Spread through air spaces (STAS) in invasive mucinous adenocarcinoma of the lung: Incidence, prognostic impact, and prediction based on clinicoradiologic factors.
Spread through air spaces (STAS) in invasive mucinous adenocarcinoma of the lung: Incidence, prognostic impact, and prediction based on clinicoradiologic factors.
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DOI：
10.1111/1759-7714.13632
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发表时间：
2020-11
期刊：
影响因子：
2.9
通讯作者：
Shim YM
中科院分区：
文献类型：
--
作者：
Lee MA;Kang J;Lee HY;Kim W;Shon I;Hwang NY;Kim HK;Choi YS;Kim J;Zo JI;Shim YM
最近已证实经气隙扩散（STAS）对肺腺癌预后有负面影响。然而，这些研究大多调查非粘液腺癌的STAS。在这里，我们调查了浸润性肺粘液腺癌（IMA）中STAS的发生率，并评估肿瘤STAS是否是IMA疾病复发的危险因素。我们还检查了IMA携带STAS患者的临床放射学因素。我们回顾了132例因IMA接受手术切除的原发性肿瘤患者的病理标本和影像学特征，以评估STAS。采用逻辑回归分析比较了有无STAS患者的临床特征以及计算机断层扫描（CT）成像。分析包括STAS在内的所有变量与生存的关系。在132例患者中，119例患者的完整病理标本可用，86例（72.3%）观察到STAS。IMA伴STAS患者与年龄较大、CT扫描存在分叶和毛刺边缘显著相关（P = 0.009，P = 0.006和P = 0.027）。在多因素分析中，STAS是一个边缘独立的预后不良的预测因子（P = 0.028）。年龄大、吸烟史、T分期高、淋巴结转移和实变形态学类型仍是OS的独立预测因素。STAS与OS降低相关，是IMA的边缘独立预后不良因素。IMA伴STAS与年龄较大以及CT扫描上存在分叶和毛刺边缘相关。与其他亚型相比，IMA显示出更高的STAS发生率，即使在IMA中，STAS也是独立的不良预后预测因子。CT上的分叶状和毛刺状边缘与STAS相关。考虑到STAS可能携带气源性转移，使用术前替代CT成像预测STAS是可取的，以避免有限的切除。 粘液性肺腺癌的STAS发生率为72%。即使在粘液腺癌中，STAS也是一个独立的不良预后预测因子。STAS与年龄较大、CT上有分叶和毛刺边缘有关。
Spread through air spaces (STAS) has recently been demonstrated to exhibit a negative impact on lung adenocarcinoma prognosis. However, most of these studies investigated STAS in nonmucinous adenocarcinoma. Here, we investigated the incidence of STAS in invasive mucinous adenocarcinoma (IMA) of the lung and evaluated whether tumor STAS was a risk factor of disease recurrence in IMA. We also examined clinicoradiologic factors in patients with IMA harboring STAS. We reviewed pathologic specimens and imaging characteristics of primary tumors from 132 consecutive patients who underwent surgical resection for IMA to evaluate STAS. Patients with and without STAS were compared with respect to clinical characteristics as well as computed tomography (CT) imaging using logistic regression. The relationships between all variables including STAS and survival were analyzed. Among a total of 132 patients, full pathologic specimens were available for 119 patients, and STAS was observed in 86 (72.3%). IMA patients with STAS were significantly associated with older age, presence of lobulated and spiculated margins on CT scan (P = 0.009, P = 0.006, and P = 0.027). In multivariate analysis for overall survival (OS), STAS was a borderline independent poor prognostic predictor (P = 0.028). Older age, history of smoking, higher T stage, presence of lymph node metastasis, and consolidative morphologic type remained independent predictors for OS. STAS was associated with reduced OS and was a borderline independent poor prognostic factor in IMA. IMA with STAS was associated with older age and presence of lobulated and spiculated margins on CT scan. Compared with other subtypes, IMA shows a higher incidence of STAS, which is an independent poor prognostic predictor even in IMA. Lobulated and spiculated margins on CT are associated with STAS. Considering that STAS can carry the potential for aerogenous metastasis, predicting STAS using preoperative surrogate CT imaging is desirable to avoid limited resection. Mucinous lung adenocarcinoma shows an incidence of STAS of 72%. STAS is an independent poor prognostic predictor even in mucinous adenocarcinoma. STAS is associated with older age, and lobulated and spiculated margins on CT.
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DOI：
10.1016/j.jtho.2018.09.005
发表时间：
2019-01
期刊：
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
影响因子：
--
作者：
Eguchi T;Kameda K;Lu S;Bott MJ;Tan KS;Montecalvo J;Chang JC;Rekhtman N;Jones DR;Travis WD;Adusumilli PS
通讯作者：
Adusumilli PS
影响因子：
20.4
作者：
Hwang, David H.;Sholl, Lynette M.;Dong, Fei
通讯作者：
Dong, Fei
影响因子：
3.4
作者：
Lardinois, Didier;De Leyn, Paul;Weder, Walter
通讯作者：
Weder, Walter
影响因子：
2.2
作者：
Isaka, Tetsuya;Yokose, Tomoyuki;Masuda, Munetaka
通讯作者：
Masuda, Munetaka
DOI：
10.1016/j.jtho.2018.09.008
发表时间：
2019-01
期刊：
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
影响因子：
--
作者：
Bains S;Eguchi T;Warth A;Yeh YC;Nitadori JI;Woo KM;Chou TY;Dienemann H;Muley T;Nakajima J;Shinozaki-Ushiku A;Wu YC;Lu S;Kadota K;Jones DR;Travis WD;Tan KS;Adusumilli PS
通讯作者：
Adusumilli PS