Histopathologic Features of the Tumor Budding in Adenocarcinoma of the Lung Tumor Budding As an Index to Predict the Potential Aggressiveness
Histopathologic Features of the Tumor Budding in Adenocarcinoma of the Lung Tumor Budding As an Index to Predict the Potential Aggressiveness
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DOI：
10.1097/jto.0b013e3181eaf2f3
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发表时间：
2010-09-01
影响因子：
20.4
通讯作者：
Ochiai, Atsushi
中科院分区：
文献类型：
--
作者：
Yamaguchi, Yoko;Ishii, Genichiro;Ochiai, Atsushi
简介：肿瘤芽殖这一术语已被应用于结直肠癌浸润边缘间质组织内的单个细胞或小簇细胞，这种形态特征越来越被认为是一种不良预后因素。本研究的目的是评估肺腺癌中肿瘤芽殖的临床病理意义。我们通过回顾201例连续的肺腺癌完全切除患者的病例，研究了肿瘤出芽与肺腺癌临床病理参数之间的关系以及肿瘤出芽的预后意义。结果：181例浸润性腺癌中78例（43.1%）有肿瘤出芽现象，肿瘤出芽与淋巴结转移密切相关（P = 0.005）。病理分期（P <0.001）。血管浸润（p = 0.003）。淋巴管浸润（p = 0 0 0 9）。和胸膜侵犯（p = 0029）检查肿瘤出芽与主要组织学亚型I之间的关系，发现主要乳头状亚型与肿瘤出芽显著相关（p = 0.0023），而主要的细支气管肺泡癌亚型与肿瘤无出芽显著相关5年生存率有芽生组为67.5%，无芽生组为88.3%，差异有显著性（P <0.001）（p = 0.0057）与癌细胞形成巢相比，BCs显示细胞粘附分子、E-钙粘蛋白、和β-连环蛋白（分别为p < 0 0 5和p < 0 0 5），层粘连蛋白5-γ 2表达增加（p < 0 0 5）。多因素分析显示肿瘤屈曲是影响肺小腺癌预后的独立因素。结论：肺腺癌中肿瘤出芽是一种独特的形态学特征，具有生物学意义和预后意义
Introduction: The term tumor budding has been applied to single cells or small clusters of up to foul cells within the stromal tissue at the invasive margin of colorectal cancers This morphologic feature is increasingly being recognized as an adverse prognostic factor The purpose of this study was to evaluate the clinicopathologic significance of tumor budding in adenocarcinomas of the lung.Methods: We investigated the relationship between tumor budding and clinicopathologic parameters of adenocarcinomas of the lung and the prognostic significance of tumor budding by reviewing the cases of 201 consecutive patients who had undergone complete resection of adenocarcinoma of the lung measuring 30 mm or less in diameter We examined immunohistochemical profile of budding cells (BCs) by immunohistochemical staining with 14 antibodies.Results: Tumor budding was observed in 78 (43 1%) of the 181 cases with invasive adenocarcinoma The presence of tumor budding was significantly associated with lymph node metastasis (p = 0005). pathologic stage (p < 0001). vascular invasion (p = 0003). lymphatic invasion (p = 0 009). and pleural invasion (p = 0 029) Examination of the relation between the presence of tumor budding and the predominant histologic subtype I revealed that the predominant papillary subtype was significantly associated with the presence of tumor budding (p = 0 0023), whereas the predominant bronchioloalveolar carcinoma subtype was significantly associated with the absence of tumor budding (p < 0 001) The overall 5-year survival rates of the group with budding and the group without budding was 67 5% and 88 3%, respectively, and difference was significant (p = 0 0057) Compared with cancer cells forming nests, BCs displayed reduced expression of cellular adhesion molecule, E-cadherin, and beta-catenin (p < 0 05 and p < 0 05, respectively) and increased expression of laminin5-gamma 2 (p < 0 05) However. BCs displayed reduced expression of differentiation marker, surfactant protein A (p < 0 05) Multivariate analysis revealed that tumor buckling was significant independent prognostic factor of the small-sized adenocarcinoma of the lungConclusions: Our data showed that tumor budding in adenocarcinoma of the lung is a distinct morphologic feature that has biologic and prognostic significance