Qu Rirong, Zhang Yang, Qin Shenghui, Xiong Jing, Fu Xiangning, Li Lequn, Tu Dehao, Cai Yixin
Thoracic Surgery Laboratory, Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030, China.
Department of Pelvic Floor Rehabilitation, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Respir Res. 2025 Apr 13;26(1):138. doi: 10.1186/s12931-025-03217-6.
The prognosis of ground glass opacity featured lung adenocarcinomas (GGO-LUAD) is significantly better than that of solid nodule featured lung adenocarcinomas (SN-LUAD), but the underlying reasons remain unclear. Ki-67 and cell cycle regulator proteins are highly expressed in many cancers and linked to prognosis. This study aims to investigate their differential expression in LUAD with different radiological subtypes.
Patients with resected pathological stage 0-III LUAD in our department between July 2019 and March 2022 were retrospectively reviewed. All included patients were divided into four groups based on different consolidation-to-tumour ratio (CTR), we focuses on evaluating the differential expression of Ki-67 and cell cycle regulatory proteins (CCNA2, CCNB1, CCND1, P16, P21, TOP2A, TP53, and pRb) in LUAD with different CTR.
A total of 481 patients were included, 108 in the pure ground glass opacity (PGGO, CTR = 0) group, 103 in the GGO-dominant (GGO-D, 0 < CTR ≤ 0.5) group, 74 in the SN-dominant (SN-D, 0.5 < CTR < 1) group, and 196 in the pure solid nodule (SN, CTR = 1) group. The expression of Ki-67 was significantly higher in elderly patients (P < 0.05), former or current smokers (P < 0.0001), males (P < 0.05), poorly differentiated tumors (P < 0.0001), and tumors with spread through air spaces (STAS) (P < 0.0001), and advanced stage tumors (P < 0.0001). Regardless of age, gender, smoking status and epidermal growth factor receptor (EGFR) mutation status, GGO-LUAD demonstrated significantly lower expression of Ki-67 compared to SN-LUAD. The expression of Ki-67 and cell cycle regulatory proteins (except P21) were significantly lower in the PGGO, GGO-D, SN-D than in the SN group. However, there was no significant difference in the expression of Ki-67 and cell cycle regulatory proteins among the PGGO, GGO-D, and SN-D groups.
GGO-LUAD demonstrated significantly lower expression of Ki-67 and cell cycle regulatory proteins compared to SN-LUAD, which may explain the reasons behind the excellent prognosis of GGO-LUAD.
磨玻璃影型肺腺癌（GGO-LUAD）的预后明显优于实性结节型肺腺癌（SN-LUAD），但其潜在原因尚不清楚。Ki-67和细胞周期调节蛋白在许多癌症中高表达并与预后相关。本研究旨在探讨它们在不同放射学亚型的LUAD中的差异表达。
回顾性分析2019年7月至2022年3月在我科接受手术切除的病理分期为0-III期的LUAD患者。所有纳入患者根据不同的实性成分与肿瘤比例（CTR）分为四组，我们重点评估不同CTR的LUAD中Ki-67和细胞周期调节蛋白（CCNA2、CCNB1、CCND1、P16、P21、TOP2A、TP53和pRb）的差异表达。
共纳入481例患者，纯磨玻璃影（PGGO，CTR = 0）组108例，磨玻璃影为主（GGO-D，0 < CTR≤0.5）组103例，实性结节为主（SN-D，0.5 < CTR < 1）组74例，纯实性结节（SN，CTR = 1）组196例。Ki-67的表达在老年患者（P < 0.05）、既往或当前吸烟者（P < 0.0001）、男性（P < 0.05）、低分化肿瘤（P < 0.0001）、有气腔播散（STAS）的肿瘤（P < 0.0001）和晚期肿瘤（P < 0.0001）中显著更高。无论年龄、性别、吸烟状态和表皮生长因子受体（EGFR）突变状态如何，与SN-LUAD相比，GGO-LUAD的Ki-67表达均显著降低。PGGO、GGO-D、SN-D组中Ki-67和细胞周期调节蛋白（P21除外）的表达均显著低于SN组。然而，PGGO、GGO-D和SN-D组之间Ki-67和细胞周期调节蛋白的表达无显著差异。
与SN-LUAD相比，GGO-LUAD的Ki-67和细胞周期调节蛋白表达显著降低，这可能解释了GGO-LUAD预后良好的原因。
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