Prognostic value of the IASLC/ATS/ERS classification of lung adenocarcinoma in stage I disease of Japanese cases
Prognostic value of the IASLC/ATS/ERS classification of lung adenocarcinoma in stage I disease of Japanese cases
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DOI：
10.1111/pin.12016
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发表时间：
2012-12-01
影响因子：
2.2
通讯作者：
Masuda, Munetaka
中科院分区：
文献类型：
--
作者：
Woo, Tetsukan;Okudela, Koji;Masuda, Munetaka
2011年，国际肺癌研究协会、美国胸科学会和欧洲呼吸学会（IASLC/ATS/ERS）提出了一种新的腺癌分类（ADC）。本研究评估其在日本病例I期疾病的预后价值。根据新的分类系统对179例病理I期ADC进行分类，并分析其与疾病复发的关系。原位腺癌（AIS）18例（10.1%），微创腺癌（MIA）24例（13.4%）。137例浸润性腺癌（IVA）占76.5%，（24.0%）为癫痫（LEP），腺泡型占33.0%，乳头状腺癌（PAP）12例（8.9%），微乳头状腺癌（MPAP）1例（0.6%），实性为主腺癌（SOL）12例（6.7%），浸润性粘液腺癌（MUC）6例（3.4%）。AIS和MIA患者的5年无病生存率（DFS）均为100%。LEP、ACN、PAP、SOL和MUC的阳性率分别为93.5%、83.7%、75.0%、44.4%和62.5%。多因素分析显示，高组织学分级（SOL、MPAP、MUC）对预测术后复发有独立的预后价值（HR 3.661，95% CI 1.4219.437，P = 0.007）。总之，本研究证明了2011年IASLC/ATS/ERS ADC分类在日本病例中的预后价值。
A new classification of adenocarcinoma (ADC) was proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS) in 2011. The present study evaluates its prognostic value in stage I disease of Japanese cases. One-hundred-and-seventy-nine cases with pathological stage I ADC were classified according to the new classification system and their association with disease recurrence was analyzed. Eighteen (10.1%) and 24 (13.4%) cases were adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA), respectively. One-hundred-and-thirty-seven cases (76.5%) were invasive adenocarcinoma (IVA), in which 43 (24.0%) were lepidic (LEP), 59 (33.0%) were acinar (ACN), 16 (8.9%) were papillary (PAP), 1 (0.6%) was micropapillary (MPAP), 12 (6.7%) were solid predominant subtypes (SOL), and 6 (3.4%) were invasive mucinous adenocarcinoma (MUC). The5-year disease-free survivals (DFS) of patients with AIS and MIA were 100%. Those of LEP, ACN, PAP, SOL and MUC were 93.5%, 83.7%, 75.0%, 44.4% and 62.5%, respectively. Multivariate analysis showed that high-histological grade (SOL, MPAP, MUC) had an independent prognostic value to predict post-operative recurrence (HR 3.661, 95% CI 1.4219.437, P = 0.007). In conclusion, the present study demonstrates a prognostic value of the 2011 IASLC/ATS/ERS classification of ADC in Japanese cases.