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Y.W. Koh



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    P2.01 - Poster Session with Presenters Present (ID 461)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P2.01-028 - Prognostic Significance of GLUT1 and CAIX Expression: Correlation with Volume-Based PET Parameters in Non-Small Cell Lung Cancer (ID 4674)

      14:30 - 14:30  |  Author(s): Y.W. Koh

      • Abstract

      Background:
      Glucose transporter type 1 (GLUT1) and carbonic anhydrase IX (CAIX) represent glucose metabolism and tissue hypoxia, respectively. The purpose of this study is to measure the GLUT1 and CAIX expression and volume-based 18F-fluorodeoxyglucose positron emission tomography (FDG PET) parameters in non-small cell lung cancer (NSCLC) patients and examined the correlations between above parameters and their prognostic significance.

      Methods:
      We evaluated GLUT1 and CAIX expression by immunohistochemical methods and volume-based FDG PET parameters in 269 NSCLC patients treated with surgical resection (158 adenocarcinoma, 93 squamous cell carcinoma and 18 other type carcinoma). Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of NSCLC were measured using pretreatment 18F-FDG PET/CT. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of MTV or TLG. Correlations between GLUT1, CAIX, MTV, TLG, and clinicopathological factors were assessed, and prognostic significance was determined.

      Results:
      The GLUT1 expression was identified in 99% of squamous cell carcinoma and 50% of adenocarcinoma. In patients with adenocarcinoma, GLUT1 expression showed positive correlation with MTV or TLG (P = 0.012 and P = 0.037, respectively). In patients with squamous cell carcinoma, correlation analyses between GLUT1, MTV and TLG were not performed because most cases of squamous cell carcinoma showed GLUT1 positivity. There was no correlation between CAIX expression, MTV and TLG in squamous cell carcinoma and adenocarcinoma. In cases with adenocarcinoma, GLUT1-positive patients had lower overall survival (OS) rates and lower recur-free survival (RFS) rates than GLUT1-negative patients (P < 0.001 and P = 0.004, respectively). CAIX expression was not significantly associated with either OS or RFS in squamous cell carcinoma and adenocarcinoma. Patients with high MTV or TLG had significantly lower OS rates and lower RFS rates than patients with low MTV or TLG in adenocarcinoma. High GLUT1, TLG and MTV were significantly associated with adverse clinicopathologic variables. When patients with adenocarcinoma were stratified into two groups (High GLUT1 and TLG vs. the other 3 groups), high GLUT1 and TLG was an independent prognostic marker for OS in multivariate analysis (P = 0.003).

      Conclusion:
      Our results show that high GLUT1 expression levels were significantly associated with MTV or TLG in patients with adenocarcinoma. High GLUT1 and TLG was an independent prognostic marker for OS. High GLUT1 and TLG can be used to identify a subgroup of patients with adenocarcinoma at high risk of recurrence or progression who may benefit from aggressive chemotherapy or radiotherapy.

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    P2.03b - Poster Session with Presenters Present (ID 465)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03b-061 - Baseline Neutrophil–Lymphocyte Ratio is Related to Baseline Presence of Brain Metastases and Subsequent Brain Metastases in Stage IV NSCLC (ID 4685)

      14:30 - 14:30  |  Author(s): Y.W. Koh

      • Abstract

      Background:
      We examine the predictive value of neutrophil–lymphocyte ratio (NLR) by examining their association with baseline presence and subsequent development of brain metastases in patients with stage IV non-small-cell lung cancer (NSCLC).

      Methods:
      We examined the predictive value of NLR for brain metastasis in 263 stage IV NSCLC using the receiver operating characteristic (ROC) curve analysis for optimal cut-off value. Logistic regression models were used to determine the association of NLR with the baseline presence of brain metastases. For patients without brain metastases at diagnosis, a competing risk analysis was performed, calculating the probability of brain metastasis in the presence of the competing risk of mortality by other causes using Gray’s test.

      Results:
      The median follow-up time was 11 months (range: 1–95 months). Univariate analysis reveals that patients with high NLR(≥4.95) had significantly more brain metastases at diagnosis than those with low NLR (P = 0.038), multivariate analysis was not performed because there was no significant risk factor for predicting brain metastases at diagnosis, except NLR. In patients who did not have baseline brain metastasis, competing risks analysis reveals that patients with high NLR showed higher cumulative incidence of subsequent brain metastases, compared to those with patients with low NLR (P = 0.02). A high NLR was associated with the baseline presence or the subsequent development of brain metastases, particularly in the group with adenocarcinoma (P = 0.006 and P = 0.04, respectively). Furthermore, an increase in NLR during treatment was associated with subsequent brain metastases (P = 0.003)

      Conclusion:
      The NLR is a predictive factor for the baseline presence of brain metastases and subsequent brain metastases in stage IV NSCLC. The NLR can be used to identify a subgroup of adenocarcinoma who is at a high risk for brain metastasis, and who may benefit from prophylactic treatment.