Urer Halide Nur, Kocaturk Celalettin Ibrahim, Gunluoglu Mehmet Zeki, Arda Naciye, Bedirhan Mehmet Ali, Fener Neslihan, Dincer Seyyit Ibrahim
Department of Pathology, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Zeytinburnu, Istanbul, Turkey.
Ann Thorac Cardiovasc Surg. 2014;20(1):12-8. doi: 10.5761/atcs.oa.12.02073. Epub 2013 Jan 31.
Lung adenocarcinoma (AC) demonstrates various histological subtypes within the tumour tissue. A panel established jointly by the IASLC, ATS and ERS classified invasive lung ACs based on the predominant histological subtype. We examined the distribution of tumours in lung AC patients according to histological subtype and analysed the effects of this classification on survival.
The records of patients who had pulmonary resection for lung cancer between January 2000 and December 2009 were reviewed and 226 lung AC patients who fulfilled the inclusion criteria were identified. Histological subtypes of the ACs and their ratios in the tumour tissue were determined. Tumours were classified according to the predominant histological subtype and subsequently graded. The relationship between the predominant histological subtype, grade and survival were analysed.
Tumours were predominantly acinar in 99 cases (43.8%), solid in 89 (39.3%), lepidic in 20 (8.8%), and papillary in 11 (4.8%), whereas 7 tumours (3%) were variants of AC. Stage significantly affected survival (p = 0.001); however, the predominant histological subtype had no significant effect. The 5-year survival rate for patients with histologically grade II tumours was 48.6%, whereas that in patients with grade III tumours was 56%. (p = 0.69).
Invasive lung ACs may be defined by their predominant histological subtype. However, it is not yet possible to conclude that this classification is related to survival.
肺腺癌（AC）在肿瘤组织内表现出多种组织学亚型。由国际肺癌研究协会（IASLC）、美国胸科学会（ATS）和欧洲呼吸学会（ERS）联合制定的一个分类系统，根据主要组织学亚型对浸润性肺AC进行分类。我们根据组织学亚型检查了肺AC患者肿瘤的分布情况，并分析了这种分类对生存的影响。
回顾了2000年1月至2009年12月期间因肺癌接受肺切除术患者的记录，确定了226例符合纳入标准的肺AC患者。确定了AC的组织学亚型及其在肿瘤组织中的比例。根据主要组织学亚型对肿瘤进行分类，随后分级。分析了主要组织学亚型、分级与生存之间的关系。
99例（43.8%）肿瘤主要为腺泡状，89例（39.3%）为实性，20例（8.8%）为鳞屑状，11例（4.8%）为乳头状，而7例肿瘤（3%）为AC的变异型。分期显著影响生存（p = 0.001）；然而，主要组织学亚型没有显著影响。组织学II级肿瘤患者的5年生存率为48.6%，而III级肿瘤患者为56%。（p = 0.69）。
浸润性肺AC可根据其主要组织学亚型来定义。然而，尚不能得出这种分类与生存相关的结论。
