Invasive size is an independent predictor of survival in pulmonary adenocarcinoma.
Invasive size is an independent predictor of survival in pulmonary adenocarcinoma.
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DOI：
10.1097/pas.0b013e318190157c
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Powell CA
中科院分区：
文献类型：
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作者：
Borczuk AC;Qian F;Kazeros A;Eleazar J;Assaad A;Sonett JR;Ginsburg M;Gorenstein L;Powell CA
肺腺癌的现行分类包括非浸润性细支气管肺泡癌、混合亚型腺癌以及几种浸润性癌的类型。混合亚型腺癌的浸润程度是可变的，先前的研究表明，对间质增生或浸润程度以及肿瘤大体大小的估计是生存的预测因素。对1997 - 2000年间连续178例原发性肺腺癌切除标本进行了病理检查，检查时对结果不知情。浸润小于0.6 cm的腺癌无淋巴结转移。在多变量分析以及根据分期调整的分层分析中，浸润线性范围的测量与生存显著相关，而仅肿瘤大体大小的测量则不然。当将患者分为非浸润性、微浸润性（浸润<0.6 cm）和浸润性亚组时，观察到中位生存期存在显著差异。总之，在肺腺癌中，对浸润性生长的组织学评估可能提供有价值的预后信息，并且浸润小于0.6 cm的肿瘤在切除后具有更惰性的临床病程。
Current classification of pulmonary adenocarcinoma includes non-invasive bronchioloalveolar carcinoma, mixed subtype adenocarcinoma and several patterns of invasive carcinoma. The extent of invasion in mixed subtype adenocarcinoma is variable, and prior studies suggest that estimates of extent of desmoplasia or invasion and gross tumor size are predictors of survival. Pathologic review of 178 consecutive primary lung adenocarcinoma resections from 1997-2000 was performed blinded to outcome. Lymph node metastases were not present in adenocarcinomas with less then 0.6 cm of invasion. In multivariate analysis and in strata adjusted for stage, measurement of linear extent of invasion was significantly associated with survival while gross size measurement alone was not. Significant differences in median survival were observed when patients were divided into non-invasive, micro-invasive (<0.6 cm invasion) and invasive subcategories. In conclusion, among lung adenocarcinomas, histologic assessment of invasive growth may provide valuable prognostic information, and tumors with invasion under 0.6 cm have a more indolent clinical course after resection.