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G.D. Lee



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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-037 - Histopathologic Results of Surgically Resected Pure Ground-Glass Opacity Lung Nodules (ID 6269)

      14:30 - 14:30  |  Author(s): G.D. Lee

      • Abstract

      Background:
      Little is known about the histopathology of persistent pure ground-glass opacity lung nodules (GGNs).

      Methods:
      We reviewed preoperative chest computed tomography (CT) in patients who underwent surgery for GGNs between Mar. 2015 and May 2016. A total of 58 surgically resected pure GGNs persistent more than 3 months and their diameter at CT scan less than 15 mm in 41 patients were included. Then pathologic reports of 58 GGNs were retrospectively reviewed.

      Results:
      Median age of the patients was 58 years (range, 33 – 75) and 34 patients (83.3%) were female. Median preoperative follow-up duration of GGNs was 11 months (range, 3–114). In spite of all patients were asymptomatic, the reasons of check-up the chest CT included to follow-up for other malignant disease in 29 patients (70.1%), routine health check-up in 10 (25.0%), and to follow-up of other benign disease in 2 (4.9%). Among a total 45 operations, preoperative CT-guided localization was performed in 31 operations (68.9%). Extents of resection included wedge resection in 29 patients (64.4%), segmentectomy in 7 (15.6%), and lobectomy in 9 (20.0%). Lymph node sampling or dissection was performed in 27 operations (60.0%). Among 58 resected GGNs, median diameter of GGNs was 8mm (range, 3-15mm), median number of resected GGN per operation was 2 (range, 1-5). The distribution of pathologic diagnosis included benign disease in 3 GGNs (5.2%), atypical adenomatous hyperplasia (AAH) in 4 (6.9%), adenocarcinoma in situ (AIS) in 17 (29.3%), minimally invasive adenocarcinoma (MIA) in 19 (32.8%), and invasive adenocarcinoma (IA) in 15 (25.9%). The diameter of GGNs classified into 3 categories (0 – 5mm, 6 – 10mm, 11 – 15mm) were associated with pathologic invasiveness (Cochran-Amitage test, p = 0.005). However, follow-up duration of GGNs classified into 3 categories (3 - 12 months, 13 - 24 months, more than 25 months) was not associated with diameter of GGNs (p = 0.453) or pathologic invasiveness (p = 0.893). Among 18 GGNs tested, epidermal growth factor receptor (EGFR) mutations were detected in 5 GGNs (27.7%).

      Conclusion:
      The prevalence of lung adenocarcinoma (AIS, MIA, IA) was 87.9% in surgically resected pure GGNs persistent more than 3 months and their diameter at CT scan less than 15 mm. A diameter of GGNs diameter was associated with pathologic invasiveness. Further studies are needed for persistent pure GGNs not affected by partial-volume effect of CT in non-selected patients.

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    P3.02c - Poster Session with Presenters Present (ID 472)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.02c-005 - MET Exon 14 Skipping in Quintuple-Negative (EGFR-/KRAS-/ALK-/ROS1-/RET-) Lung Adenocarcinoma (ID 6012)

      14:30 - 14:30  |  Author(s): G.D. Lee

      • Abstract

      Background:
      MET exon 14 (METex14) skipping has been reported as a potentially targetable driver mutation in lung adenocarcinoma. We aimed to evaluate the prevalence and clinicopathologic characteristics of lung adenocarcinoma harboring METex14 skipping in patients with lung adenocarcinoma in which targetable genomic alterations are not available.

      Methods:
      We screened 795 patients with lung adenocarcinoma and 45 patients with quintuple-negative (EGFR-/KRAS-/ALK-/ROS1-/RET-) lung adenocarcinomas were finally included to identify the patients harboring METex14 skipping by using RT-PCR with probes overlapping an exon 13–15 junction. In addition, we summarized recent articles reported about METex14 skipping in lung cancer.

      Results:
      Based on the present study, seventeen patients (37.8%) had tumors harboring METex14 skipping alterations. Diverse genomic sequence variants causing METex14 skipping were identified. The median age of the METex14 skipping-positive patients was 73 years (range, 55–81 years), 8 patients (47.1%) were female, and 7 (41.2%) had never smoked. The predominant subtype was acinar followed by the solid type. The MET immunohistochemistry test for METex14 skipping demonstrated 100% (95% CI, 79.6–100) sensitivity and 70.4% (95% CI, 51.5–84.2) specificity. In literature reviews, we included 619 patients with lung cancer harboring METex14 skipping. The median age of the patients was 68 years (range, 41-84), 60% (251/418) were female, and 50% (58/116) were never smoker. MET immunochemical stain was positive in 62.3% (48/77), MET amplification was identified in 14.6% (45/309) of the patients. The prevalences of METex14 skipping were 12.9% (20/155) in sarcomatoid carcinoma, 3.9% (11/282) in adenosquamous carcinoma, 2.6% (398/15050) in adenocarcinoma, 2.1% (26/1226) in squamous cell carcinoma, and 0.8% (2/243) in large cell carcinoma, respectively.

      Conclusion:
      The prevalence of METex14 skipping was relatively high in patients with quintuple-negative (EGFR-/KRAS-/ALK-/ROS1-/RET-) lung adenocarcinomas. Lung adenocarcinomas harboring METex14 skipping were associated with old age, acinar or solid histolgy, and MET protein overexpression. Identification of subpopulation harboring METex14 skipping can be an important step toward developing targeted therapies for patients with lung cancer.