A Grading System Combining Tumor Budding and Nuclear Diameter Predicts Prognosis in Resected Lung Squamous Cell Carcinoma
A Grading System Combining Tumor Budding and Nuclear Diameter Predicts Prognosis in Resected Lung Squamous Cell Carcinoma
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DOI：
10.1097/pas.0000000000000826
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发表时间：
2017-06-01
影响因子：
5.6
通讯作者：
Haba, Reiji
中科院分区：
文献类型：
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作者：
Kadota, Kyuichi;Miyai, Yumi;Haba, Reiji
对于肺鳞状细胞癌，没有被普遍接受为预后因素的组织学表现。肿瘤出芽和核分级已被认为是其他癌症的预后因素。在这项研究中，我们调查了病理结果是否可以决定日本肺鳞状细胞癌患者的临床结果。对手术切除的肺鳞状细胞癌（1999年至2012年）的肿瘤切片进行了审查（n= 216）。评价肿瘤的组织学亚型、分化、肿瘤出芽、核直径和有丝分裂。使用对数秩检验和考克斯比例风险模型分析无复发生存期（RFS）和总生存期（OS）。在调整病理分期和淋巴管浸润后，多变量分析显示，肿瘤芽生和大核是RFS较差（分别为P< 0.001和P= 0.002）和OS较差（分别为P< 0.001和P= 0.038）的独立预后因素。然而，组织学亚型，分化，核分裂计数与预后无关。结合肿瘤出芽和核直径的分级系统是RFS恶化的独立预后因素（2级与1级，风险比[HR]= 2.91; P< 0.001，3级与1级，HR= 7.60，P< 0.001）和更差的OS（2级对1级，HR= 2.15; P= 0.014; 3级对1级，HR= 4.54，P< 0.001）。我们发现，结合肿瘤出芽和核直径的分级系统是日本肺鳞状细胞癌切除患者的一个重要预后因素。
For lung squamous cell carcinomas, there are no histologic findings that have been universally accepted as prognostic factors. Tumor budding and nuclear grade have been recognized as prognostic factors in other carcinomas. In this study, we investigated whether pathologic findings could determine clinical outcome in Japanese patients with lung squamous cell carcinomas. Tumor slides from surgically resected lung squamous cell carcinomas (1999 to 2012) were reviewed (n= 216). Tumors were evaluated for histologic subtypes, differentiation, tumor budding, nuclear diameter, and mitosis. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the log-rank test and the Cox proportional hazards model. Tumor budding and large nuclei were independent prognostic factors of a worse RFS (P< 0.001 and P= 0.002, respectively) and a worse OS (P< 0.001 and P= 0.038, respectively) on multivariate analysis after adjustment for pathologic stage and lymphatic invasion. However, histologic subtypes, differentiation, and mitotic count did not correlate with prognosis. A grading system combining tumor budding and nuclear diameter was an independent prognostic factors of a worse RFS (grade 2 vs. 1, hazard ratio [HR]= 2.91; P< 0.001, and grade 3 vs. 1, HR= 7.60, P< 0.001) and a worse OS (grade 2 vs. 1, HR= 2.15; P= 0.014, and grade 3 vs. 1, HR= 4.54, P< 0.001). We found that a grading system combining tumor budding and nuclear diameter was a significant prognostic factor among Japanese patients with resected lung squamous cell carcinoma.