1.Mutation-Driven Immune Microenvironments in Non-Small Cell Lung Cancer: Unrevealing Patterns through Cluster Analysis
Youngtaek KIM ; Joon Yeon HWANG ; Kwangmin NA ; Dong Kwon KIM ; Seul LEE ; Seong-san KANG ; Sujeong BAEK ; Seung Min YANG ; Mi Hyun KIM ; Heekyung HAN ; Seong Su JEONG ; Chai Young LEE ; Yu Jin HAN ; Jie-Ohn SOHN ; Sang-Kyu YE ; Kyoung-Ho PYO
Yonsei Medical Journal 2024;65(12):683-694
Purpose:
We aimed to comprehensively analyze the immune cell and stromal components of tumor microenvironment at the single-cell level and identify tumor heterogeneity among the major top-derived oncogene mutations in non-small cell lung cancer (NSCLC) using single-cell RNA sequencing (scRNA-seq) data.
Materials and Methods:
The scRNA-seq dataset utilized in this study comprised 64369 primary tumor tissue cells from 21 NSCLC patients, focusing on mutations in EGFR, ALK, BRAF, KRAS, TP53, and the wild-type.
Results:
Tumor immune microenvironment (TIM) analysis revealed differential immune responses across NSCLC mutation subtypes. TIM analysis revealed different immune responses across the mutation subtypes. Two mutation clusters emerged: KRAS, TP53, and EGFR+TP53 mutations (MC1); and EGFR, BRAF, and ALK mutations (MC2). MC1 showed higher tertiary lymphoid structures signature scores and enriched populations of C2-T-IL7R, C3-T/NK-CXCL4, C9-T/NK-NKG, and C1-B-MS4A1 clusters than cluster 2. Conversely, MC2 cells exhibited higher expression levels of TNF, IL1B, and chemokines linked to alternative immune pathways. Remarkably, co-occurring EGFR and TP53 mutations were grouped as MC1. EGFR+TP53 mutations showed upregulation of peptide synthesis and higher synthetic processes, as well as differences in myeloid and T/NK cells compared to EGFR mutations. In T/NK cells, EGFR+TP53 mutations showed a higher expression of features related to cell activity and differentiation, whereas EGFR mutations showed the opposite.
Conclusion
Our research indicates a close association between mutation types and tumor microenvironment in NSCLC, offering insights into personalized approaches for cancer diagnosis and treatment.
2.Current Concepts and Medical Management for Patients with Radiographic Axial Spondyloarthritis
Seung-Hoon BAEK ; Seungbae OH ; Bum-Jin SHIM ; Jeong Joon YOO ; Jung-Mo HWANG ; Tae-Young KIM ; Seung-Cheol SHIM
Hip & Pelvis 2024;36(4):234-249
Radiographic axial spondyloarthritis (r-axSpA), a chronic inflammatory disease, can cause significant radiographic damage to the axial skeleton. Regarding the pathogenic mechanism, association of r-axSpA with tumor necrosis factor (TNF) and the interleukin-23/17 (IL23/IL17) pathway has been reported. Development of extraarticular manifestations, including uveitis, inflammatory bowel disease, and psoriasis, has been reported in some patients. The pivotal role of human leukocyte antigenB27 in the pathogenesis of r-axSpA remains to be clarified. Symptoms usually start in late adolescence or early adulthood, and disease progression can vary in each patient, with clinical manifestations ranging from mild joint stiffness without radiographic changes to advanced manifestations including complete fusion of the spine, and severe arthritis of the hip, and could include peripheral arthritis and extraarticular manifestations. The modified New York criteria was used previously in diagnosis of r-axSpA. However, early diagnosis of the disease prior to development of bone deformity was required due to development of biological agents. As a result of Assessment of SpondyloArthritis international Society (ASAS), the classification was improved in part for diagnosis of spondyloarthritis prior to development of bone deformity. The diagnosis is based on comprehensive laboratory findings, physical examinations, and radiologic findings. Medical treatment for r-axSpA involves the use of a stepwise strategy, starting with administration of nonsteroidal anti-inflammatory drugs and physiotherapy, and progressing to sulfasalazine or methotrexate and biologics including TNF-α inhibitors or IL-17 inhibitors as needed. Use of Janus kinase inhibitors has been recently reported.
3.Mutation-Driven Immune Microenvironments in Non-Small Cell Lung Cancer: Unrevealing Patterns through Cluster Analysis
Youngtaek KIM ; Joon Yeon HWANG ; Kwangmin NA ; Dong Kwon KIM ; Seul LEE ; Seong-san KANG ; Sujeong BAEK ; Seung Min YANG ; Mi Hyun KIM ; Heekyung HAN ; Seong Su JEONG ; Chai Young LEE ; Yu Jin HAN ; Jie-Ohn SOHN ; Sang-Kyu YE ; Kyoung-Ho PYO
Yonsei Medical Journal 2024;65(12):683-694
Purpose:
We aimed to comprehensively analyze the immune cell and stromal components of tumor microenvironment at the single-cell level and identify tumor heterogeneity among the major top-derived oncogene mutations in non-small cell lung cancer (NSCLC) using single-cell RNA sequencing (scRNA-seq) data.
Materials and Methods:
The scRNA-seq dataset utilized in this study comprised 64369 primary tumor tissue cells from 21 NSCLC patients, focusing on mutations in EGFR, ALK, BRAF, KRAS, TP53, and the wild-type.
Results:
Tumor immune microenvironment (TIM) analysis revealed differential immune responses across NSCLC mutation subtypes. TIM analysis revealed different immune responses across the mutation subtypes. Two mutation clusters emerged: KRAS, TP53, and EGFR+TP53 mutations (MC1); and EGFR, BRAF, and ALK mutations (MC2). MC1 showed higher tertiary lymphoid structures signature scores and enriched populations of C2-T-IL7R, C3-T/NK-CXCL4, C9-T/NK-NKG, and C1-B-MS4A1 clusters than cluster 2. Conversely, MC2 cells exhibited higher expression levels of TNF, IL1B, and chemokines linked to alternative immune pathways. Remarkably, co-occurring EGFR and TP53 mutations were grouped as MC1. EGFR+TP53 mutations showed upregulation of peptide synthesis and higher synthetic processes, as well as differences in myeloid and T/NK cells compared to EGFR mutations. In T/NK cells, EGFR+TP53 mutations showed a higher expression of features related to cell activity and differentiation, whereas EGFR mutations showed the opposite.
Conclusion
Our research indicates a close association between mutation types and tumor microenvironment in NSCLC, offering insights into personalized approaches for cancer diagnosis and treatment.
4.Mutation-Driven Immune Microenvironments in Non-Small Cell Lung Cancer: Unrevealing Patterns through Cluster Analysis
Youngtaek KIM ; Joon Yeon HWANG ; Kwangmin NA ; Dong Kwon KIM ; Seul LEE ; Seong-san KANG ; Sujeong BAEK ; Seung Min YANG ; Mi Hyun KIM ; Heekyung HAN ; Seong Su JEONG ; Chai Young LEE ; Yu Jin HAN ; Jie-Ohn SOHN ; Sang-Kyu YE ; Kyoung-Ho PYO
Yonsei Medical Journal 2024;65(12):683-694
Purpose:
We aimed to comprehensively analyze the immune cell and stromal components of tumor microenvironment at the single-cell level and identify tumor heterogeneity among the major top-derived oncogene mutations in non-small cell lung cancer (NSCLC) using single-cell RNA sequencing (scRNA-seq) data.
Materials and Methods:
The scRNA-seq dataset utilized in this study comprised 64369 primary tumor tissue cells from 21 NSCLC patients, focusing on mutations in EGFR, ALK, BRAF, KRAS, TP53, and the wild-type.
Results:
Tumor immune microenvironment (TIM) analysis revealed differential immune responses across NSCLC mutation subtypes. TIM analysis revealed different immune responses across the mutation subtypes. Two mutation clusters emerged: KRAS, TP53, and EGFR+TP53 mutations (MC1); and EGFR, BRAF, and ALK mutations (MC2). MC1 showed higher tertiary lymphoid structures signature scores and enriched populations of C2-T-IL7R, C3-T/NK-CXCL4, C9-T/NK-NKG, and C1-B-MS4A1 clusters than cluster 2. Conversely, MC2 cells exhibited higher expression levels of TNF, IL1B, and chemokines linked to alternative immune pathways. Remarkably, co-occurring EGFR and TP53 mutations were grouped as MC1. EGFR+TP53 mutations showed upregulation of peptide synthesis and higher synthetic processes, as well as differences in myeloid and T/NK cells compared to EGFR mutations. In T/NK cells, EGFR+TP53 mutations showed a higher expression of features related to cell activity and differentiation, whereas EGFR mutations showed the opposite.
Conclusion
Our research indicates a close association between mutation types and tumor microenvironment in NSCLC, offering insights into personalized approaches for cancer diagnosis and treatment.
5.Capsular Contracture After Postmastectomy Radiation in Implant-Based Breast Reconstruction:Effect of Implant Pocket and Two-Stage Surgery
Sohyun MOON ; Kyunghyun MIN ; Tae Ho KIM ; Jung Hwan UM ; Yoonwon KOOK ; Seung Ho BAEK ; In Sik YUN ; Tai Suk ROH ; Soong June BAE ; Joon JEONG ; Sung Gwe AHN ; Young Seok KIM
Journal of Breast Cancer 2024;27(6):395-406
Capsular contracture (CC) is a concerning issue for individuals undergoing postmastectomy radiation therapy (PMRT) with implant-based breast reconstruction. This study investigated whether the extent of CC and implant migration differs based on implant placement and the reconstruction stage. Insertion plane and stage of breast implants were investigated, and the presence and severe cases of CC and implant migration were analyzed. Among 195 participants, 83 were in the pre-pectoral group, and 112 were in the sub-pectoral group. Two-staged surgery was performed on 116 patients, while 79 underwent direct-to-implant (DTI).Notably, The occurrence of CC (prepectoral, 17 [20.48%] and subpectoral, 42 [37.50%];p = 0.011), CC severity (prepectoral, 4 [4.82%] and subpectoral, 17 [15.17%]; p = 0.021), and implant upward migration (prepectoral, 15 [18.07%] and subpectoral, 38 [33.92%]; p = 0.014) significantly varied between the two groups. The incidence of CC was more common in the DTI group (odds ratio [OR], 2.283; 95% confidence interval [CI], 1.164–4.478). Furthermore, subpectoral placement was an independent risk factor for occurrence (OR, 2.989; 95% CI, 1.476–6.054) and severity of CC (OR, 38.552; 95% CI, 1.855–801.186) and upward implant migration (OR, 2.531; 95% CI, 1.263–5.071). Our findings suggest that pre-pectoral reconstruction and the two-stage operation benefit patients who may undergo PMRT. These approaches can help reduce the incidence of CC and abnormal implant migration following radiation, leading to improved aesthetic outcomes and greater patient satisfaction.
6.Current Concepts and Medical Management for Patients with Radiographic Axial Spondyloarthritis
Seung-Hoon BAEK ; Seungbae OH ; Bum-Jin SHIM ; Jeong Joon YOO ; Jung-Mo HWANG ; Tae-Young KIM ; Seung-Cheol SHIM
Hip & Pelvis 2024;36(4):234-249
Radiographic axial spondyloarthritis (r-axSpA), a chronic inflammatory disease, can cause significant radiographic damage to the axial skeleton. Regarding the pathogenic mechanism, association of r-axSpA with tumor necrosis factor (TNF) and the interleukin-23/17 (IL23/IL17) pathway has been reported. Development of extraarticular manifestations, including uveitis, inflammatory bowel disease, and psoriasis, has been reported in some patients. The pivotal role of human leukocyte antigenB27 in the pathogenesis of r-axSpA remains to be clarified. Symptoms usually start in late adolescence or early adulthood, and disease progression can vary in each patient, with clinical manifestations ranging from mild joint stiffness without radiographic changes to advanced manifestations including complete fusion of the spine, and severe arthritis of the hip, and could include peripheral arthritis and extraarticular manifestations. The modified New York criteria was used previously in diagnosis of r-axSpA. However, early diagnosis of the disease prior to development of bone deformity was required due to development of biological agents. As a result of Assessment of SpondyloArthritis international Society (ASAS), the classification was improved in part for diagnosis of spondyloarthritis prior to development of bone deformity. The diagnosis is based on comprehensive laboratory findings, physical examinations, and radiologic findings. Medical treatment for r-axSpA involves the use of a stepwise strategy, starting with administration of nonsteroidal anti-inflammatory drugs and physiotherapy, and progressing to sulfasalazine or methotrexate and biologics including TNF-α inhibitors or IL-17 inhibitors as needed. Use of Janus kinase inhibitors has been recently reported.
7.Capsular Contracture After Postmastectomy Radiation in Implant-Based Breast Reconstruction:Effect of Implant Pocket and Two-Stage Surgery
Sohyun MOON ; Kyunghyun MIN ; Tae Ho KIM ; Jung Hwan UM ; Yoonwon KOOK ; Seung Ho BAEK ; In Sik YUN ; Tai Suk ROH ; Soong June BAE ; Joon JEONG ; Sung Gwe AHN ; Young Seok KIM
Journal of Breast Cancer 2024;27(6):395-406
Capsular contracture (CC) is a concerning issue for individuals undergoing postmastectomy radiation therapy (PMRT) with implant-based breast reconstruction. This study investigated whether the extent of CC and implant migration differs based on implant placement and the reconstruction stage. Insertion plane and stage of breast implants were investigated, and the presence and severe cases of CC and implant migration were analyzed. Among 195 participants, 83 were in the pre-pectoral group, and 112 were in the sub-pectoral group. Two-staged surgery was performed on 116 patients, while 79 underwent direct-to-implant (DTI).Notably, The occurrence of CC (prepectoral, 17 [20.48%] and subpectoral, 42 [37.50%];p = 0.011), CC severity (prepectoral, 4 [4.82%] and subpectoral, 17 [15.17%]; p = 0.021), and implant upward migration (prepectoral, 15 [18.07%] and subpectoral, 38 [33.92%]; p = 0.014) significantly varied between the two groups. The incidence of CC was more common in the DTI group (odds ratio [OR], 2.283; 95% confidence interval [CI], 1.164–4.478). Furthermore, subpectoral placement was an independent risk factor for occurrence (OR, 2.989; 95% CI, 1.476–6.054) and severity of CC (OR, 38.552; 95% CI, 1.855–801.186) and upward implant migration (OR, 2.531; 95% CI, 1.263–5.071). Our findings suggest that pre-pectoral reconstruction and the two-stage operation benefit patients who may undergo PMRT. These approaches can help reduce the incidence of CC and abnormal implant migration following radiation, leading to improved aesthetic outcomes and greater patient satisfaction.
8.Mutation-Driven Immune Microenvironments in Non-Small Cell Lung Cancer: Unrevealing Patterns through Cluster Analysis
Youngtaek KIM ; Joon Yeon HWANG ; Kwangmin NA ; Dong Kwon KIM ; Seul LEE ; Seong-san KANG ; Sujeong BAEK ; Seung Min YANG ; Mi Hyun KIM ; Heekyung HAN ; Seong Su JEONG ; Chai Young LEE ; Yu Jin HAN ; Jie-Ohn SOHN ; Sang-Kyu YE ; Kyoung-Ho PYO
Yonsei Medical Journal 2024;65(12):683-694
Purpose:
We aimed to comprehensively analyze the immune cell and stromal components of tumor microenvironment at the single-cell level and identify tumor heterogeneity among the major top-derived oncogene mutations in non-small cell lung cancer (NSCLC) using single-cell RNA sequencing (scRNA-seq) data.
Materials and Methods:
The scRNA-seq dataset utilized in this study comprised 64369 primary tumor tissue cells from 21 NSCLC patients, focusing on mutations in EGFR, ALK, BRAF, KRAS, TP53, and the wild-type.
Results:
Tumor immune microenvironment (TIM) analysis revealed differential immune responses across NSCLC mutation subtypes. TIM analysis revealed different immune responses across the mutation subtypes. Two mutation clusters emerged: KRAS, TP53, and EGFR+TP53 mutations (MC1); and EGFR, BRAF, and ALK mutations (MC2). MC1 showed higher tertiary lymphoid structures signature scores and enriched populations of C2-T-IL7R, C3-T/NK-CXCL4, C9-T/NK-NKG, and C1-B-MS4A1 clusters than cluster 2. Conversely, MC2 cells exhibited higher expression levels of TNF, IL1B, and chemokines linked to alternative immune pathways. Remarkably, co-occurring EGFR and TP53 mutations were grouped as MC1. EGFR+TP53 mutations showed upregulation of peptide synthesis and higher synthetic processes, as well as differences in myeloid and T/NK cells compared to EGFR mutations. In T/NK cells, EGFR+TP53 mutations showed a higher expression of features related to cell activity and differentiation, whereas EGFR mutations showed the opposite.
Conclusion
Our research indicates a close association between mutation types and tumor microenvironment in NSCLC, offering insights into personalized approaches for cancer diagnosis and treatment.
9.Current Concepts and Medical Management for Patients with Radiographic Axial Spondyloarthritis
Seung-Hoon BAEK ; Seungbae OH ; Bum-Jin SHIM ; Jeong Joon YOO ; Jung-Mo HWANG ; Tae-Young KIM ; Seung-Cheol SHIM
Hip & Pelvis 2024;36(4):234-249
Radiographic axial spondyloarthritis (r-axSpA), a chronic inflammatory disease, can cause significant radiographic damage to the axial skeleton. Regarding the pathogenic mechanism, association of r-axSpA with tumor necrosis factor (TNF) and the interleukin-23/17 (IL23/IL17) pathway has been reported. Development of extraarticular manifestations, including uveitis, inflammatory bowel disease, and psoriasis, has been reported in some patients. The pivotal role of human leukocyte antigenB27 in the pathogenesis of r-axSpA remains to be clarified. Symptoms usually start in late adolescence or early adulthood, and disease progression can vary in each patient, with clinical manifestations ranging from mild joint stiffness without radiographic changes to advanced manifestations including complete fusion of the spine, and severe arthritis of the hip, and could include peripheral arthritis and extraarticular manifestations. The modified New York criteria was used previously in diagnosis of r-axSpA. However, early diagnosis of the disease prior to development of bone deformity was required due to development of biological agents. As a result of Assessment of SpondyloArthritis international Society (ASAS), the classification was improved in part for diagnosis of spondyloarthritis prior to development of bone deformity. The diagnosis is based on comprehensive laboratory findings, physical examinations, and radiologic findings. Medical treatment for r-axSpA involves the use of a stepwise strategy, starting with administration of nonsteroidal anti-inflammatory drugs and physiotherapy, and progressing to sulfasalazine or methotrexate and biologics including TNF-α inhibitors or IL-17 inhibitors as needed. Use of Janus kinase inhibitors has been recently reported.
10.Capsular Contracture After Postmastectomy Radiation in Implant-Based Breast Reconstruction:Effect of Implant Pocket and Two-Stage Surgery
Sohyun MOON ; Kyunghyun MIN ; Tae Ho KIM ; Jung Hwan UM ; Yoonwon KOOK ; Seung Ho BAEK ; In Sik YUN ; Tai Suk ROH ; Soong June BAE ; Joon JEONG ; Sung Gwe AHN ; Young Seok KIM
Journal of Breast Cancer 2024;27(6):395-406
Capsular contracture (CC) is a concerning issue for individuals undergoing postmastectomy radiation therapy (PMRT) with implant-based breast reconstruction. This study investigated whether the extent of CC and implant migration differs based on implant placement and the reconstruction stage. Insertion plane and stage of breast implants were investigated, and the presence and severe cases of CC and implant migration were analyzed. Among 195 participants, 83 were in the pre-pectoral group, and 112 were in the sub-pectoral group. Two-staged surgery was performed on 116 patients, while 79 underwent direct-to-implant (DTI).Notably, The occurrence of CC (prepectoral, 17 [20.48%] and subpectoral, 42 [37.50%];p = 0.011), CC severity (prepectoral, 4 [4.82%] and subpectoral, 17 [15.17%]; p = 0.021), and implant upward migration (prepectoral, 15 [18.07%] and subpectoral, 38 [33.92%]; p = 0.014) significantly varied between the two groups. The incidence of CC was more common in the DTI group (odds ratio [OR], 2.283; 95% confidence interval [CI], 1.164–4.478). Furthermore, subpectoral placement was an independent risk factor for occurrence (OR, 2.989; 95% CI, 1.476–6.054) and severity of CC (OR, 38.552; 95% CI, 1.855–801.186) and upward implant migration (OR, 2.531; 95% CI, 1.263–5.071). Our findings suggest that pre-pectoral reconstruction and the two-stage operation benefit patients who may undergo PMRT. These approaches can help reduce the incidence of CC and abnormal implant migration following radiation, leading to improved aesthetic outcomes and greater patient satisfaction.

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