Prognostic significance of adenocarcinoma in situ, minimally invasive adenocarcinoma, and nonmucinous lepidic predominant invasive adenocarcinoma of the lung in patients with stage I disease.
Prognostic significance of adenocarcinoma in situ, minimally invasive adenocarcinoma, and nonmucinous lepidic predominant invasive adenocarcinoma of the lung in patients with stage I disease.
复制标题
DOI：
10.1097/pas.0000000000000134
复制
发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Travis WD
中科院分区：
文献类型：
--
作者：
Kadota K;Villena-Vargas J;Yoshizawa A;Motoi N;Sima CS;Riely GJ;Rusch VW;Adusumilli PS;Travis WD
根据IASLC/ATS/ERS分类，麻风占优势的类型包括3个亚型：原位腺癌(AIS)、微侵袭性腺癌(MIA)和非粘液性麻风占优势的浸润性腺癌。我们回顾了1038例I期肺腺癌患者的肿瘤切片，记录了每种组织学类型的百分比，并测量了侵袭性肿瘤的大小。肿瘤按IASLC/ATS/ERS分类：AIS 2例，MIA 34例，以麻风为主的103例。用累积复发率(CIR)估计复发概率。AIS和MIA的患者没有复发。麻风浸润性肿瘤患者的复发风险(5年CIR为8%)低于非麻风浸润性肿瘤(n=899；19%；P=0.003)。50%的病例无复发(n=84)，10%-50%的病例有中等复发风险(n=344；5年CIR，12%)，≤为10%的病例风险最高(22%；P<；0.001)。≤2 cm肿瘤患者的CIR低于<gt；2-3 cm肿瘤患者(肿瘤总大小和浸润性肿瘤大小)，浸润性肿瘤大小的差异更为明显(5年CIR，13%比21%[总大小；P=0.022]和12%比27%[侵袭性大小；P<；0.001])。大多数复发的隐匿性腺癌患者有潜在的危险因素，包括叶下近缘切除(≤0.5 cm；n=2)，20%~30%的微乳头成分(n=2)，淋巴管或血管侵犯(n=2)。因此，有可能发现复发风险较低或较高的以麻风为主的腺癌。
According to the IASLC/ATS/ERS classification, the lepidic predominant pattern consists of 3 subtypes: adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and nonmucinous lepidic predominant invasive adenocarcinoma. We reviewed tumor slides from 1038 patients with stage I lung adenocarcinoma, recording the percentage of each histologic pattern and measuring invasive tumor size. Tumors were classified according to the IASLC/ATS/ERS classification: 2 were AIS, 34 MIA, and 103 lepidic predominant invasive. Cumulative incidence of recurrence (CIR) was used to estimate the probability of recurrence. Patients with AIS and MIA experienced no recurrences. Patients with lepidic predominant invasive tumors had a lower risk of recurrence (5-year CIR, 8%) than non-lepidic predominant tumors (n=899; 19%; P=0.003). Patients with >50% lepidic pattern tumors experienced no recurrences (n=84), those with >10%–50% lepidic pattern tumors had an intermediate risk of recurrence (n=344; 5-year CIR, 12%), and those with ≤10% lepidic pattern tumors had the highest risk (n=610; 22%; P<0.001). CIR was lower for patients with ≤2 cm tumors than for those with >2–3 cm tumors (for both total and invasive tumor size), with the difference more pronounced for invasive tumor size (5-year CIR, 13% vs. 21% [total size; P=0.022] and 12% vs. 27% [invasive size; P<0.001]). Most patients with lepidic predominant adenocarcinoma who experienced a recurrence had potential risk factors, including sublobar resection with close margins (≤0.5 cm; n=2), 20%–30% micropapillary component (n=2), and lymphatic or vascular invasion (n=2). It therefore may be possible to identify lepidic predominant adenocarcinomas that carry a low or high risk of recurrence.