Zou Ji'an, Han Wei, Hu Yan, Zeng Chao, Li Jina, Lei Weixuan, Cao Jieming, Fei Quanming, Shao Mengqi, Yi Junqi, Cheng Zeyu, Wang Li, Wu Fang, Liu Wenliang
Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
Hunan Key Laboratory of Early Diagnosis and Precision Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China.
World J Surg Oncol. 2025 Jan 22;23(1):16. doi: 10.1186/s12957-025-03680-x.
With the wide use of CT scan in clinical practice, more lung cancer was diagnosed in resectable stage. Pathological examination and genetic testing have become a routine procedure for lung adenocarcinoma following radical resection. This study analyzed special pathological components and gene mutations to explore their relationship with clinical characteristics and overall survival.
Clinical, pathological, and gene mutation data from 1,118 patients were collected. All patients underwent surgery at the Department of Thoracic Surgery, the Second Xiangya Hospital of Central South University. Patients were grouped based on pathological components and gene mutations. Differences in clinical features and overall survival were analyzed as well.
Patients with mucinous, neuroendocrine, and poor-differentiated components were presented with more prognostic risk factors, including pleural invasion, carcinothrombosis, STAS, and advanced stages, along with varying frequencies of gene mutations. These factors significantly shortened overall survival. ALK and KRAS mutations were also associated with risk factors such as solid nodules, pleural invasion, STAS, and later stages. However, a significant reduction in overall survival was observed only in patients with the KRAS mutation. Relationship between gene mutations and pathological components still requires further investigation.
Special pathological components (mucinous, neuroendocrine, and poor-differentiated) and gene mutations had an influence on biological behavior of tumors, resulting in different clinical characteristics and prognosis.
随着CT扫描在临床实践中的广泛应用，更多的肺癌在可切除阶段被诊断出来。病理检查和基因检测已成为肺腺癌根治性切除术后的常规程序。本研究分析了特殊病理成分和基因突变，以探讨它们与临床特征和总生存期的关系。
收集了1118例患者的临床、病理和基因突变数据。所有患者均在中南大学湘雅二医院胸外科接受手术。根据病理成分和基因突变对患者进行分组。同时分析临床特征和总生存期的差异。
具有黏液性、神经内分泌性和低分化成分的患者呈现出更多的预后危险因素，包括胸膜侵犯、癌栓形成、STAS和晚期，以及不同频率的基因突变。这些因素显著缩短了总生存期。ALK和KRAS突变也与实性结节、胸膜侵犯、STAS和晚期等危险因素相关。然而，仅在KRAS突变患者中观察到总生存期显著缩短。基因突变与病理成分之间的关系仍需进一步研究。
特殊病理成分（黏液性、神经内分泌性和低分化）和基因突变对肿瘤的生物学行为有影响，导致不同的临床特征和预后。
