Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma
ObjectiveInvasive lung adenocarcinoma is composed of five different histological subgroups with diverse biological behavior and heterogeneous morphology, the acinar/papillary-predominant lung adenocarcinomas are the most common subgroups and recognized as an intermediate-grade group. In the real wor...
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1090544/full |
| _version_ | 1797978644430192640 |
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| author | Wei Liu Wei Liu Qian Zhang Qian Zhang Tiantian Zhang Tiantian Zhang Li Li Li Li Chunhua Xu Chunhua Xu |
| author_facet | Wei Liu Wei Liu Qian Zhang Qian Zhang Tiantian Zhang Tiantian Zhang Li Li Li Li Chunhua Xu Chunhua Xu |
| author_sort | Wei Liu |
| collection | DOAJ |
| description | ObjectiveInvasive lung adenocarcinoma is composed of five different histological subgroups with diverse biological behavior and heterogeneous morphology, the acinar/papillary-predominant lung adenocarcinomas are the most common subgroups and recognized as an intermediate-grade group. In the real world, clinicians primarily consider predominant patterns and ignore the impact of minor components in the prognosis of lung adenocarcinoma. The study evaluated the clinicopathologic characteristics of the lepidic, solid, and micropapillary patterns as non-predominant components and whether the minimal patterns had prognostic value on acinar/papillary-predominant lung adenocarcinomas.MethodsA total of 153 acinar/papillary-predominant lung adenocarcinoma patients with tumor size ≤4 cm were classified into four risk subgroups based on the presence of lepidic and micropapillary/solid components: MP/S−Lep+, MP/S+Lep+, MP/S−Lep−, and MP/S+Lep− groups. The Cox-proportional hazard regression model was used to assess disease-free survival (DFS).ResultsThe risk subgroups based on the non-predominant patterns were associated with differentiation (P = 0.001), lymphovascular invasion (P = 0.001), and recurrence (P = 0.003). In univariate analysis, DFS was correlated with non-predominant components (P = 0.014), lymphovascular invasion (P = 0.001), carcinoembryonic antigen (CEA) (P = 0.001), and platelet-to-lymphocyte ratio (PLR) (P = 0.012). In the multivariate analysis, non-predominant components (P = 0.043) and PLR (P = 0.032) were independent prognostic factors for DFS. The 5-year survival rates of MP/S−Lep+, MP/S+Lep+, MP/S−Lep− and MP/S+Lep− subgroups were 93.1%,92.9%,73.1%,61.9%, respectively. The MP/S−Lep+ subgroup had the favorable prognosis than MP/S+Lep− subgroup with a statistically significant difference (P = 0.002). As minor components, the lepidic patterns were a protective factor, and the solid and micropapillary components were poor factors. The recurrence was related to the presence of non-predominant patterns rather than their proportion. Adjuvant chemotherapy did not significantly improve the prognosis of the MP/S+Lep- subgroup (P = 0.839).ConclusionsRegardless of the proportion, the presence of micropapillary/solid components and the absence of lepidic patterns are aggressive factors of DFS in patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma. |
| first_indexed | 2024-04-11T05:27:19Z |
| format | Article |
| id | doaj.art-95a7d646030948dc82e84a1f5a9b8cd5 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T05:27:19Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-95a7d646030948dc82e84a1f5a9b8cd52022-12-23T06:26:34ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-12-011210.3389/fonc.2022.10905441090544Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinomaWei Liu0Wei Liu1Qian Zhang2Qian Zhang3Tiantian Zhang4Tiantian Zhang5Li Li6Li Li7Chunhua Xu8Chunhua Xu9Department of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, ChinaClinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing chest hospital, Jiangsu, ChinaDepartment of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, ChinaClinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing chest hospital, Jiangsu, ChinaDepartment of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, ChinaClinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing chest hospital, Jiangsu, ChinaDepartment of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, ChinaClinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing chest hospital, Jiangsu, ChinaDepartment of Respiratory Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, ChinaClinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing chest hospital, Jiangsu, ChinaObjectiveInvasive lung adenocarcinoma is composed of five different histological subgroups with diverse biological behavior and heterogeneous morphology, the acinar/papillary-predominant lung adenocarcinomas are the most common subgroups and recognized as an intermediate-grade group. In the real world, clinicians primarily consider predominant patterns and ignore the impact of minor components in the prognosis of lung adenocarcinoma. The study evaluated the clinicopathologic characteristics of the lepidic, solid, and micropapillary patterns as non-predominant components and whether the minimal patterns had prognostic value on acinar/papillary-predominant lung adenocarcinomas.MethodsA total of 153 acinar/papillary-predominant lung adenocarcinoma patients with tumor size ≤4 cm were classified into four risk subgroups based on the presence of lepidic and micropapillary/solid components: MP/S−Lep+, MP/S+Lep+, MP/S−Lep−, and MP/S+Lep− groups. The Cox-proportional hazard regression model was used to assess disease-free survival (DFS).ResultsThe risk subgroups based on the non-predominant patterns were associated with differentiation (P = 0.001), lymphovascular invasion (P = 0.001), and recurrence (P = 0.003). In univariate analysis, DFS was correlated with non-predominant components (P = 0.014), lymphovascular invasion (P = 0.001), carcinoembryonic antigen (CEA) (P = 0.001), and platelet-to-lymphocyte ratio (PLR) (P = 0.012). In the multivariate analysis, non-predominant components (P = 0.043) and PLR (P = 0.032) were independent prognostic factors for DFS. The 5-year survival rates of MP/S−Lep+, MP/S+Lep+, MP/S−Lep− and MP/S+Lep− subgroups were 93.1%,92.9%,73.1%,61.9%, respectively. The MP/S−Lep+ subgroup had the favorable prognosis than MP/S+Lep− subgroup with a statistically significant difference (P = 0.002). As minor components, the lepidic patterns were a protective factor, and the solid and micropapillary components were poor factors. The recurrence was related to the presence of non-predominant patterns rather than their proportion. Adjuvant chemotherapy did not significantly improve the prognosis of the MP/S+Lep- subgroup (P = 0.839).ConclusionsRegardless of the proportion, the presence of micropapillary/solid components and the absence of lepidic patterns are aggressive factors of DFS in patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma.https://www.frontiersin.org/articles/10.3389/fonc.2022.1090544/fulllung adenocarcinomaprognosisstage Inon-predominant patternshistological subtype |
| spellingShingle | Wei Liu Wei Liu Qian Zhang Qian Zhang Tiantian Zhang Tiantian Zhang Li Li Li Li Chunhua Xu Chunhua Xu Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma Frontiers in Oncology lung adenocarcinoma prognosis stage I non-predominant patterns histological subtype |
| title | Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma |
| title_full | Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma |
| title_fullStr | Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma |
| title_full_unstemmed | Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma |
| title_short | Minor histological components predict the recurrence of patients with resected stage I acinar- or papillary-predominant lung adenocarcinoma |
| title_sort | minor histological components predict the recurrence of patients with resected stage i acinar or papillary predominant lung adenocarcinoma |
| topic | lung adenocarcinoma prognosis stage I non-predominant patterns histological subtype |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1090544/full |
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