Zhu Lewei, Jiang Long, Yang Jie, Gu Weiquan, He Jianxing
The First Clinical College, Southern Medical University, Guangzhou 510515, China.
Department of Thoracic Surgery, The First People's Hospital of Foshan City Guangdong Province, Foshan 528000, China.
J Thorac Dis. 2018 Apr;10(4):2397-2402. doi: 10.21037/jtd.2018.03.186.
Adenosquamous carcinoma (ASC) is a mixed glandular and squamous cell carcinoma (SCC) with more aggressive behavior than the other histologic subtypes of lung cancer. We aim to evaluate the prognosis of patients with ASC after surgical resection.
We reviewed records of patients who underwent surgical resection for lung cancer in two institutes between January 2010 and December 2015. Survival data were collected with a median follow-up of 59 (range from 10 to 85) months. Kaplan-Meier survival curve was determined for all patients.
Patients with ASC accounted for 1.6% of all NSCLC patients (33 males, 25 females). The cumulative postoperative 3- and 5-year survival rates were 56% and 48%, respectively. Overall survival (OS) was significantly lower in ASC patients than in adenocarcinoma (AC) patients operated during the same period (P<0.01). Patients with ASC containing acinar predominant AC had better survival than those with non-acinar predominant ASC (P=0.03). No difference of OS was found in patients with or without visceral pleural invasion (VPI), vascular invasion (VI) or EGFR mutation status. Multivariate analysis showed gender, pathological subtype, and TNM staging to be independent prognostic factors.
We demonstrated that ASC were uncommon and aggressive lung tumors. Predominant histological subtype of AC might be an independent prognostic factor for ASC. Further prospective studies are warranted to clarify the characteristics of this rare tumor.
腺鳞癌（ASC）是一种混合性腺上皮和鳞状细胞癌（SCC），其行为比肺癌的其他组织学亚型更具侵袭性。我们旨在评估手术切除后ASC患者的预后。
我们回顾了2010年1月至2015年12月期间在两个机构接受肺癌手术切除的患者记录。收集生存数据，中位随访时间为59（范围10至85）个月。为所有患者确定Kaplan-Meier生存曲线。
ASC患者占所有非小细胞肺癌患者的1.6%（男性33例，女性25例）。术后3年和5年累积生存率分别为56%和48%。ASC患者的总生存期（OS）显著低于同期接受手术的腺癌（AC）患者（P<0.01）。以腺泡为主型AC的ASC患者生存率高于非腺泡为主型ASC患者（P=0.03）。有无脏层胸膜侵犯（VPI）、血管侵犯（VI）或表皮生长因子受体（EGFR）突变状态的患者在OS方面无差异。多因素分析显示性别、病理亚型和TNM分期是独立的预后因素。
我们证明ASC是罕见且具有侵袭性的肺部肿瘤。AC的主要组织学亚型可能是ASC的独立预后因素。有必要进行进一步的前瞻性研究以阐明这种罕见肿瘤的特征。
