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Molecular analysis for the pathogenesis of lung cancer associatedvwith acromegaly

肢端肥大症相关肺癌发病机制的分子分析

基本信息

批准号：
19590922
负责人：
吉村邦彦
金额：
$ 2.41万
依托单位：
Okinaka Memorial Institute for Medical Research
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2007
资助国家：
日本
起止时间：
2007 至 2008
项目状态：
已结题

项目摘要

先端肥大症(acromegaly)患者には複数臓器に悪性腫瘍が発症する頻度が高い.これまで肺に多発性の肺癌を発症した先端肥大症の症例を経験し報告してきた.これらの症例では手術前の下垂体腫瘍,あるいは術後の残存腫瘍からの成長ホルモン(GH)の作用で,肝臓や間葉系細胞によるinsulin-like growth factor 1 (IGF-1)の産生が亢進し,この結果血中IGF-1 が持続的に高値を示すのみならず,肺癌細胞においてIGF-1 受容体(IGF-1R)が強発現していることを見出した2007 年1 月から2009 年2 月の26 ヶ月に虎の門病院間脳下垂体外科にて下垂体腫瘍切除術を受けた20 歳以上の成人先端肥大症患者255 例のうち,胸部CT を撮影しえた5 例に関して解析した.結節影を呈した症例は1 例,肺野の限局性すりガラス陰影(GGO)は2 例に認められ,うち1 例は右肺の単発GGO,もう1 例は左右肺に合計3 個のGGO が確認できた.すなわち画像上細気管支肺胞上皮癌(BAC)や異型性腺腫様過形成(AAH)を疑わせる所見を有する患者は40%にのぼった.いずれも径が10 mm に満たないため,現在経過観察中であり,摘出組織を用いたISH による IGF-1 およびIGF-1 受容体発現,腫瘍組織と近傍の正常組織におけるcDNA microarray 解析などの検討は未施行である.また,新たに68 歳の先端肥大症Hardy 手術既往の肺癌患者を経験した.この症例では,右肺内に同時多発性の2 つの肺腺癌(上葉S^3 : 高分化乳頭腺癌,下葉S^7 : 中等度分化混合型亜型癌)を発症し,胸腔胸下切除術+術後補助化学療法,左側の肺癌推定病変への放射線療法を施行した

Patients with acromegaly developed multiple organ cysts more frequently. This is a report on the development of multiple lung cancer and cases of hypertrophic lung disease. In these cases, the production of insulin-like growth factor 1 (IGF-1) in liver mesenchymal cells was increased due to the role of GH in pituitary tumors before surgery and in residual tumors after surgery. As a result, IGF-1 levels in the blood remained high. IGF-1 receptor (IGF-1R) was strongly detected in lung cancer cells from January 2007 to February 26, 2009. Hypophysis surgery was performed in 255 adult patients over 20 years old with acromegaly. Nodular shadow was found in 1 case, and localized GGO in lung field was found in 2 cases, GGO in right lung in 1 case, and GGO in left lung in 1 case. 40% of patients were diagnosed with BAC and AAH. The diameter of the inner edge is 10 mm and the machine is now inspected. During the inspection, IGF-1 and IGF-1 receptors were detected when the tissue was extracted and ISH was used. The review of cDNA microarray analysis between the tumor tissue and the adjacent normal tissue has not yet been carried out. New, 68-year-old hypertrophic syndrome Hardy surgery in patients with lung cancer in the past. In this case, there were 2 cases of lung adenocarcinoma (upper lobe S^3 : well-differentiated papillary adenocarcinoma, lower lobe S^7 : moderately differentiated mixed carcinoma) in the right lung, subthoracotomy + postoperative adjuvant chemotherapy, radiation therapy for presumed lung cancer in the left lung