Semiquantitative Assessment of Tumor Spread through Air Spaces (STAS) in Early-Stage Lung Adenocarcinomas
Semiquantitative Assessment of Tumor Spread through Air Spaces (STAS) in Early-Stage Lung Adenocarcinomas
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DOI：
10.1016/j.jtho.2017.03.019
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发表时间：
2017-07-01
影响因子：
20.4
通讯作者：
Kishi, Kazuma
中科院分区：
文献类型：
--
作者：
Uruga, Hironori;Fujii, Takeshi;Kishi, Kazuma
前言：肿瘤经空气扩散(STAS)是近年来报道的一种预后不良的肿瘤侵袭形式，但少量STAS的意义尚不清楚。这项研究的目的是对STAS进行半定量的评估。方法：使用20倍的物镜和10倍的人工晶状体，对小的(=5个单个细胞或簇的STAS)进行评估。结果：208例患者中，无STAS 109例(52.4%)，低STAS 38例(18.3%)，高STAS 61例(29.3%)。在统计学上，较高的STA与实质性的浸润性腺癌(p<；0.001)、胸膜侵犯(p<；0.001)、淋巴侵犯(p<；0.001)、血管侵犯(p<；0.001)以及肿瘤大小大于或等于10 mm(p=0.037)有关。在单因素分析中，STAS的增加与较短的无复发生存期(RFS)显著相关。分析(无STAS，154.2个月；低STAS，147.6个月；高STAS，115.6个月)。在多变量COX比例风险模型中，只有STA(p=0.015)仍然是RFS的显著预测因素。结论：我们发现三分之一切除的小腺癌有高的STAS。较高的STAS预示较差的RFS。(C)2017年国际肺癌研究协会。爱思唯尔公司出版，版权所有。
Introduction: Tumor spread through air spaces (STAS) has recently been reported as a form of tumor invasion having an unfavorable prognosis, but the significance of a small amount of STAS is not known. The aim of this study was to perform a semiquantitative assessment of STAS.Methods: Small (= 5 single cells or clusters of STAS) by using a 20x objective and a 10x ocular lens. A statistical analysis was performed to determine the impact of clinicopathologic parameters on STAS and to clarify the relationship between STAS and patient survival.Results: STAS was assessed as no STAS in 109 of 208 cases (52.4%), as low STAS in 38 cases (18.3%), and as high STAS in 61 cases (29.3%). There were statistically significant associations between higher STAS and solid predominant invasive adenocarcinoma (p < 0.001), pleural invasion (p < 0.001), lymphatic invasion (p < 0.001), vascular invasion (p < 0.001), and tumor size of 10 mm or more (p = 0.037). There was a significant association between increasing STAS and shorter recurrence-free survival (RFS) in univariate. analysis (no STAS, 154.2 months; low STAS, 147.6 months; and high STAS, 115.6 months). In a multivariate Cox proportional hazards model, only STAS (p = 0.015) remained a significant predictor of RFS.Conclusions: We found that one-third of resected small adenocarcinomas had high STAS. Higher STAS was predictive of worse RFS. (C) 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.