Yu Renke, He Zhengfu, Lou Ying, Jiang Hanliang, Wu Yuhui, Liu Zhen, Pan Hongming, Han Weidong
Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of Thoracic Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Oncotarget. 2017 Oct 26;8(58):97801-97810. doi: 10.18632/oncotarget.22082. eCollection 2017 Nov 17.
According to the IASLC/ATS/ERS 2011 classification, there are two new conceptions of lung adenocarcinoma, adenocarcinoma (AIS), minimally invasive adenocarcinoma (MIA), which are very early stages of lung adenocarcinoma. This study aimed to analyze clinical features of AIS and MIA and determine the expression profile of PD-L1 in AIS and MIA.
In all 274 patients, 77 were diagnosed as AIS and 197 as MIA. We accidentally found 4 patients with recurrence, which were all MIA. The median age of the patients at diagnosis was both 52 years. 71.4% were female in AIS as while as 71.1% in MIA. 36.4% patients were observed with ever symptoms in AIS and 28.9% in MIA. 12.9% and 8.6% had smoking history respectively in AIS an MIA. All AIS and MIA cases were PD-L1 negative. There was significant association between symptoms and more mild progression of nodules in chest CT before surgery.
We analyzed some clinical features of 274 patients including age, sex, smoking history, family history, surgery, EGFR mutation, ALK, ROS-1, serum CEA level . The expression of PD-L1 was evaluated by immunohistochemical analysis in 37 specimens of MIA and 17 specimens of AIS.
There are no significant differences between AIS and MIA in clinical features. AIS and MIA almost do not express PD-L1 protein and without any lymph node metastasis. The surgery intervention is supposed to be as small as possible.
根据国际肺癌研究协会（IASLC）/美国胸科学会（ATS）/欧洲呼吸学会（ERS）2011年分类标准，肺腺癌有两个新的概念，即原位腺癌（AIS）和微浸润腺癌（MIA），它们是肺腺癌的极早期阶段。本研究旨在分析AIS和MIA的临床特征，并确定AIS和MIA中程序性死亡受体1配体（PD-L1）的表达谱。
在全部274例患者中，77例被诊断为AIS，197例被诊断为MIA。我们意外发现4例复发患者，均为MIA。患者诊断时的中位年龄均为52岁。AIS患者中女性占71.4%，MIA患者中女性占71.1%。AIS患者中有症状者占36.4%，MIA患者中有症状者占28.9%。AIS和MIA患者有吸烟史者分别占12.9%和8.6%。所有AIS和MIA病例的PD-L1均为阴性。症状与术前胸部CT中结节较轻微进展之间存在显著关联。
我们分析了274例患者的一些临床特征，包括年龄、性别、吸烟史、家族史、手术情况、表皮生长因子受体（EGFR）突变、间变性淋巴瘤激酶（ALK）、原癌基因酪氨酸蛋白激酶ROS-1、血清癌胚抗原（CEA）水平。通过免疫组织化学分析评估37例MIA标本和17例AIS标本中PD-L1的表达。
AIS和MIA在临床特征方面无显著差异。AIS和MIA几乎不表达PD-L1蛋白且无任何淋巴结转移。手术干预应尽可能小。
