Differences of tumor microenvironment between stage I lepidic-positive and lepidic- negative lung adenocarcinomas Shinya Katsumata, MD, Keiju Aokage,

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Presentation transcript:

Differences of tumor microenvironment between stage I lepidic-positive and lepidic- negative lung adenocarcinomas Shinya Katsumata, MD, Keiju Aokage, MD, PhD, Tomohiro Miyoshi, MD, PhD, Kenta Tane, MD, Hiroshi Nakamura, MD, Masato Sugano, MD, Motohiro Kojima, MD, PhD, Satoshi Fujii, MD, PhD, Takeshi Kuwata, MD, PhD, Atsushi Ochiai, MD, PhD, Ryuichi Hayashi, MD, Masahiro Tsuboi, MD, PhD, Genichiro Ishii, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 156, Issue 4, Pages 1679-1688.e2 (October 2018) DOI: 10.1016/j.jtcvs.2018.05.053 Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Microscopic features of Lep+ and Lep- adenocarcinomas. A, Low-power view of Lep+ adenocarcinomas. B, Low-power view of Lep- adenocarcinomas. a: High-power view of Lep+ adenocarcinomas; 1: peripheral region, 2: central region. b: High-power view of Lep- adenocarcinomas; 1: peripheral region, 2: central region. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Distinct IHC staining patterns of Lep+ and Lep- adenocarcinomas. Left: Lep+ adenocarcinomas; the staining score of CD44 is higher. Right: Lep- adenocarcinomas; the staining scores of hypoxic marker (GLUT-1, CA IX) and tumor-promoting stromal cells (PDPN + CAFs and CD204 + TAMs) are higher. There were no significant differences in the expression levels of laminin-5 between the 2 groups. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Schematic of a model for Lep+ and Lep- adenocarcinoma development. Upper: Lep+ adenocarcinomas progress slowly with preservation of the alveolar structure as stepwise progression, which can be maintained with co-opted vessels. Lower: Lep- adenocarcinomas often grow rapidly and destructively, and widespread vascular disruption and regression of co-opted vessels may occur in the invasive area, resulting in a hypoxic core. AIS, Adenocarcinoma in situ; MIA, minimally invasive adenocarcinoma; LPA, lepidic predominant adenocarcinoma. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Comparison of overall and relapse-free survival between patients with Lep+ and Lep- adenocarcinomas (adjusted for age, sex, smoking status, and total tumor size). A, Overall survival. B, Relapse-free survival. (+): Lep+ adenocarcinomas; (−): Lep- adenocarcinomas. HR, Hazard ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Comparison of overall and relapse-free survival between patients with Lep+ and Lep- adenocarcinomas, which were performed by using IHC staining (adjusted for age, sex, smoking status, and total tumor size). A, Overall survival. B, Relapse-free survival. (+): Lep+ adenocarcinomas; (−): Lep- adenocarcinomas. HR, Hazard ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Lep+ adenocarcinomas are less malignant than invasive size-matched Lep- adenocarcinomas. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1679-1688.e2DOI: (10.1016/j.jtcvs.2018.05.053) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions