Lin Dong-mei, Ma Ying, Liu Xiang-yang, Zheng Shan, Xue Li-yan, Liu Xiu-yun, Zou Shuang-mei, Lü Ning, He Zu-gen, Liu Fu-sheng
Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Bing Li Xue Za Zhi. 2006 Mar;35(3):151-4.
To evaluate the prognostic significance of micropapillary pattern (MPP) in adenocarcinoma of lung.
Ninety-one consecutively excised cases of pulmonary adenocarcinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups: those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows: MPP + (constituting 1% to 10% of the tumor), MPP ++ (constituting 11% to 30% of the tumor) and MPP +++ (constituting more than 30% of the tumor).
The overall 5-year survival rate was 64.8%. The 5-year survival rates were 88.9% for stage I tumors, 46.2% for stage II tumors, and 23.8% for stage III tumor respectively (P = 0.000). The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate (P = 0.065, 0.358 and 0.206, respectively). On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group (number = 41) and 84.0% for patients in the MPP-negative group (number = 50). The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group (P = 0.000). In pulmonary adenocarcinoma, this characteristic histology correlated with tumor stage and size, but not with patient's gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows: for stage I, 78.6% versus 92.6% (P = 0.1548), for stage II, 30.0% versus 100% (P = 0.0598), and for stage III, 17.7% versus 28.6% (P = 0.4045).
MPP in primary pulmonary adenocarcinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert clinicians for more active treatment and closer follow up.
评估微乳头模式（MPP）在肺腺癌中的预后意义。
回顾性研究91例连续切除的肺腺癌病例，包括随访数据。这些肿瘤被分为两大组：有MPP的和无MPP的。前者根据微乳头成分的范围进一步细分如下：MPP +（占肿瘤的1%至10%）、MPP ++（占肿瘤的11%至30%）和MPP +++（占肿瘤的30%以上）。
总体5年生存率为64.8%。I期肿瘤的5年生存率为88.9%，II期肿瘤为46.2%，III期肿瘤为23.8%（P = 0.000）。微乳头成分的范围与肿瘤分期、大小及5年生存率均无相关性（P分别为0.065、0.358和0.206）。另一方面，MPP阳性组（n = 41）患者的5年生存率为41.5%，MPP阴性组（n = 50）患者为84.0%。MPP阳性组的淋巴结转移率也高于MPP阴性组（P = 0.000）。在肺腺癌中，这种特征性组织学与肿瘤分期和大小相关，但与患者性别及吸烟史无关。在同一分期内，MPP阳性和阴性组的5年生存率如下：I期，78.6%对92.6%（P = 0.1548）；II期，30.0%对100%（P = 0.0598）；III期，17.7%对28.6%（P = 0.4045）。
原发性肺腺癌中的MPP，即使仅占次要成分，也预示着侵袭性临床行为并与预后不良相关。虽然它可能不是一个独立的预后因素，但这种组织学模式的存在应提醒临床医生进行更积极的治疗和更密切的随访。
