肺癌是最常見的癌症之一，每年有許多病患死於肺癌。肺腺癌是非小細胞肺癌中較常見的的一種分類，小型的肺腺癌雖然轉移的機率不高，也因此容易被忽略，導致病人有較差的存活率，然而小型肺腺癌轉移的相關因子仍有待研究。在本篇論文中，我們利用T1肺腺癌病人的手術檢體進行研究，分析galectin-3與血管擬態是否與T1肺腺癌轉移有關。

Background: Lung cancer is one of the most common human cancer and causes major cancer-related mortality in the world. The factors associated with metastasis of small-sized lung adenocarcinoma were not completely clarified yet. We examined the expressions of galectin-3 and vasculogenic mimicry, and investigated on their association with metastasis and disease-free survival in T1 lung adenocarcinoma.
Methods: We used a prospectively-maintained cancer-registry database and tissue bank in the single institute for patient enrollment and RNA sequencing. It the first part, 293 patients were surveyed and 76 patients with T1 lung adenocarcinoma were enrolled. We compared 38 patients without metastasis (stage IA) to 38 patients without metastasis (stage II-IV). We examined the differences of clinicopathological features and immunohistochemical expression of galectin-3, vasculogenic mimicry, COX-2 and SOX2. In the second part, we examined six samples by mRNA sequencing and compared the mRNA level with the findings of immunohistochemical staining.
Results: Male gender, larger tumor size, advanced subtypes and lymphovascular invasion were significantly associated with metastasis of T1 lung adenocarcinoma (p=0.002, <0.001, <0.001, 0.047, respectively). Interestingly, lower galectin-3 expression was associated with metastasis (p=0.015). Higher galectin-3 expression was associated with better disease-free survival in T1 lung adenocarcinoma (Log-rank p=0.022) and T1a lung adenocarcinoma (Log-rank p=0.034). By using RNA-seq, we found that a higher ratio of galectin1-to-galectin3 was associated with metastasis of T1 lung adenocarcinoma. We revealed that the vasculogenic mimicry was not remarkably associated with metastasis in T1 lung adenocarcinoma but only potentially. We noted higher COX-2 expression was associated with vasculogenic mimicry formation.
Conclusion: We found lower galectin-3 expression was associated metastasis and a poorer clinical outcome in T1 lung adenocarcinoma. We used RNA sequencing and revealed a similar result. The findings suggested galectin-3 may play a distinct role in T1 lung adenocarcinoma. In addition, the presence of vasculogenic mimicry was not remarkably associated with metastasis and clinical outcome in T1 lung adenocarcinoma.

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