Background: ENCODE project revealed that nearby or distantly located non-coding DNA regulates the expression of coding genes. RegulomeDB is a new database that can be used to predict whether variants affect transcription factor binding and gene expression. We investigated the association between lung cancer risk and potentially functional polymorphisms of XRCC1 that were selected using RegulomeDB in a Korean population. Methods: 185 polymorphisms of XRCC1 were evaluated using RegulomeDB. There was strong evidence that 10 polymorphisms affected XRCC1 expression with scores of 1a-1f that were based on the RegulomeDB. rs2854510 polymorphism was rare in Asians. Eight polymorphisms were in strong linkage disequilibrium (LD). rs2854509, which was one of the 8 polymorphisms in LD, and rs7248167, which was not in the LD block, were genotyped using the Taq-Man® assay in 610 lung cancer patients and 607 age- and sex-matched controls. Additionally, 4 polymorphisms of XRCC1 (Arg399Gln, Arg280His,Arg194Trp, and -77T>C), which were investigated with regard to the association with lung cancer risk in previous studies, were also genotyped. Results: Two polymorphisms (rs2854509 and rs7248167) that were predicted to affect XRCC1 expression based on their RegulomeDB scores were not associated with lung cancer risk (P = 0.31 and 0.93, respectively). When stratifi ed according to age, gender, smoking status, and tumor histology, the 2 polymorphisms of XRCC1 were not associated with lung cancer risk. Among the 4 polymorphisms that were previously studied, only XRCC1 Arg280His was signifi cantly associated with lung cancer risk (dominant model, adjusted odds ratio = 0.61, 95 % confi dence interval = 0.46-0.83, P = 0.002). Conclusions: Although RegulomeDB is an attractive tool for predicting regulatory potential of variants, the 2 polymorphisms that were selected using RegulomeDB were not associated with lung cancer risk.
Durvalumab consolidation is less effective in patients with epidermal growth factor receptor mutant (EGFR M+) NSCLC. Studies of durvalumab on EGFR M+ NSCLC as an expression of programmed death-ligand 1 (PD-L1) expression are limited. The purpose of this study was to determine the effect of durvalumab on PD-L1 expression in EGFR M+ patients.
Differential leukocyte counts of pleural fluid are routinely recommended for the early diagnosis and management of exudative pleural effusions. Rapid automated cellular analysis agrees strongly with standard manual microscopic counts and has become a reality in many clinical laboratories. However, discordant results sometimes observed between automated and manual analyses raise concern about using automated analysis to aid prompt differential diagnosis. This study aimed to evaluate the real-world disagreement between automated and manual leukocyte analyses in exudative pleural effusions and to investigate whether the discordant results occur in specific cellular ranges or randomly. We conducted a retrospective study of patients who were diagnosed with parapneumonic pleural effusions (PPE), tuberculous pleural effusions (TPE), and malignant pleural effusions (MPE) between September 2018 and December 2020. Differential and predominant leukocyte counts were performed using an automated XN-350 analyzer with a two-part differential count consisting of polymorphonuclear (PMN) and mononuclear (MN) leukocytes and a manual method with Wright-stained cytospin slides. We compared the two methods on cases of 109 PPEs, 50 TPEs, and 116 MPEs. Although the overall correlation between the two methods for differential leukocyte counts was excellent, there were etiologic variations; MPEs showed a lower correlation compared to PPEs and TPEs. Automated-PMN predominance almost corresponded to manual cytospin-neutrophilic predominance. In contrast, ~10% of the automated-MN predominance did not correspond with the cytospin-lymphocytic predominance. These discrepancies occurred most in the automated-MN% range of 51% to 60%, followed by 61% to 70%. The PMN% range ≥50% and <30% on the automated analysis reliably corresponds to the neutrophilic and lymphocytic predominance, respectively. However, the MN% range of 51% to 70% may not coincide with lymphocytic predominance on manual cytospin analysis. This range leaves the potential cause of exudative pleural effusions open.
The cause of epithelioid granulomatous inflammation varies widely depending on the affected organ, geographic region, and whether the granulomas morphologically contain necrosis.Compared with other organs, the etiological distribution and morphological patterns of pleural epithelioid granulomas have rarely been investigated.We evaluated the final etiologies and morphological patterns of pleural epithelioid granulomatous inflammation in a tuberculosis (TB)-prevalent country.Of 83 patients with pleural granulomas, 50 (60.2%)had confirmed TB pleurisy (TB-P) and 29 (34.9%) had probable TB-P.Four patients (4.8%) with non-TB-P were diagnosed.With the exception of microbiological results, there was no significant difference in clinical characteristics and granuloma patterns between the confirmed TB-P and non-TB-P groups, or between patients with confirmed and probable TB-Ps.These findings suggest that most pleural granulomatous inflammation (95.2%) was attributable to TB-P in TB-endemic areas and that the granuloma patterns contributed little to the prediction of final diagnosis compared with other organs.
Abstract This study was conducted to investigate the relationship between genetic variants in LKB1/AMPK/mTOR pathway and treatment outcomes of patients with non‐small cell lung cancer (NSCLC) treated with chemotherapy. A total of 379 patients with NSCLC who underwent first‐line paclitaxel‐cisplatin chemotherapy was enrolled. The associations between 19 single nucleotide variants (SNVs) in the LKB1/AMPK/mTOR pathway and the chemotherapy response and overall survival (OS) were analyzed. Among the SNVs analyzed, AKT1 rs2494750G>C and TSC1 rs2809244C>A were associated with clinical outcomes after chemotherapy in multivariate analyses. The AKT1 rs2494750G>C was significantly associated with a better response to chemotherapy (adjusted odds ratio [aOR]: 1.92, 95% confidence interval [CI]: 1.02–3.62, p = 0.04). The TSC1 rs2809244C>A were significantly associated with better OS (adjusted hazard ratio [aHR]: 0.79, 95% CI: 0.62–0.99, p = 0.04). When stratified by tumor histology, AKT1 rs2494750G>C exhibited a significant association with the chemotherapy response only in adenocarcinoma and TSC1 rs2809244C>A was also significantly associated with OS only in adenocarcinoma. This result suggests that the AKT1 rs2494750G>C and TSC1 rs2809244 C>A may be useful for predicting the clinical outcome of first‐line paclitaxel‐cisplatin chemotherapy in NSCLC.
Abstract We investigated the association between genetic variants in the histone modification regions and the prognosis of lung adenocarcinoma after curative surgery. Potentially functional SNPs were selected using integrated analysis of ChIP-seq and RNA-seq. The SNPs were analyzed in a discovery set (n = 166) and a validation set (n = 238). The associations of the SNPs with overall survival (OS) and disease-free survival (DFS) were analyzed. A total of 279 SNPs were selected for genotyping. Among these, CAPN1 rs17583C>T was significantly associated with better OS and DFS ( P = 0.001 and P = 0.007, respectively), and LINC00959 rs4751162A>G was significantly associated with worse DFS ( P = 0.008). Luciferase assays showed a significantly lower promoter activity of CAPN1 in the rs17583 T allele than C allele ( P = 0.008), and consistently the CT + TT genotypes had significantly lower CAPN1 expression than CC genotype ( P = 0.01) in clinical samples. The rs4751162 G allele had higher promoter activity of GLRX3 than A allele ( P = 0.05). The motif analyses and ChIP-qPCR confirmed that the variants are located in the active promoter/enhancer regions where transcription factor binding occurs. This study showed that genetic variants in the histone modification regions could predict the prognosis of lung adenocarcinoma after surgery.
The data regarding pulmonary artery stump thrombosis (PAST) after lung cancer surgery are insufficient. The aim of the present study was to evaluate the incidence, clinical characteristics, and prognosis of PAST. We retrospectively investigated the incidence and clinical characteristics of PAST among patients who underwent lung resection for lung cancer at 2 institutions. We compared the clinical parameters between PAST and pulmonary embolism (PE) and examined the clinical course of patients with PAST. Of the 1885 patients, PAST was found in 36 patients (1.9%). Right lower lobectomy (n = 13) and middle-lower bilobectomy (n = 9) were the most common types of surgery. The median time interval from lung resection to the detection of PAST was 3.8 months. Immobilization and a history of cerebrovascular disease were not observed in the PAST group. Most of the patients with PAST (91.7%) were diagnosed incidentally, whereas many patients with PE (75.9%) were symptomatic at the time of diagnosis. During the follow-up, one patient (2.8%) had contralateral PE complications. However, no patients in the PAST group experienced pulmonary thromboembolism-related in-hospital death or adverse outcomes. There was no difference in the prognosis of patients with PAST according to the administration of anticoagulation. PAST was rarely detected in lung cancer patients on follow-up chest computed tomography after lung resection. Patients with PAST were asymptomatic in most cases and had relatively favorable clinical outcomes. However, these patients are at risk of contralateral PE, despite its rarity.
Purpose Nowadays, chromosomal regions containing genes associated with the risk of lung cancer are identified by a number of genome-wide association studies (GWASs). As part of the study, GWAS has identified the association of six chromosomal regions, 1q23, 4q22, 4q31, 5p15, 6p21, and 15q25, as being associated with lung cancer risk in the European population. We investigated the impact of genetic variants identified in GWASs for lung cancer susceptibility on the survival outcomes in patients with early stage non-small cell lung cancer (NSCLC). Materials and Methods Three hundred and sixty-three patients with surgically resected NSCLC were enrolled. Eight single nucleotide polymorphisms (SNPs), rs2808630 on 1q23, rs7671167 on 4q22, rs1489759 and rs2202507 on 4q31, rs2736100 and rs402710 on 5p15, rs1052486 on 6p21 and rs16969968 on 15q25, were genotyped using a polymerase chain reaction-restriction fragment length polymorphism assay. The associations between genotypes and overall survival (OS) and disease-free survival (DFS) were analyzed. Results None of the eight SNPs were significantly associated with OS or DFS. In addition, when the patients were categorized according to age, gender, smoking status, tumor histology and pathologic stage, there were no significant associations between the eight SNPs and the survival outcomes. Conclusion These results suggest that the genetic variants identified by GWASs for lung cancer susceptibility may not affect the prognosis of early stage NSCLC.