RESUMEN
BACKGROUND: The detection rate of multiple lung adenocarcinomas, which display multiple ground glass opacity nodules in the peripheral lung, is increasing because of advances in high resolution computed tomography. The genetic backgrounds of multiple nodules and the mechanisms that underlie their multicentric development are unknown. In this study, we examined single nucleotide polymorphisms (SNPs) of the cytochrome P450 19A1 gene to determine if they are associated with multiple adenocarcinomas risk. METHODS: Fifty-one cases of multiple adenocarcinomas with lepidic growth, 62 cases of a single adenocarcinoma with lepidic growth, and 126 control cases were analyzed. Three SNPs were analyzed by using a 5' nuclease assay with TaqMan minor-groove-binder probe. The expression level of CYP19A1 in the noncancerous lung was quantified by real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS: A minor allele of SNP rs3764221, which is located in the CYP19A1 gene, was significantly associated with multiple adenocarcinomas risk (adjusted odds ratio = 3.06; P = 0.006). Other polymorphisms of CYP19A1 were not significantly associated with the risk of multiple adenocarcinomas. A minor allele of SNP rs3764221 was also associated with a higher level of CYP19A1 messenger RNA expression (P = 0.03). CONCLUSIONS: SNP rs3764221 contributes to the development of multicentric adenocarcinomas in the peripheral lung by causing higher levels of CYP19A1 expression.
Asunto(s)
Adenocarcinoma/genética , Adenocarcinoma/patología , Aromatasa/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Polimorfismo de Nucleótido Simple/genética , Anciano , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estadificación de Neoplasias , Reacción en Cadena de la Polimerasa , Pronóstico , ARN Mensajero/genética , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
A 55-year-old female felt a transient chest pain soon after a fish meal. Sixteen days later she presented a local clinic with fever of 38°C. After chest computed tomography( CT) and upper gastrointestinal endoscopy showed fish bone embedded in the wall of the middle portion of the esophagus, she referred to our hospital 22 days after the meal. Thirty days after the meal ,endoscopic removal of the fish bone was challenged bygastroentenologists in vain. Chest CT after the attempt showed migration of the fish bone to the lung adjacent to the right inferior pulmonary vein. The fish bone which stuck out from the lung after division of the pulmonary ligament was removed successfully under thoracoscopic surgery. The patient is well 26 months after the surgery.
Asunto(s)
Esófago , Peces , Cuerpos Extraños/terapia , Migración de Cuerpo Extraño/terapia , Pulmón , Toracoscopía , Animales , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Lung adenocarcinoma has never before been reported to be associated with von Hippel-Lindau (VHL) disease. Here, we report a case of VHL disease in a patient who had metachronous multiple lung adenocarcinomas. The patient is a 64-year-old-woman with VHL disease. She underwent surgical resection of one adenocarcinoma and one atypical adenomatous hyperplasia. A second lung adenocarcinoma developed metachronously. A point mutation in the VHL gene was confirmed in DNA from a blood sample, and loss of heterozygosity at the VHL locus was detected in the lung adenocarcinoma. The VHL dysfunction may have a role in the development of multiple lung adenocarcinomas.