NUF2 Expression in Cancer Tissues and Lymph Nodes Suggests Post-Surgery Recurrence of Non-Small Cell Lung Cancer.

In non-small cell lung cancer (NSCLC) cases, detecting potential lymph node metastases is essential to determine the indications for sublobar resection or adjuvant therapy. NUF2 is a tumor-specific antigen that is highly expressed in lung cancer tissues. However, the significance of analyzing NUF2 expression in dissected lymph nodes has not yet been studied. Thus, we investigated the association between NUF2 expression in lung cancer tissues and dissected lymph nodes and early recurrence of NSCLC to determine its usefulness as a marker of lymph node micrometastasis. This retrospective study quantified NUF2 expression in the cancer tissues of 88 patients with NSCLC who underwent complete resection using real-time polymerase chain reaction and investigated its relationship with clinicopathological features and prognosis. We also quantified NUF2 RNA expression in mediastinal lymph nodes from 255 patients with pN0 NSCLC who underwent complete resection with lymph node dissection and analyzed its association with prognosis. NUF2 expression in primary tumors was correlated with lymph node metastasis and unfavorable outcomes in terms of poor recurrence-free and cancer-specific survival. In N0 NSCLC cases, high NUF2 expression in mediastinal lymph nodes indicated poor prognosis, especially in lymph node recurrence. NUF2 emerges as a promising marker for predicting lymph node metastatic recurrence, offering potential utility in guiding post-surgical adjuvant therapy for lung cancer or assisting in intraoperative decisions for sublobar resection.

Molecular Imaging of PD-1 Unveils Unknown Characteristics of PD-1 Itself by Visualizing "PD-1 Microclusters".

Programmed cell death-1 (PD-1) is one of the most famous coinhibitory receptors that are expressed on effector T cells to regulate their function. The PD-1 ligands, PD-L1 and PD-L2, are expressed by various cells throughout the body at steady state and their expression was further regulated within different pathological conditions such as tumor-bearing and chronic inflammatory diseases. In recent years, immune checkpoint inhibitor (ICI) therapies with anti-PD-1 or anti-PD-L1 has become a standard treatment for various malignancies and has shown remarkable antitumor effects. Since the discovery of PD-1 in 1992, a huge number of studies have been conducted to elucidate the function of PD-1. Herein, this paper provides an overview of PD-1 biological findings and sheds some light on the current technology for molecular imaging of PD-1.

Evaluation of therapeutic PD-1 antibodies by an advanced single-molecule imaging system detecting human PD-1 microclusters.

With recent advances in immune checkpoint inhibitors (ICIs), immunotherapy has become the standard treatment for various malignant tumors. Their indications and dosages have been determined empirically, taking individually conducted clinical trials into consideration, but without a standard method to evaluate them. Here we establish an advanced imaging system to visualize human PD-1 microclusters, in which a minimal T cell receptor (TCR) signaling unit co-localizes with the inhibitory co-receptor PD-1 in vitro. In these microclusters PD-1 dephosphorylates both the TCR/CD3 complex and its downstream signaling molecules via the recruitment of a phosphatase, SHP2, upon stimulation with the ligand hPD-L1. In this system, blocking antibodies for hPD-1-hPD-L1 binding inhibits hPD-1 microcluster formation, and each therapeutic antibody (pembrolizumab, nivolumab, durvalumab and atezolizumab) is characterized by a proprietary optimal concentration and combinatorial efficiency enhancement. We propose that our imaging system could digitally evaluate PD-1-mediated T cell suppression to evaluate their clinical usefulness and to develop the most suitable combinations among ICIs or between ICIs and conventional cancer treatments.

[Lung Metastases from Pancreatic Cancer Initially Suspected to be Primary Lung Cancer due to Lepidic Tumor Growth].

A 46-year-old patient man was pointed out multiple abnormal shadows on the chest X-ray. Computed tomography( CT) scans showed diffuse multiple granular shadows associated with ground-glass opacity in the surrounding area. Therefore, sarcoidosis or inflammatory lung disease was suspected. Bronchoscopic examination could not establish definitive diagnosis. Since an increase in the size and number of granular shadows was observed during the follow-up period, surgical biopsy was performed. Pathologically, adenocarcinoma with lepidic tumor growth into the surrounding area was observed suggesting primary lung cancer. Positron emission tomography (PET) after surgery for establishing stage of disease detected an abnormal accumulation in the pancreatic head which was demonstrated to be pancreatic cancer by biopsy. The final diagnosis of multiple lung tumor was metastases from pancreatic cancer.

PD-L2 suppresses T cell signaling via coinhibitory microcluster formation and SHP2 phosphatase recruitment.

The coinhibitory receptor, PD-1, is of major importance for the suppression of T cell activation in various types of immune responses. A high-resolution imaging study showed that PD-1 forms a coinhibitory signalosome, "PD-1 microcluster", with the phosphatase, SHP2, to dephosphorylate the TCR/CD3 complex and its downstream signaling molecules. Such a consecutive reaction entirely depended on PD-1-PD-L1/2 binding. PD-L2 is expressed on professional antigen-presenting cells and also on some tumor cells, which possibly explains the discrepant efficacy of immune checkpoint therapy for PD-L1-negative tumors. Here, we performed precise imaging analysis of PD-L2 forming PD-1-PD-L2 clusters associating with SHP2. PD-L2 could compete with PD-L1 for binding to PD-1, occupying the same space at TCR microclusters. The PD-1 microcluster formation was inhibited by certain mAbs with functional consequences. Thus, PD-1 microcluster formation provides a visible index for the effectiveness of anti-PD-1- or anti-PD-L1/2-mediated T cell suppression. PD-L2 may exert immune suppressive responses cooperatively with PD-L1 on the microcluster scale.

Interstitial fluid pressure of thymic epithelial tumours.

Tumours show an increased interstitial fluid pressure, which correlates with various pathophysiological features. Moreover, interstitial fluid pressure is a prognostic factor for cervical and lung cancer. However, there have been no reports on the usefulness of measuring interstitial fluid pressure in thymic epithelial tumours. Therefore, this study aimed to examine the relationship between interstitial fluid pressure and the clinicopathological characteristics of thymic epithelial tumours. Interstitial fluid pressure was prospectively measured at the centre of the tumour using a 1-Fr Mikro-Tip sensor catheter in 44 patients with thymic epithelial tumours, 40 with thymomas and 4 with thymic carcinomas. Data from these 44 patients were analysed for correlations between interstitial fluid pressure and clinicopathological and demographic factors including sex, age, tumour size, World Health Organization histological subtypes, myasthenia gravis, capsular invasion, mediastinal pleura invasion, lung invasion, pericardium invasion, dissemination, Masaoka-Koga stage, maximal standardized uptake value and recurrence-free survival (RFS). The mean interstitial fluid pressure was 11.3 mmHg; interstitial fluid pressure was significantly correlated with maximal standardized uptake value, lung invasion, dissemination and Masaoka-Koga stage. Low interstitial fluid pressure (≤14 mmHg) showed a tendency for better RFS compared with high interstitial pressure (P = 0.053). Lung invasion, dissemination and Masaoka-Koga stage were correlated with RFS in univariable analysis; lung invasion was selected as an independent prognostic factor in multivariable analysis. On the basis of these results, interstitial fluid pressure of thymic epithelial tumours has been shown to correlate with their clinicopathological features.

[Chronic Progressive Pulmonary Aspergillosis after Surgery for Lung Cancer].

Case 1:A 62-year-old man underwent right S9+10 segmentectomy for non-small cell lung cancer. Three years later, pleural thickening appeared in the apex, and gradually developed cystic change. Case 2:A 64-year-old man underwent left upper lobectomy for non-small cell lung cancer. One year after surgery, chest computed tomography (CT) showed cysts in the apex of the lower lobe. The cysts expanded slowly with consolidation. Both cases were diagnosed as chronic progressive pulmonary aspergillosis. Although anti-fungal drugs were administered in both cases, case 1 died of the disease. Chronic progressive pulmonary aspergillosis is a rare late postoperative complication;when CT shows progressive cysts with consolidation in the apex area of the residual lung, frequent check-ups are needed.