Fu Yiyun, Zha Junmei, Wu Qian, Tang Yuan, Wang Weiya, Zhou Qiao, Jiang Lili
Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China.
Pathol Res Pract. 2023 Aug;248:154595. doi: 10.1016/j.prp.2023.154595. Epub 2023 Jun 7.
This study aims to investigate the clinicopathologic characteristics of lung adenocarcinoma with micropapillary pattern (MPP) and the expression of CD44s and CD44v6 in MPP.
A total of 202 patients diagnosed with primary lung adenocarcinoma with MPP were included. We estimated the proportion of MPP in each tumor tissue and divided MPP into aerogenous micropapillary pattern (AMP) and stromal micropapillary pattern (SMP). The expression of CD44s and CD44v6 was estimated by immunohistochemical staining. Clinicopathologic data were collected from the patients' medical records. We also collected patients' follow-up data and used PFS (progression-free survival) as a survival indicator.
Lung adenocarcinoma with MPP had a high risk of pleural invasion, lymph node metastasis, in advanced TNM stage, and a high rate of EGFR mutation. The presence of SMP indicated a higher rate of pleural invasion, lymphovascular invasion, lymph node metastasis, and a worse PFS compared with pure AMP. We found high expression of CD44s in micropapillary, especially in AMP, while the absence of CD44s expression indicated shorter survival, which was an independent unfavorable factor for PFS.
Lung adenocarcinoma with micropapillary pattern indicated an unfavorable prognosis, which had two different pattens, AMP and SMP. SMP indicated a worse survival than AMP, and was an independent unfavorable factor for PFS. So, AMP/SMP subclassification is necessary to evaluate patient's prognosis. Furthermore, the absent expression of CD44s in micropapillary indicated shorter survival, especially in patients with EGFR mutation. Herein, CD44s may be a biological marker for micropapillary lung adenocarcinoma.
本研究旨在探讨具有微乳头模式（MPP）的肺腺癌的临床病理特征以及MPP中CD44s和CD44v6的表达情况。
纳入202例诊断为原发性具有MPP的肺腺癌患者。我们评估了每个肿瘤组织中MPP的比例，并将MPP分为气源性微乳头模式（AMP）和间质微乳头模式（SMP）。通过免疫组织化学染色评估CD44s和CD44v6的表达。从患者病历中收集临床病理数据。我们还收集了患者的随访数据，并将无进展生存期（PFS）用作生存指标。
具有MPP的肺腺癌具有胸膜侵犯、淋巴结转移、晚期TNM分期的高风险以及EGFR突变的高发生率。与单纯AMP相比，SMP的存在表明胸膜侵犯、淋巴管侵犯、淋巴结转移的发生率更高，PFS更差。我们发现微乳头中CD44s高表达，尤其是在AMP中，而CD44s表达缺失表明生存期较短，这是PFS的一个独立不良因素。
具有微乳头模式的肺腺癌预后不良，其有两种不同模式，即AMP和SMP。SMP表明生存期比AMP更差，并且是PFS的一个独立不良因素。因此，AMP/SMP亚分类对于评估患者预后是必要的。此外，微乳头中CD44s表达缺失表明生存期较短，尤其是在EGFR突变患者中。在此，CD44s可能是微乳头型肺腺癌的一个生物学标志物。
