Department of Pathology, Inha University School of Medicine, Incheon, Korea.
J Korean Med Sci. 2012 Sep;27(9):1027-36. doi: 10.3346/jkms.2012.27.9.1027. Epub 2012 Aug 22.
Lung cancer rarely occurs in young patients. Recent studies have demonstrated that epidemiologic data are closely correlated to some molecular characteristics. We investigated the clinicopathologic characteristics of lung adenocarcinoma in young patients and evaluated immunohistochemically detected epidermal growth factor receptor (EGFR) mutation status and anaplastic lymphoma kinase (ALK) positivity. Among lung adenocarcinoma patients, 31 cases were of the ≤ 40 yr-old group and 261 cases of > 50 yr-old group. Young patients were more likely to be females (67.7% vs 40.2%), and nonsmokers (58.1% vs 45.2%) and more often had high TNM stage (stage IV was 80.6% vs 52.1%) and had a high rate of distant metastasis (51.6% vs 28.0%) compared with older patients. The signet ring cell feature was more common (25.8% vs 11.5%) and lepidic growth pattern was rarely present (3.2% vs 16.5%) in the adenocarcinoma of young patients. There was no significant survival difference between the two age groups. The rate of EGFR mutation status and ALK positivity did not show a statistical difference between two groups. In conclusion, lung adenocarcinoma of young patients demonstrates distinct pathologic features with frequent presence of a signet ring cell feature and rare occurrence of lepidic growth pattern. Further investigation for other genetic abnormalities would be needed.
肺癌在年轻患者中很少发生。最近的研究表明，流行病学数据与某些分子特征密切相关。我们调查了年轻患者肺腺癌的临床病理特征，并评估了表皮生长因子受体（EGFR）突变状态和间变性淋巴瘤激酶（ALK）阳性的免疫组织化学检测。在肺腺癌患者中，31 例为≤40 岁组，261 例为>50 岁组。年轻患者更可能为女性（67.7%比 40.2%）和不吸烟者（58.1%比 45.2%），且更常处于较高的 TNM 分期（IV 期为 80.6%比 52.1%），远处转移率更高（51.6%比 28.0%）。与老年患者相比，年轻患者的腺癌中更常见印戒细胞特征（25.8%比 11.5%），而贴壁生长模式较少见（3.2%比 16.5%）。两组间的生存差异无统计学意义。两组间 EGFR 突变状态和 ALK 阳性率无统计学差异。总之，年轻患者的肺腺癌具有明显的病理特征，常存在印戒细胞特征，贴壁生长模式罕见。需要进一步研究其他遗传异常。
