在Ⅲ期（N2）肺腺癌中，通过气腔播散是复发的独立预测因素。
Spread through air spaces is an independent predictor of recurrence in stage III (N2) lung adenocarcinoma.
作者信息
Terada Yuriko, Takahashi Tsuyoshi, Morita Shigeki, Kashiwabara Kosuke, Nagayama Kazuhiro, Nitadori Jun-Ichi, Anraku Masaki, Sato Masaaki, Shinozaki-Ushiku Aya, Nakajima Jun
机构信息
Department of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
出版信息
Interact Cardiovasc Thorac Surg. 2019 Sep 1;29(3):442-448. doi: 10.1093/icvts/ivz116.
OBJECTIVES
Spread through air space (STAS) is recognized as a pattern of invasion in lung adenocarcinoma and has been reported to be a predictor of recurrence and survival in patients with early-stage lung adenocarcinoma. However, this parameter has not been studied well in stage III (N2) lung adenocarcinoma. In this study, we evaluated the association between STAS invasion patterns and recurrence and survival in stage III (N2) lung adenocarcinoma.
METHODS
We retrospectively reviewed data from 76 patients at University of Tokyo with stage III (N2) lung adenocarcinoma who underwent surgery from August 1998 to December 2013. Statistical analysis was performed to determine the impact of STAS invasion clinicopathological features and clarify the relationship between this pattern of invasion and survival.
RESULTS
Tumour STAS was observed in 46 of 76 patients (60.5%) and was significantly associated with the presence of lymphatic invasion (P < 0.001), papillary components (P < 0.001) and micropapillary components (P < 0.001). STAS was also significantly associated with recurrence (5-year recurrence-free probability: 19.0% vs 46.1%, P < 0.05). Univariate analyses showed that STAS was a significant risk factor for recurrence (hazard ratio 1.94, 95% confidence interval 1.07-3.51; P = 0.029).
CONCLUSIONS
The presence of STAS invasion pattern is a significant risk factor for recurrence in stage III (N2) lung adenocarcinoma.
目的
气腔播散（STAS）被认为是肺腺癌的一种侵袭模式，据报道它是早期肺腺癌患者复发和生存的一个预测指标。然而，该参数在Ⅲ期（N2）肺腺癌中尚未得到充分研究。在本研究中，我们评估了STAS侵袭模式与Ⅲ期（N2）肺腺癌复发及生存之间的关联。
方法
我们回顾性分析了1998年8月至2013年12月在东京大学接受手术的76例Ⅲ期（N2）肺腺癌患者的数据。进行统计分析以确定STAS侵袭的临床病理特征的影响，并阐明这种侵袭模式与生存之间的关系。
结果
76例患者中有46例（60.5%）观察到肿瘤STAS，其与淋巴血管浸润（P < 0.001）、乳头成分（P < 0.001）和微乳头成分（P < 0.001）显著相关。STAS也与复发显著相关（5年无复发生存概率：19.0%对46.1%，P < 0.05）。单因素分析显示STAS是复发的显著危险因素（风险比1.94，95%置信区间1.07 - 3.51；P = 0.029）。
结论
STAS侵袭模式的存在是Ⅲ期（N2）肺腺癌复发的显著危险因素。
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