gene for B-type mucinous adenocarcinoma revealed 38% of EGFR-mutation-positive, 18 % of EML4-ALK-positive, 9% of K-ras-mutation-positive and 35% of the others. On the other hand, the gene for G-type showed 3% of EGFR-mutation-positive, 55% of K-ras-mutation-positive and 42% of the others. About prognostic analyses, aerogenous metastases have occurred in 8 cases on both of B-type and G-type. However, there was no lymph-node recurrence in G-type, although 6 cases were seen in B-type. Distant-metastases were seen in 8 cases of B-type and 3 of G-type. Over all 5-year-survival-rates were 67.9% of B-type and 78.6% of G-type (p=0.34). Disease-free-survival-rates for 5-years were 51.2% in B-type and 73.0% in G-type (p=0.05). Median-survival-months from the post-operative-recurrence were 25.3 in B-type and 6.9 in G-type (P=0.016).

    Conclusion
    The present study showed many differences of the clinical characteristics between B-type and G-type mucinous adenocarcinoma in the lung. This study also suggests that there is a clinical meaning to classify mucinous adenocarcinoma of the lung into the two groups according to the mucin properties.