Department of Cardio-Thoracic Surgery, Zhoushan Hospital, 739 Dingshen Road, Zhoushan, Zhejiang 316000, PR China.
Department of Pathology, Zhoushan Hospital, 739 Dingshen Road, Zhoushan, Zhejiang 316000, PR China.
Ann Diagn Pathol. 2022 Aug;59:151945. doi: 10.1016/j.anndiagpath.2022.151945. Epub 2022 Apr 1.
The specific impacts of solid and micropapillary components on prognosis in lung adenocarcinoma remain unclear. Herein, we elucidated their distinct contributions to lung adenocarcinoma recurrence.
Lung adenocarcinoma was classified into solid and micropapillary absent (S-M-); solid absent, micropapillary present (S-M+); micropapillary absent, solid present (S + M-); and solid and micropapillary present (S + M+). Cumulative incidence of recurrence (CIR) was calculated using competing risk analysis.
Of 994 adenocarcinomas, 650 (65.4%) were classified as S-M-; 152 (15.3%), S-M+; 148 (14.9%), S + M-; and 44 (4.4%), S + M+. In total, 168 (16.9%) patients had recurrence; 16 (1.6%) died from other causes. S-M- had significantly lower CIR than other groups (S-M- vs. S-M+: P < 0.001, S-M- vs. S + M-: P < 0.001, S-M- vs. S + M+: P < 0.001); S + M- had significantly higher CIR than S-M+ (P = 0.002). These differences remained significant in multivariable analysis. In stage IA, S-M- had significantly lower CIR than other groups (S-M- vs. S-M+: P = 0.006, S-M- vs. S + M-: P < 0.001, S-M- vs. S + M+: P < 0.001); S + M- and S + M+ had significantly higher CIR than S-M+ (P = 0.005, P = 0.008, respectively). These differences remained significant in multivariable analysis. CIR was not significantly different between S + M- and S-M+ subgroups.
The presence of solid or micropapillary component (≥1%) was an independent risk factor for CIR; patients with solid component alone had a higher CIR than those with micropapillary component alone. In IA lung adenocarcinoma, patients with both solid and micropapillary components had a higher CIR than those with micropapillary component alone; the proportion of solid or micropapillary component was not associated with CIR.
实性和微乳头成分对肺腺癌预后的具体影响仍不清楚。在此，我们阐明了它们对肺腺癌复发的不同贡献。
将肺腺癌分为实性和微乳头缺失型（S-M-）、实性缺失型，微乳头存在型（S-M+）、微乳头缺失型，实性存在型（S+M-）和实性和微乳头均存在型（S+M+）。采用竞争风险分析计算累积复发率（CIR）。
在 994 例腺癌中，650 例（65.4%）为 S-M-；152 例（15.3%）为 S-M+；148 例（14.9%）为 S+M-；44 例（4.4%）为 S+M+。共有 168 例（16.9%）患者复发；16 例（1.6%）因其他原因死亡。S-M-的 CIR 显著低于其他组（S-M-比 S-M+：P<0.001，S-M-比 S+M-：P<0.001，S-M-比 S+M+：P<0.001）；S+M-的 CIR 显著高于 S-M+（P=0.002）。多变量分析结果仍有显著差异。在 IA 期，S-M-的 CIR 显著低于其他组（S-M-比 S-M+：P=0.006，S-M-比 S+M-：P<0.001，S-M-比 S+M+：P<0.001）；S+M-和 S+M+的 CIR 显著高于 S-M+（P=0.005，P=0.008）。多变量分析结果仍有显著差异。S+M-和 S-M+亚组之间的 CIR 无显著差异。
实性或微乳头成分（≥1%）的存在是 CIR 的独立危险因素；单纯存在实性成分的患者 CIR 高于单纯存在微乳头成分的患者。在 IA 期肺腺癌中，同时存在实性和微乳头成分的患者 CIR 高于单纯存在微乳头成分的患者，而实性或微乳头成分的比例与 CIR 无关。
