Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China.
Lung Cancer. 2018 Oct;124:211-218. doi: 10.1016/j.lungcan.2018.07.040. Epub 2018 Jul 29.
To characterize the relationship between metastasis-associated protein 1 (MTA1) and spread through air spaces (STAS), and to investigate the joint prognostic value of MTA1 and STAS in resected lung adenocarcinomas.
We retrospectively reviewed 208 operated patients with stage I-III lung adenocarcinoma from January 2009 to December 2014. STAS was identified by H&E staining. Expression level of MTA1 was determined by immunohistochemistry. The relationship between MTA1 and STAS was determined by using a logistic regression model. The synergistic effects of MTA1 and STAS on prognosis were analyzed using a Cox proportional hazards regression model.
Patients with either STAS or high expression of MTA1 had significantly worse overall survival (OS) and shorter recurrence-free survival (RFS) than those without STAS or with low expression of MTA1 (p < 0.001). Among 107 patients with STAS presence in lung adenocarcinomas, 57 (53.3%) cases had high expression of MTA1. High expression of MTA1 was positively associated with the increased frequency of STAS presence (p < 0.01). Subgroup analysis showed that the patients with both high expression of MTA1 and STAS-positive presence had significantly worst OS and shortest RFS compared with the others (p < 0.001), while the patients with high expression of MTA1 /STAS-negative presence shared similar RFS with those with high expression of MTA1 /STAS-positive presence. Furthermore, high MTA1 levels in STAS-positive patients was associated with a higher risk of postoperative metastasis and recurrence (p < 0.001).
STAS was more frequently observed in adenocarcinomas with high MTA1 expression levels. MTA1 was associated with a higher risk of worse overall survival among patients with STAS and could provide helpful prognostic information in STAS-positive patients with stage I-III lung adenocarcinoma.
分析转移相关蛋白 1（MTA1）与气腔内播散（STAS）之间的关系，并探讨 MTA1 和 STAS 联合在可切除肺腺癌中的预后价值。
回顾性分析 2009 年 1 月至 2014 年 12 月期间 208 例 I-III 期肺腺癌患者的临床资料。采用 H&E 染色确定 STAS 状态，免疫组化检测 MTA1 表达水平。采用 logistic 回归模型确定 MTA1 与 STAS 的关系，采用 Cox 比例风险回归模型分析 MTA1 和 STAS 对预后的协同作用。
STAS 阳性或 MTA1 高表达患者的总生存（OS）和无复发生存（RFS）均显著低于 STAS 阴性或 MTA1 低表达患者（p<0.001）。在 107 例 STAS 阳性的肺腺癌患者中，57 例（53.3%）患者 MTA1 高表达。MTA1 高表达与 STAS 阳性频率增加呈正相关（p<0.01）。亚组分析显示，同时存在 MTA1 高表达和 STAS 阳性的患者 OS 和 RFS 最差（p<0.001），而 MTA1 高表达/STAS 阴性的患者 RFS 与 MTA1 高表达/STAS 阳性的患者相似。此外，STAS 阳性患者中 MTA1 水平升高与术后转移和复发风险增加相关（p<0.001）。
MTA1 高表达的腺癌中更常出现 STAS。MTA1 与 STAS 患者的总体生存较差相关，可在 I-III 期肺腺癌 STAS 阳性患者中提供有价值的预后信息。
