Solid predominant histologic subtype and early recurrence predict poor postrecurrence survival in patients with stage I lung adenocarcinoma.
Solid predominant histologic subtype and early recurrence predict poor postrecurrence survival in patients with stage I lung adenocarcinoma.
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实性主要组织学亚型和早期复发预测 I 期肺腺癌患者复发后生存率较差
DOI：
10.18632/oncotarget.12540
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发表时间：
2017-01-24
期刊：
影响因子：
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通讯作者：
Chen H
中科院分区：
文献类型：
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作者：
Luo J;Wang R;Han B;Zhang J;Zhao H;Fang W;Luo Q;Yang J;Yang Y;Zhu L;Chen T;Cheng X;Huang Q;Wang Y;Zheng J;Chen H
介绍本研究探讨了组织学的主要模式和复发后生存（PRS）之间的相关性，并确定了临床病理因素影响PRS完全切除的I期肺腺癌患者。方法选择136例Ⅰ期肺腺癌根治术后复发的患者。为分析浸润性腺癌组织学类型与PRS的关系，将浸润性腺癌组织学类型分为实性组和非实性组（包括片状、腺泡状、乳头状、微乳头状）。采用Kaplan-Meier方法和多变量考克斯模型分析PRS以确定预后预测因子。结果I期浸润性腺癌术后复发多发生在2年内。以实体为主的组织学类型患者与不利的PRS相关（HR，2.40; 95%CI 1.13-5.08，p=.022）。在术后12个月内诊断为肿瘤复发的患者中，PRS差有显著差异（HR，2.34; 95%CI 1.12-4.90，p= 0.024）。在单变量分析中，胸外转移与较差的中位PRS相关（p = 0.011），然而，在多变量分析中，与胸内转移相比，没有显著的PRS差异（HR，1.56; 95%CI 0.65-3.73，p= 0.322）。结论I期肺腺癌以实体型为主，无复发间隔时间小于12个月，预测PRS较差。
Introduction This study investigated the correlation between histologic predominant pattern and postrecurrence survival (PRS), and identified the clinicopathologic factors influencing PRS in patients with completely resected stage I lung adenocarcinoma. Methods A total of 136 stage I lung adenocarcinoma patients who experienced tumor recurrence after completely resection were included in this study. To analysis the association between histologic predominant pattern and PRS, invasive adenocarcinomas with mixed histologic components were divided into 2 groups: solid and nonsolid group (including lepidic, acinar, papillary, micropapillary) based on the histologic predominant pattern. PRS was analyzed to identify the prognostic predictors using the Kaplan-Meier approach and multivariable Cox models. Results For all stage I invasive adenocarcinoma patients, the majority of postsurgical recurrences occurred within 2 years. Patients with solid predominant histological pattern were associated with unfavorable PRS (HR, 2.40; 95%CI 1.13-5.08, p=.022). There was a significant difference for poor PRS for patients who diagnosed tumor recurrence shorter than 12 months after surgery (HR, 2.34; 95%CI 1.12-4.90, p=.024). Extrathoracic metastasis was associated with poor media PRS in univariable analysis (p =.011), however, there was no significant PRS difference in multivariable analysis (HR, 1.56; 95%CI 0.65-3.73, p=.322) compared with intrathoracic metastasis. Conclusions Solid predominant histologic subtype and recurrence free interval less than 12 months predict worse PRS in patients with stage I lung adenocarcinoma.