Ye Ting, Shen Xuxia, Wang Shengping, Wu Haoxuan, Wang Yue, Hu Hong, Zhang Yang, Huang Qingyuan, Wang Zezhou, Gu Yajia, Li Yuan, Chen Haiquan
Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China.
Institute of Thoracic Oncology, Fudan University, Shanghai, China.
Transl Lung Cancer Res. 2025 Feb 28;14(2):341-352. doi: 10.21037/tlcr-2024-1063. Epub 2025 Feb 27.
The radiologic and pathologic correlations of subsolid lung cancers are unclear. No study has used the whole-mount sections to analyze the correlations. This study aims to clarify the radiologic and pathologic correlations through the use of the whole-mount sections analysis.
Patients with subsolid lung adenocarcinomas receiving segmentectomy or lobectomy were included. The whole-mount sections were made. The same radiologic and pathologic sections were identified. Radiologic and pathologic tumor and solid/invasive sizes were compared. Histologic features in the solid component and ground-glass opacity (GGO) regions were evaluated.
There were 102 patients with 20 pure GGO and 82 part-solid tumors analyzed. There was one adenocarcinoma , 32 minimal invasive adenocarcinomas, and 69 invasive adenocarcinomas. For all patients or patients with the matched sections, radiologic tumor diameter was larger than pathologic one (P<0.001; P=0.009), while radiologic solid component diameter was smaller than that of pathologic invasive diameter (P=0.01; P<0.001). The clinical T stage was pathologically upstaged in nearly 50% of patients. For pure GGO tumors, prevalence of lepidic, acinar, and papillary subtypes was 100.0%, 84.2%, and 47.4%, with no micropapillary or solid subtype. For part-solid tumors, in the GGO region, prevalence of lepidic, acinar, papillary, and micropapillary subtypes was 100.0%, 83.3%, 57.1%, and 11.9%, no solid subtype existed. In the solid region, prevalence of lepidic, acinar, papillary, micropapillary, and solid subtypes was 19.0%, 95.2%, 59.5%, 26.2%, and 2.3%.
For subsolid lung cancers, the pathologic invasive size was radiologically underestimated. There were acinar/papillary, but no micropapillary subtype in pure GGO tumors. In part-solid tumors, there were micropapillary subtypes in GGO region and micropapillary/solid subtypes in solid region.
亚实性肺癌的影像学与病理学相关性尚不清楚。尚无研究使用整装切片来分析这些相关性。本研究旨在通过整装切片分析来阐明影像学与病理学的相关性。
纳入接受肺段切除术或肺叶切除术的亚实性肺腺癌患者。制作整装切片。识别相同的影像学和病理学切片。比较影像学和病理学的肿瘤及实性/浸润性大小。评估实性成分和磨玻璃影（GGO）区域的组织学特征。
共分析了102例患者的20个纯GGO肿瘤和82个部分实性肿瘤。其中有1例腺癌、32例微浸润腺癌和69例浸润性腺癌。对于所有患者或有匹配切片的患者，影像学肿瘤直径大于病理学肿瘤直径（P<0.001；P=0.009），而影像学实性成分直径小于病理学浸润直径（P=0.01；P<0.001）。近50%的患者临床T分期在病理学上被上调。对于纯GGO肿瘤，贴壁型、腺泡型和乳头型亚型的患病率分别为100.0%、84.2%和47.4%，无微乳头型或实体型亚型。对于部分实性肿瘤，在GGO区域，贴壁型、腺泡型、乳头型和微乳头型亚型的患病率分别为100.0%、83.3%、57.1%和11.9%，无实体型亚型。在实性区域，贴壁型、腺泡型、乳头型、微乳头型和实体型亚型的患病率分别为19.0%、95.2%、59.5%、26.2%和2.3%。
对于亚实性肺癌，病理学浸润大小在影像学上被低估。纯GGO肿瘤中有腺泡/乳头型，但无微乳头型亚型。在部分实性肿瘤中，GGO区域有微乳头型亚型，实性区域有微乳头/实体型亚型。
