Investigation of the metastatic mechanisms in spread through air spaces (STAS) in lung cancer

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K17742
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55040:Respiratory surgery-related
• Research Institution: Shinshu University
• Principal Investigator: Eguchi Takashi 信州大学, 学術研究院医学系(医学部附属病院), 講師 (50447744)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 肺癌 / 経気腔進展 / 腫瘍免疫 / 微小環境

Outline of Final Research Achievements

[Research on STAS and Immune Cell Distribution] We created a tissue microarray (TMA) from 301 primary lung cancers. We evaluated tumor infiltration of immune cells using this TMA, focusing on their distribution within the tumor. We discovered that cases where anti-tumor immune cells (e.g., CD8-positive T cells) cannot migrate into the tumor have poor prognoses and that FoxP3-positive T cells at the tumor margin are prognostic factors in STAS-positive lung cancer. These results were presented at the World Conference on Lung Cancer in August 2022 and have been submitted for publication in Heliyon, currently under the second revision.

[STAS Evaluation Using Frozen Specimens] To diagnose STAS intraoperatively, we conducted a prospective study evaluating the sensitivity and specificity of 114 frozen specimens. The results were presented at the World Conference on Lung Cancer in August 2022 and published in JTCVS Techniques 2023.

Free Research Field

呼吸器外科

Academic Significance and Societal Importance of the Research Achievements

本研究は、肺癌におけるSTASと免疫細胞分布の関係を明らかにし、STAS陽性症例の予後不良に関与する免疫細胞の動態を解明した。特に腫瘍内への抗腫瘍免疫脂肪の浸潤障害と、腫瘍辺縁部における腫瘍促進免疫細胞とSTASの共存が重要な予後規定因子であることを発見した。また、術中迅速診断によるSTAS検出の実現可能性を確認した。
本研究の成果は、STASの術中診断精度を向上させ、患者の予後を予測し、治療方法を選択するための新たなバイオマーカーの開発に寄与すると考える。これにより個別化治療の向上や術後管理の最適化、ひいては患者の生存率向上と医療資源の効率的活用につながる。