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- Title
F-020MORPHOLOGICAL AND MOLECULAR CHARACTERIZATION OF CANCER PHENOTYPES ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
- Authors
Schiavon, Marco; Marulli, G.; Zuin, A.; Calabrese, F.; Nannini, N.; Comacchio, G.M.; Rossi, E.; Battistella, L.; Rebusso, A.; Rea, F.
- Abstract
Objectives NSCLC comprises a group of diseases with heterogeneous clinical and molecular characteristics. Chronic obstructive pulmonary disease (COPD) and lung cancer are strictly related and COPD-associated cancers seem to have specific pathogenetic and morphological features, different from tumours arising in non-COPD patients. Our aim was to identify the presence of specific morphological and molecular cancer phenotypes in COPD patients compared to control groups (healthy smokers and never-smokers). Methods From 2010 to 2012, we prospectively analysed 43 patients with adenocarcinoma (10 COPD, 23 smokers, 10 never-smokers). Each patient underwent a complete clinical and instrumental assessment (GOLD criteria were used to identify COPD patients). Morphological study included pTNM staging, morphometric analysis of growth pattern, cell proliferation (Ki67/MIB1 expression) and parameters of intra- and peri-tumoural remodelling (inflammation, fibrosis, necrosis). Genetic analysis of EGFR and KRAS mutations was performed. Results Three groups were comparable for main demographic and functional parameters except for male/female ratio, reversed in never-smokers, and for lung function, reduced in COPD patients. Compared to COPD and never-smoker cancers, tumours in smokers presented an increase of solid component (20% vs 10% and 0%, respectively, P = 0.045), a reduction of lepidic pattern (0% vs 25% and 25%, respectively, P = 0.01) and higher Ki67/MIB1 value (50 ± 25% vs 30 ± 30% vs 24 ± 18%, respectively, P = 0.013). An increase of necrosis was found in smokers (20 ± 23%) and COPD (18 ± 23%) compared to never-smokers (2 ± 4%, P = 0.03 and P = 0.05, respectively). Concerning EGFR mutation, no differences was found between groups while KRAS mutation presented a significant higher percentage in smokers compared to COPD and never-smoker patients (39% vs 15% vs 11%, P <0.001). The presence of KRAS mutation was associated to higher value of Ki67/MIB1 (60% vs 25%, P = 0.04) and solid pattern (20% vs 5%, P = 0.02) and to a strong reduction of lepidic pattern (0% vs 15%, P = 0.125) compared to wild-type form. Conclusions COPD-related cancer presents molecular and morphological features of lower aggressiveness (increased lepidic component, reduced solid pattern, lower cell proliferation and a less frequent incidence of KRAS mutation) compared to smokers. Disclosure All authors have declared no conflicts of interest.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2013, Vol 17, Issue suppl_1, pS1
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivt288.20