Background. Recurrence in Stage I non‐small cell lung cancer was examined with respect to vascular invasion and the immunohistochemical expression of sialyldimeric Lewisx (SLX) and proliferating cell nuclear antigen (PCNA). Methods. One hundred twenty‐eight patients with Stage I non‐small cell lung cancer who had a curative resection were the subjects of this study. Using tumor tissues fixed in formaldehyde solution, blood vessel invasion (BVI) and lymphatic invasion stained with Victoria blue‐hematoxylin and eosin and the immunohistochemical expression of SLX and PCNA were retrospectively studied with respect to postoperative recurrence. Results. By univariate analysis, BVI and SLX and PCNA expression were significantly important factors of disease‐free survival (P <0.01). The disease‐free survival of the patients with both BVI and SLX expression was significantly shorter than that of the patients with BVI but negative SLX expression (P <0.02). In 35 patients with recurrence, tumors with PCNA expression showed a significantly shorter time to recurrence compared with tumors without PCNA expression (P <0.01). Conclusions. BVI and SLX expression may be important determinants of recurrence. PCNA may be a determinant of time to recurrence.

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Abstract. Expression of copper-transporting P-type adenosine triphosphatase A (ATP7A) is reportedly associated with platinum drug resistance in various types of solid tumors. However, the impact of ATP7A expression on platinum drug resistance in non-small cell lung cancer (NSCLC) has yet to be adequately elucidated. In vitro cisplatin (CDDP) sensitivity was investigated using the collagen gel-droplet embedded culture drug sensitivity test, and the ATP7A mRNA expression levels were assessed by real-time polymerase chain reaction in surgically resected specimens of NSCLC. The relationship between the ATP7A expression levels and the in vitro CDDP sensitivity was then evaluated. The ATP7A mRNA expression levels in the CDDP-resistant tumors were significantly higher than those in the CDDP-sensitive tumors (p=0.0167, Mann-Whitney U test). In conclusion, the results suggest that evaluation of ATP7A expression is useful as a marker for cisplatin chemoresistance. IntroductionCisplatin (CDDP), an anticancer drug containing platinum, is widely used in the treatment of solid tumors, such as testicular, ovarian, cervical, bladder, head and neck, and non-small cell lung cancers (NSCLC) (1). CDDP has been used as a key drug for chemotherapy against NSCLC for more than 20 years.However, the overall response rate to cisplatin used as a single agent is reported to be no more than 20% in patients with NSCLC (2). Furthermore, development of resistance to CDDP is common during treatment of NSCLC and is therefore a significant factor to be considered by clinical oncologists. Subsequently, exploration of a chemoresistance marker is crucial. The mechanisms underlying the development of CDDP resistance include decreased drug accumulation, enhanced detoxification and increased DNA repair efficiency. However, previous studies have been limited mainly to the in vitro or in vivo level. Additionally, no study has shown factors that have been validated as common contributors to clinical CDDP resistance and prognosis in NSCLC patients (1).Copper-transporting P-type adenosine triphosphatase A (ATP7A) plays a significant role in copper distribution within cells. ATP7A is expressed in the intestinal epithelium as well as in most other tissues apart from the liver (3-7). Binding of Cu to ATP7A triggers highly regulated subcellular relocalization that involves movement from the basal position in the trans-Golgi network to the plasma membrane (3,8). Defective function of ATP7A causes Menkes disease, and the pathology of Menkes disease reflects the inadequate mobilization of Cu from a number of tissues. Previous studies suggested that the copper export system also functions as an efflux transporter for platinum drugs. These studies also showed an association between ATP7A expression and resistance to platinum drugs in malignancies (9-11). However, the ATP7A expression level and its impact on CDDP resistance in NSCLC has yet to be adequately elucidated.The present study aimed to investigate the predictive value of ATP7A gene expression for the in vitr...

During the treatment of 86 patients with video-assisted thoracoscopic surgery (VATS) anatomical resection (include segmentectomy) within the last two years, we have encountered five patients (5.8%) with anomalous venous returns. Anomalous returns included: 1) common trunk of the left pulmonary vein; 2) right middle pulmonary vein (V4) draining into the inferior pulmonary vein (IPV); 3) left lingular vein (V4+5) draining into the IPV; 4) right posterior pulmonary vein (V2) draining directly into the left atrium; and 5) left upper lobe vein draining into the left innominate vein. If a surgeon were to perform VATS lobectomy without paying attention to these anomalies according to the affected lobe, serious surgical complications might result. Multi-detector row angiography is useful for recognizing such anomalies before surgery and allow safe VATS lobectomy.