Ji Yun Jeong’s research while affiliated with Kyungpook National University and other places

Adenocarcinoma occurs very rarely in the paranasal sinuses; moreover, adenocarcinoma diagnosed in the external nose is rarely reported. A 58-year-old male patient visited our hospital with an enlarged right nasal mass. On image studies, a 1.5 cm sized mass was found on the right nasolabial fold, which was surgically removed via sublabial approach. Intraoperative frozen section examination showed inflammatory tissue without tumor cells. However, adenocarcinoma showing infiltration between the skeletal muscle layers was diagnosed on the final histopathologic examination after surgery. In the immunohistochemical staining test, CK7 positive, CK20 negative, and GCDFP-15 positive were confirmed, so metastasis of adenocarcinoma was considered first rather than primary cancer of the nasolabial fold. There was no recurrence and no tumor development in other sites after postoperative chemoradiation therapy of 32 months.

Lung adenocarcinoma (LUAD) is the most frequently observed subtype found in non-small cell lung cancer (NSCLC). Despite its high prevalence, the molecular and histological heterogeneity in LUAD pose a significant challenge for providing effective patient care and aiming to reduce the high mortality rate. The histopathological classification proposed by WHO in 2015 describes five histologic patterns of lung adenocarcinoma (lepidic, acinar, papillary, micropapillary, and solid), and it has been shown that the existence of high-grade subtypes (micropapillary and solid) is associated with poorer survival outcomes. Nevertheless, the specific cellular and molecular mechanisms responsible for these clinical outcome differences based on distinct histological patterns remain unclear. Here, we conducted single-cell RNA sequencing (scRNA-seq) to unveil insights into the tumor microenvironment (TME) and identify cancer cell biomarkers associated with distinct histological patterns. Our study involved 18 specimens from primary LUAD patients who underwent surgical resection, all of whom were previously untreated. These specimens were classified into three groups: acinar/papillary (A/P), micropapillary (MP), and solid. Remarkably, patients with solid-type tumors showed a notable enrichment of CD8+ T cell exhaustion, alongside a significant abundance of GPNMB-high macrophages in the myeloid compartment. Additionally, macrophages from the solid-type demonstrated cholesterol-efflux activation, particularly in alveolar macrophages. It is well-known that cholesterol efflux-activated macrophages display a tumor-associated macrophage phenotype, contributing to immunosuppression in the TME. In contrast, the A/P group exhibited a higher enrichment of mast cells compared to the solid-type. This suggests that the solid-type tumor landscape is more immunosuppressive than the A/P group. In the context of cancer cells, we identified that A/P cancer cells displayed a well-differentiated pattern with a high alveolar epithelial type II cell (AT2) signature. In contrast, solid-type cancer cells showed poorly differentiated states, coupled with a significant activation of the epithelial-mesenchymal transition (EMT) process. Remarkably, even within A/P patients, those with a small portion of solid patterns in the tumor tissue showed higher clonal complexity compared to patients without any solid pattern. Furthermore, we found that cancer cell plasticity can be regulated by cell-cell interactions in the TME. Collectively, this study unveils the relationship between histological patterns and the TME, encompassing distinct immune responses and molecular characteristics of cancer cells in LUAD. These findings provide valuable insights for potential targeted therapeutic strategies. Citation Format: Ju Sung Lee, Ji Yun Jeong, Mi Jeong Hong, Hyo-Gyoung Kang, Jin Eun Choi, Ju Young Kim, Yoon Ha Choi, Jong Kyoung Kim, Shin Yup Lee. Deciphering histological subtype-associated cellular and molecular characteristics of lung adenocarcinoma using single-cell RNA sequencing and spatial transcriptomics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2942.

Myxofibrosarcoma (MFS) is a rare subtype of soft tissue sarcoma, most commonly occurring in the lower extremities and rarely in the head and neck region. To our knowledge, there have been no reported cases of MFS originating from the maxillary sinus in Korea. Herein, we describe a case of a 61-year-old male who presented with left-sided hypoesthesia and a mass in the maxillary sinus, which was subsequently diagnosed as MFS originating from the maxillary sinus through endoscopic surgery with a prelacrimal approach. The patient was administered postoperative radiation therapy, and after two years of follow-up, there was no evidence of recurrence. This report presents a case of successful treatment of MFS in the maxillary sinus.

Background Primary thymic mucinous adenocarcinoma is an extremely rare and aggressive tumor with poor prognosis. The tumor may present as a heterogeneous solid or cystic mass accompanied by calcifications. However, clinical and radiologic features of the tumor are not well known due to the rarity of the disease, which makes accurate diagnosis difficult. Case Presentation Here we present a rare case of primary thymic mucinous adenocarcinoma in the anterior mediastinum, including computed tomography (CT) and magnetic resonance imaging (MRI) findings. Chest computed tomography revealed a large anterior mediastinal mass with extensive calcifications with poor enhancement. MRI showed that anterior mediastinal mass showed intermediate signal intensity on T1-weighted images (T1WI), high SI on T2-weighted images (T2WI), and heterogeneous enhancement. Biopsy was performed and the anterior mediastinal tumor was diagnosed as thymic mucinous adenocarcinoma by histopathologic examination and immunohistochemical staining. Conclusion Thymic mucinous adenocarcinomas could be included in differential diagnoses of anterior mediastinal tumors showing extensive calcification, and common imaging findings of mucinous adenocarcinoma such as T2 high signal intensity and heterogeneous enhancement on MRI may be helpful to diagnose thymic mucinous adenocarcinoma.

Purpose: Self-management of diabetes is a significant challenge. This study aimed to assess diabetes self-care activities and barriers among Korean young adults with diabetes mellitus. Materials and methods: This study recruited 209 Korean adults with diabetes, with an onset age of 20-39 years, from four university hospitals. Demographic characteristics and the Summary of Diabetes Self-Care Activities (SDSCA) measure and Diabetes Self-Care Barriers Assessment Scale for Older Adults (DSCB-OA) scores were assessed using questionnaires. Results: The average age of study participants was 32.9±6.1 years. Their self-care activities, including adherence to recommended diabetes medication (5.6±2.4) and number of diabetes pills (5.5±2.3) in the SDSCA measure, were the most well-performed activities among all domains. Responses to inspection of the inside of shoes in the foot care activity (0.8±1.5) and specific exercise sessions in the exercise activity (1.6±1.9) reflected poor levels of compliance. According to the DSCB-OA questionnaire, the mean diabetes self-care barrier of DSCB-OA was 20.6±5.0 of total score 45. The greater perceived barriers to self-care on the DSCB-OA were having difficulty exercising regularly (1.9±0.7) and eating three meals and snacks leading to weight gain (1.9±0.8). Conclusion: Young adults with early-onset diabetes showed a greater barrier to regular exercise and poor compliance with foot care and blood sugar testing. Healthcare providers must strengthen their relationship with young adults with diabetes to provide more education and guidelines for lifestyle modification focused on exercise and to promote higher compliance with diabetic self-care activities for improving clinical outcomes.

Background/aim: This study evaluated the possibility of clinical use of circulating-tumor DNA (ctDNA) as a biomarker to determine up-front autologous stem cell transplantation (auto-SCT) for patients with high-risk diffuse large B-cell lymphoma (DLBCL) in practice. Patients and methods: To explore the dynamics of ctDNA in DLBCL, blood samples were collected sequentially before and after treatment from patients with newly diagnosed DLBCL who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. To conduct ctDNA genotyping and ctDNA monitoring simultaneously, targeted sequencing by cancer personalized profiling using deep sequencing was used. Results: Ten patients between the ages of 50 and 60 years were enrolled. Based on the international prognostic index (IPI), seven patients were classified as high-IPI-risk group, and three patients were classified as low-IPI-risk group. The IPI risk group correlated with total metabolic tumor volume. All patients completed six cycles of R-CHOP chemotherapy, and seven patients achieved complete response. Changes in ctDNA mutation numbers did not correlate with changes in PET scan images and treatment response. In most high-risk patients, new mutations appeared in ctDNA after completion of chemotherapy that conceivably marked resistant clones. Notably, disease relapse did not occur in high-risk patients with poor prognostic mutations who underwent autologous SCT. Conclusion: ctDNA monitoring was meaningful in high-risk patients. Moreover, ctDNA and well-known prognostic factors should be considered in the decision making for auto-SCT. If a new genetic mutation in ctDNA with a negative prognosis would emerge during treatment, high-risk patients should consider auto-SCT.

Chondromyxoid fibroma (CMF) is an extremely rare, benign cartilaginous tumor found in the craniofacial region. It is often misdiagnosed due to its rare occurrence in the nasal and paranasal sinus; moreover, it has similarities with other cartilaginous tumors, showing the same radiologic and histopathologic features. A 62-year-old female consulted our clinic with the chief complaint of a left nasolabial mass of one-month history. The mass was located in the nasal cavity: from there it extended anteriorly to the anterior nasal spine, posteriorly to the end of the hard palate, and laterally to the maxillary sinus. The nasal septum was deviated to the right side due to the mass effect. Complete removal of the mass was conducted via the modified endoscopic Denker’s approach, and the diagnosis of CMF was established. During the 36-month follow-up, no recurrence was observed.

Despite advances in diagnostic imaging, surgical techniques, and systemic therapy, gastric cancer (GC) is the third leading cause of cancer-related death worldwide. Unfortunately, molecular heterogeneity and, consequently, acquired resistance in GC are the major causes of failure in the development of biomarker-guided targeted therapies. However, by showing promising survival benefits in some studies, the recent emergence of immunotherapy in GC has had a significant impact on treatment-selectable procedures. Immune checkpoint inhibitors (ICIs), widely indicated in the treatment of several malignancies, target inhibitory receptors on T lymphocytes, including the programmed cell death protein (PD-1)/programmed death-ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte-associated protein 4 (CTLA4), and release effector T-cells from negative feedback signals. In this article, we review currently available predictive biomarkers (including PD-L1, microsatellite instability, Epstein–Barr virus, and tumor mutational burden) that affect the ICI treatment response, focusing on PD-L1 expression. We further briefly describe other potential biomarkers or mechanisms for predicting the response to ICIs in GC. This review may facilitate the expansion of the understanding of biomarkers for predicting the response to ICIs and help select the appropriate therapeutic approaches for patients with GC.