The BCL-6 gene is known to be located on chromosome 3q27, at the breakpoint of the 3q27-associated translocations that occur frequently in human non-Hodgkin's lymphomas (NHLs). To identify the BCL-6 protein, two antibodies that recognized distinct domains of this protein were raised in rabbits. Immunoprecipitation and immunoblotting of lysates of BCL-6-expressing cells using both antibodies showed a broad 92- to 98- kD band. Dephosphorylation of BCL-6 protein reduced the size of this band to 87 kD, suggesting that BCL-6 may be expressed in a phosphorylated form. Immunostaining with both antibodies showed that BCL-6 protein was localized in the nuclei of most of the germinal center B cells and a small number of marginal zone B cells. Furthermore, BCL-6 protein was expressed in follicular, Burkitt's, and diffuse large B-cell lymphomas. These results suggest that the BCL-6 protein, expressed in B cells of the germinal centers which are important in the maturation of immune responses, may play some physiological role(s) in the germinal center B cells.
The SUV of the primary tumour, adenocarcinoma and tumour size were risk factors for occult lymph node metastasis in patients with NSCLC diagnosed as clinical stage I by preoperative integrated FDG-PET/CT. These findings would be helpful in selecting candidates for mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration.
BackgroundThe aim of this study was to evaluate the diagnostic accuracy of integrated 18
F‐fluorodeoxyglucose positron emission tomography/computed tomography (FDG‐PET/CT) in hilar and mediastinal lymph node (HMLN) staging of non‐small cell lung cancer (NSCLC), and to investigate potential risk factors for false‐negative and false‐positive HMLN metastases.MethodsWe examined the data of 388 surgically resected NSCLC patients preoperatively staged by integrated FDG‐PET/CT. Risk factors for false‐negative and false‐positive HMLN metastases were analyzed using univariate and multivariate analyses of clinicopathological factors.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of integrated FDG‐PET/CT in detecting HMLN metastases were 47.4%, 91.0%, 56.3%, 87.7%, and 82.5%, respectively. On multivariate analysis, the maximum standardized uptake value (SUVmax) of the tumor (P = 0.042), adenocarcinoma (P = 0.003), and tumor size (P = 0.017) were risk factors for false‐negative HMLN metastases, and history of lung disease (P = 0.006) and tumor location (central; P = 0.025) were risk factors for false‐positive HMLN metastases.ConclusionsThe present study identified risk factors for false‐negative and false‐positive HMLN metastases in NSCLC patients staged by preoperative integrated FDG‐PET/CT. These findings would be helpful in selecting appropriate candidates for mediastinoscopy or endobronchial ultrasound‐guided transbronchial needle aspiration.
BackgroundPlasma D-dimer level, a marker of hypercoagulation, has been reported to be associated with survival in several types of cancers. The present study aimed to evaluate the prognostic significance of preoperative D-dimer levels in patients with surgically resected clinical stage I non-small cell lung cancer (NSCLC).MethodsParticipants comprised 237 patients with surgically resected clinical stage I NSCLC. In addition to factors such as age, sex, and smoking status, the association between preoperative D-dimer level and survival was explored.ResultsPatients were divided into two groups according to D-dimer level: Group A, ≤ 1.0 μg/ml (n = 170); and Group B, > 1.0 μg/ml (n = 67). The 5-year recurrence-free survival rate was 81.6% for Group A and 66.6% for Group B (p < 0.001). The 5-year overall survival rate was 93.6% for Group A and 84.7% for Group B (p = 0.002). Multivariate survival analysis identified D-dimer level as an independent prognostic factor, along with age, maximum standardized uptake value of the primary tumor, and pathological stage.ConclusionsPreoperative D-dimer level is an independent prognostic factor in patients with surgically resected clinical stage I NSCLC.
BackgroundThis study aimed to evaluate mutations of the epidermal growth factor receptor (EGFR) and K‐ras genes and their clinicopathological and prognostic features in patients with resected pathological stage I adenocarcinoma.MethodsWe examined 224 patients with surgically resected lung adenocarcinoma and analyzed the prognostic and predictive value of these mutations in 162 patients with pathological stage I adenocarcinoma.ResultsMutations of the EGFR and K‐ras genes were detected in 100 (44.6%) and 19 (8.5%) of all tumors, and in 81 (50.0%) and 17 (10.5%) of the pathological stage I tumors, respectively. EGFR mutations were significantly associated with female gender, smoking habit (never smoker), and low grade. By contrast, K‐ras mutations were significantly associated with male gender, smoking habit (ever smoker), and the presence of mucinous components. No significant differences were observed in recurrence‐free or overall survival between the EGFR‐mutant, K‐ras‐mutant, and wild‐type groups (five‐year recurrence‐free survival 77.8% vs. 87.8% vs. 79.5%; five‐year overall survival 82.8% vs. 82.4% vs. 79.2%, respectively). Multivariate analysis showed that neither EGFR nor K‐ras mutation was an independent prognostic factor.ConclusionsThe present study demonstrated that pathological stage I adenocarcinoma harboring EGFR and K‐ras gene mutations have distinct clinicopathological features. The presence of these mutations alone were not prognostic factors in patients with resected pathological stage I adenocarcinoma.
Pulmonary metastases from thyroid carcinoma typically cause a micronodular or miliary pattern throughout both lungs. Metastasis consisting of a solitary pulmonary nodule measuring 20 mm in diameter is rare. Here we report a case of a 66‐year‐old woman without a history of papillary thyroid carcinoma who presented with a pulmonary nodule measuring 20 mm in diameter, found on chest computed tomography during a health checkup. The patient underwent a right lobectomy. Microscopic examination showed well‐differentiated papillary adenocarcinoma. Immunohistochemical findings were consistent with a diagnosis of pulmonary metastasis from papillary thyroid carcinoma. Solitary metastasis to the lung from occult thyroid carcinoma is quite rare, but if a pulmonary nodule is encountered in a patient without a history of thyroid carcinoma, the possibility must be considered.
Tec is a novel non-receptor-type protein tyrosine kinase that was originally identified from a murine liver cDNA library. While the function of Tec remains unknown, it was shown recently that two Tec-related kinases are involved directly in the growth and differentiation of bone marrow stem cells. As the localization of Tec protein has not been reported yet, immunohistochemical and immunochemical studies of various murine organs were conducted in the present study to clarify which cells express this kinase protein. An intense immunohistologic reaction was observed in neonatal and adult testicular germ cells, and neonatal and fetal hepatic erythroblasts. In addition, a clear immunostaining was noted in neonatal and adult tubal epithelial cells, hepatocytes, basal cells of the non-glandular stomach, foveolar epithelium of the glandular stomach, sebaceous cells of the skin and fetal cartilage. The immune reaction of germ cells and erythroblasts was observed in the cell membrane, although this protein does not have a transmembrane domain. Supportive western blotting of testis, adult liver, spleen and heart of adult C.B-17 mice with the use of anti-Tec antibody demonstrated a heavy 70 kDa band in the liver and testis, and a much weaker, small band in the heart and spleen. These results suggest that Tec protein has a specific role in testicular germ cells and erythroblasts.
A 45-year-old female was diagnosed as having lung adenocarcinoma harboring an anaplastic lymphoma kinase (ALK) rearrangement, stage IV (T2bN3M1b). She was treated with crizotinib as second-line chemotherapy. The clinical stage after crizotinib treatment was ycT2aN0M0, stage IB. We performed a left lower lobectomy and lymph node dissection aimed at local control and pathological confirmation of the remaining tumor. The final pathological stage was ypT2aN2M0, stage IIIA with Ef 1b. To the best of our knowledge, this is the first case report of surgical resection in ALK rearrangement-positive lung adenocarcinoma after crizotinib treatment.
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