Department of Thoracic and Cardiovascular Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Thorac Cancer. 2021 Jul;12(14):2072-2077. doi: 10.1111/1759-7714.14013. Epub 2021 May 25.
Adenocarcinoma is the most common type of lung cancer and most adenocarcinomas have heterogeneous subtypes. Acinar-predominant adenocarcinoma is the most common. This study aimed to identify the prognostic impact of other mixed histological subtypes in acinar-predominant lung adenocarcinoma.
The medical records of patients with pathological stage IA acinar-predominant lung adenocarcinoma between January 2010 and April 2016 were reviewed. The patients were divided into two groups according to the proportion of the lepidic subtype, with a cutoff value of 20%, and prognostic factors were analyzed.
A total of 215 patients with stage IA acinar-predominant adenocarcinoma were reviewed. The 20% or more lepidic subtype group had a low value of SUVmax (p = 0.001), good differentiation (p < 0.001) and a low incidence of the solid histological subtype (p = 0.016). Recurrence was significantly lower in the 20% or more lepidic subtype group (p = 0.008). The disease-free survival (p = 0.007) and overall survival (p = 0.046) were significantly different between the two groups. Multivariate analysis showed that lymphovascular invasion (p = 0.006) and no or less than 20% lepidic subtype (p = 0.036) were significant prognostic factors for disease-free survival.
The lepidic proportion may be useful to predict recurrence in acinar-predominant stage IA lung adenocarcinoma.
腺癌是最常见的肺癌类型，大多数腺癌具有异质性亚型。以腺泡为主型腺癌最为常见。本研究旨在确定腺泡为主型肺腺癌中其他混合组织学亚型的预后影响。
回顾了 2010 年 1 月至 2016 年 4 月期间病理分期为 IA 期腺泡为主型肺腺癌患者的病历。根据贴壁亚型的比例将患者分为两组，以 20%为截断值，分析预后因素。
共回顾了 215 例 IA 期腺泡为主型腺癌患者。贴壁亚型比例≥20%组的 SUVmax 值较低（p=0.001），分化较好（p<0.001），实性组织学亚型的发生率较低（p=0.016）。贴壁亚型比例≥20%组的复发率显著较低（p=0.008）。两组间无病生存率（p=0.007）和总生存率（p=0.046）有显著差异。多因素分析显示，脉管侵犯（p=0.006）和贴壁亚型比例无或低于 20%（p=0.036）是无病生存率的显著预后因素。
贴壁比例可能有助于预测 IA 期肺腺癌的复发。
