Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan; Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan; Department of Comprehensive Oncology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.
Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan; Department of Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
J Thorac Oncol. 2022 Jan;17(1):67-75. doi: 10.1016/j.jtho.2021.09.006. Epub 2021 Oct 8.
Because several articles have reported a prognostic association with the radiologic features of ground-glass opacity, we explored whether the histologic presence of a lepidic component had similar significance.
We retrospectively evaluated 380 consecutive surgically resected lung adenocarcinomas (ADCs) of pathologic (p)stage IA. The tumors were classified into lepidic-positive and lepidic-negative ADCs. Clinicopathologic characteristics, radiographic ground-glass opacity status, and disease-free survival were compared between lepidic-positive and lepidic-negative ADCs and between part-solid and solid nodules on computed tomography images.
Of the 380 cases, 176 (46.3%) were lepidic-positive ADCs. Of the overall patients with pT1, lepidic-positive ADCs were found to have significantly better recurrence-free survival (5 y, 95.4% versus 87.0%, p = 0.005), but this significance was not reproduced in pT1 subcategories (pT1a, pT1b, and pT1c). Furthermore, the presence of the lepidic component was not an independent prognostic factor in the multivariate analysis (hazard ratio = 0.46 [95% confidence interval: 0.19-1.14], p = 0.09). We also analyzed the extent of the lepidic component with 10% incremental valuables. Although we found that a 10% or greater extent of lepidic component made the recurrence-free survival difference the largest, a clear prognostic impact was not obtained with this cutoff point.
Although lepidic-positive ADCs tended to have a favorable outcome, the lepidic component was not a clear independent prognostic factor in pstage I ADC.
由于有几篇文章报道了磨玻璃影的放射学特征与预后相关，我们探讨了是否存在贴壁生长成分也具有相似的意义。
我们回顾性评估了 380 例连续手术切除的肺腺癌（ADC）的病理分期（p）IA 期。将肿瘤分为贴壁生长阳性和贴壁生长阴性 ADC。比较贴壁生长阳性和贴壁生长阴性 ADC 以及 CT 图像上部分实性和实性结节的临床病理特征、磨玻璃影状态和无病生存率。
在 380 例患者中，176 例（46.3%）为贴壁生长阳性 ADC。在所有 pT1 患者中，贴壁生长阳性 ADC 的无复发生存率显著更好（5 年，95.4%比 87.0%，p=0.005），但在 pT1 亚组（pT1a、pT1b 和 pT1c）中并未重现这一显著差异。此外，在多因素分析中，贴壁生长成分不是独立的预后因素（危险比=0.46[95%置信区间：0.19-1.14]，p=0.09）。我们还分析了 10%递增价值的贴壁成分。尽管我们发现 10%或更多的贴壁成分使无复发生存率差异最大，但这一分界点并不能获得明确的预后影响。
尽管贴壁生长阳性 ADC 往往有良好的预后，但贴壁成分在 I 期 ADC 中并不是一个明确的独立预后因素。
