肺癌术中空气传播蔓延对预后的影响及临床特征:真实世界分析。

Prognostic Impact and Clinical Features of Spread through Air Spaces in Operated Lung Cancer: Real-World Analysis.

机构信息

Department of Medical Oncology, Health Science University, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul 34865, Turkey.

Division of Medical Oncology, School of Medicine, Koc University, Istanbul 34450, Turkey.

出版信息

Medicina (Kaunas). 2024 Aug 22;60(8):1374. doi: 10.3390/medicina60081374.

Abstract

: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall survival (OS) and disease-free survival (DFS) in patients with surgically resected stage IA-IIIA lung cancer and to identify clinicopathological features associated with STAS. : This research involved 311 lung cancer surgery patients. The relationship between the presence of STAS in the patients' surgical pathology and OS and DFS values was examined. Clinicopathological features associated with the presence of STAS were determined. : There were 103 (33%) STAS-positive patients. Adenocarcinoma histological subtype, perineural invasion (PNI), and lymphovascular invasion (LVI) were significantly correlated with being STAS positive. STAS significantly predicted DFS and OS. One-year and five-year DFS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (65% vs. 88%, 29% vs. 62%, respectively, ≤ 0.001). Similarly, one-year and five-year OS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (92% vs. 94%, 54% vs. 88%, respectively, ≤ 0.001). In multivariate analysis, STAS was found to be an independent prognostic factor for both DFS and OS (HR: 3.2 (95%CI: 2.1-4.8) and 3.1 (95%CI: 1.7-5.5), < 0.001 and <0.001, respectively). : In our study, STAS was found to be an independent prognostic biomarker in operated stage IA-IIIA lung cancer patients. It may be a beneficial pathological biomarker in predicting the survival of patients and managing their treatments.

摘要

肺癌是癌症相关死亡的主要原因。近年来,空气空间播散(STAS)作为一种不利的预后因素越来越受到关注。本研究旨在探讨 STAS 存在对手术切除的ⅠA-ⅢA 期肺癌患者总生存(OS)和无病生存(DFS)的影响,并确定与 STAS 相关的临床病理特征。

本研究纳入了 311 例肺癌手术患者。检查了患者手术病理学中 STAS 存在与 OS 和 DFS 值之间的关系。确定了与 STAS 存在相关的临床病理特征。

有 103 例(33%)STAS 阳性患者。腺癌组织学亚型、神经周围侵犯(PNI)和血管淋巴管侵犯(LVI)与 STAS 阳性显著相关。STAS 显著预测 DFS 和 OS。与 STAS 阴性组相比,STAS 阳性组的 1 年和 5 年 DFS 率显著降低(分别为 65%对 88%,29%对 62%, ≤ 0.001)。同样,与 STAS 阴性组相比,STAS 阳性组的 1 年和 5 年 OS 率显著降低(分别为 92%对 94%,54%对 88%, ≤ 0.001)。在多变量分析中,STAS 被发现是 DFS 和 OS 的独立预后因素(HR:3.2(95%CI:2.1-4.8)和 3.1(95%CI:1.7-5.5), < 0.001 和 <0.001)。

在我们的研究中,STAS 被发现是手术治疗的ⅠA-ⅢA 期肺癌患者的独立预后生物标志物。它可能是预测患者生存和治疗管理的有益的病理生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da6e/11356374/f1fb290bd6e7/medicina-60-01374-g001.jpg

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