PDF(Pubmed)
Abstract：
UNASSIGNED: Non-predominant or even minimal micropapillary and/or solid (MP/S) subtypes have been reported to exert an unfavorable prognostic influence on surgically resected lung adenocarcinoma (ADC). Currently, there is a lack of evidence to demonstrate that high-grade pathological subtypes, including MP/S components, impact the prognosis of patients with surgically resected lung ADCs with ground-glass opacity (GGO). In this investigation, we explored the prognostic implications of minimal MP/S components in lung ADCs with GGO.
UNASSIGNED: A retrospective cohort study was conducted on 1,004 consecutive patients undergoing curative resection for pathologic stage (p-stage) I lung ADCs featuring GGO on computed tomography (CT) scans between January 2014 and December 2016. Tumors were categorized into MP/S positive (MP/S+) group and MP/S negative (MP/S-) group. MP/S+ tumors were defined when MP/S subtypes constituted ≥1% of the entire tumor. The prognostic impact of MP/S subtypes was evaluated using Kaplan-Meier analysis, Cox proportional hazard model and restricted cubic spine (RCS) model.
UNASSIGNED: A total of 86 (8.6%) cases with MP/S+ tumors and 918 (91.4%) cases with MP/S- tumors were identified. The solid component tumor diameter and pathological invasive tumor size of MP/S+ tumors were both significantly larger than that of MP/S- tumors (13.0 vs. 4.0 mm, P<0.001, and 18.0 vs. 10.0 mm, P<0.001, respectively). After a median follow-up of 7.3 years, the presence of MP/S components was significantly associated with decreased RFS (5-year RFS, MP/S+ 88.3% vs. MP/S- 97.4%; P<0.001; HR =1.02). The presence of a histologic lepidic (Lep) component demonstrated a prognostic advantage in both MP/S- (5-year RFS, MP/S-Lep+ 98.0% vs. MP/S-Lep- 95.3%; P=0.01; HR =0.89) and MP/S+ subgroups (5-year RFS, MP/S+Lep+ 93.4% vs. MP/S+Lep- 83.2%; P=0.10; HR =0.84). MP/S+ components ≥5% were the only tumor-related factor that independently affected RFS [hazard ratio (HR) =1.77; 95% confidence interval (CI): 1.07-2.94] according to multivariate analysis. There was a progressively negative impact of the proportion of MP/S subtypes on RFS as illustrated by RCS model.
UNASSIGNED: The presence of MP/S patterns in stage I GGO-featured lung ADCs exhibit significant prognostic value and may have implications for tailored postoperative treatment and surveillance strategies, especially when the proportion exceeds 5% of the entire tumor.
UNASSIGNED: A retrospective cohort study was conducted on 1,004 consecutive patients undergoing curative resection for pathologic stage (p-stage) I lung ADCs featuring GGO on computed tomography (CT) scans between January 2014 and December 2016. Tumors were categorized into MP/S positive (MP/S+) group and MP/S negative (MP/S-) group. MP/S+ tumors were defined when MP/S subtypes constituted ≥1% of the entire tumor. The prognostic impact of MP/S subtypes was evaluated using Kaplan-Meier analysis, Cox proportional hazard model and restricted cubic spine (RCS) model.
UNASSIGNED: A total of 86 (8.6%) cases with MP/S+ tumors and 918 (91.4%) cases with MP/S- tumors were identified. The solid component tumor diameter and pathological invasive tumor size of MP/S+ tumors were both significantly larger than that of MP/S- tumors (13.0 vs. 4.0 mm, P<0.001, and 18.0 vs. 10.0 mm, P<0.001, respectively). After a median follow-up of 7.3 years, the presence of MP/S components was significantly associated with decreased RFS (5-year RFS, MP/S+ 88.3% vs. MP/S- 97.4%; P<0.001; HR =1.02). The presence of a histologic lepidic (Lep) component demonstrated a prognostic advantage in both MP/S- (5-year RFS, MP/S-Lep+ 98.0% vs. MP/S-Lep- 95.3%; P=0.01; HR =0.89) and MP/S+ subgroups (5-year RFS, MP/S+Lep+ 93.4% vs. MP/S+Lep- 83.2%; P=0.10; HR =0.84). MP/S+ components ≥5% were the only tumor-related factor that independently affected RFS [hazard ratio (HR) =1.77; 95% confidence interval (CI): 1.07-2.94] according to multivariate analysis. There was a progressively negative impact of the proportion of MP/S subtypes on RFS as illustrated by RCS model.
UNASSIGNED: The presence of MP/S patterns in stage I GGO-featured lung ADCs exhibit significant prognostic value and may have implications for tailored postoperative treatment and surveillance strategies, especially when the proportion exceeds 5% of the entire tumor.
摘要：
据报道，非主要或甚至最小的微乳头状和/或固体（MP/S）亚型对手术切除的肺腺癌（ADC）产生不利的预后影响。目前,缺乏证据证明高级病理亚型，包括MP/S组件，影响手术切除的肺ADC伴毛玻璃混浊（GGO）患者的预后。在这次调查中,我们探讨了GGO肺ADC中最少MP/S成分的预后意义。
在2014年1月至2016年12月期间，对1,004例连续患者进行了回顾性队列研究，这些患者接受了病理分期（p期）I型肺ADC的治疗性切除，并在计算机断层扫描（CT）扫描上进行了GGO。将肿瘤分为MP/S阳性(MP/S+)组和MP/S阴性(MP/S-)组。当MP/S亚型占整个肿瘤的≥1％时，定义MP/S肿瘤。使用Kaplan-Meier分析评估MP/S亚型的预后影响，Cox比例风险模型和受限立方脊柱(RCS)模型。
■共发现86例(8.6%)MP/S+肿瘤和918例(91.4%)MP/S-肿瘤。MP/S+肿瘤的实体肿瘤直径和病理浸润性肿瘤大小均显著大于MP/S-肿瘤(13.0vs.4.0mm,P<0.001，18.0vs.10.0mm,分别为P<0.001)。经过7.3年的平均随访，MP/S成分的存在与RFS减少显著相关(5年RFS，MP/S+88.3%vs.MP/S-97.4%；P<0.001；HR=1.02）。在MP/S-（5年RFS，MP/S-Lep+98.0%vs.MP/S-Lep-95.3%；P=0.01；HR=0.89）和MP/S+亚组（5年RFS，MP/S+Lep+93.4%vs.MP/S+Lep-83.2%；P=0.10；HR=0.84）。根据多变量分析，MP/S+组分≥5％是唯一独立影响RFS的肿瘤相关因素[风险比（HR）=1.77；95％置信区间（CI）：1.07-2.94]。如RCS模型所示，MP/S亚型的比例对RFS有逐渐的负面影响。
I期GGO特征肺ADC中MP/S模式的存在具有重要的预后价值，可能对定制的术后治疗和监测策略有影响。特别是当比例超过整个肿瘤的5%时。
在2014年1月至2016年12月期间，对1,004例连续患者进行了回顾性队列研究，这些患者接受了病理分期（p期）I型肺ADC的治疗性切除，并在计算机断层扫描（CT）扫描上进行了GGO。将肿瘤分为MP/S阳性(MP/S+)组和MP/S阴性(MP/S-)组。当MP/S亚型占整个肿瘤的≥1％时，定义MP/S肿瘤。使用Kaplan-Meier分析评估MP/S亚型的预后影响，Cox比例风险模型和受限立方脊柱(RCS)模型。
■共发现86例(8.6%)MP/S+肿瘤和918例(91.4%)MP/S-肿瘤。MP/S+肿瘤的实体肿瘤直径和病理浸润性肿瘤大小均显著大于MP/S-肿瘤(13.0vs.4.0mm,P<0.001，18.0vs.10.0mm,分别为P<0.001)。经过7.3年的平均随访，MP/S成分的存在与RFS减少显著相关(5年RFS，MP/S+88.3%vs.MP/S-97.4%；P<0.001；HR=1.02）。在MP/S-（5年RFS，MP/S-Lep+98.0%vs.MP/S-Lep-95.3%；P=0.01；HR=0.89）和MP/S+亚组（5年RFS，MP/S+Lep+93.4%vs.MP/S+Lep-83.2%；P=0.10；HR=0.84）。根据多变量分析，MP/S+组分≥5％是唯一独立影响RFS的肿瘤相关因素[风险比（HR）=1.77；95％置信区间（CI）：1.07-2.94]。如RCS模型所示，MP/S亚型的比例对RFS有逐渐的负面影响。
I期GGO特征肺ADC中MP/S模式的存在具有重要的预后价值，可能对定制的术后治疗和监测策略有影响。特别是当比例超过整个肿瘤的5%时。
