PDF(Pubmed)
Abstract：
UNASSIGNED: Pulmonary invasive mucinous adenocarcinoma (IMA) is a rare subtype of lung cancer which is easily misdiagnosed as inflammatory nodules, tuberculosis, pulmonary diffuse lesions, or hamartomas due to the lack of clinical specificity. This study aims to identify the pathological and imaging characteristics of IMA, which will favor to improve the diagnostic and therapeutic efficacy.
UNASSIGNED: A retrospective study was conducted by enrolling patients histopathologically diagnosed with pulmonary IMA in the current study between January 2014 and December 2021. The clinical pathological and radiological data were collected for analysis to evaluate the radiological patterns and pathological and molecular characteristics of IMA.
UNASSIGNED: A total of 136 patients were included in the study, of whom 58 were male and 78 were female. The patients had an average age of 63.0±9.7 years. The tumors were classified into the following three pathological types: pure mucinous (76 cases) featured by only mucinous cells observed under the microscope; mixed mucinous (23 cases) featured as an attached-wall, papillary, acinar, and solid tumor cells with more than 10% mucinous cells.; and mucinous-absent (29 cases) featured with the absence of mucous cells, but still can detect more than 10% of mucin expresses. In terms of the morphological classification based on the CT scans, 88 (64.7%) cases were identified as the nodular type, 31 (22.8%) as the inflammatory type, 15 (11.1%) as the mass-like type, and two (1.5%) as the diffuse type. For the molecular features, patients afflicted with IMA showed much lower levels of thyroid transcription factor-1 (15%) than those with usual adenocarcinoma (over 80%). However, cytokeratin 20 was more common in IMA (50%) than the usual adenocarcinoma (about 5%). The K-RAS mutation was prevalent in 75% of IMA, which contrasted sharply to its occurrence in a mere 15% of the usual adenocarcinoma. Epidermal growth factor receptor mutations were rarer in IMA (less than 5%) than the usual adenocarcinoma (about 50%).
UNASSIGNED: The pathological and imaging features enrich our understanding of the disease\'s heterogeneity, which will contribute to more personalized diagnostic and therapeutic strategies.
UNASSIGNED: A retrospective study was conducted by enrolling patients histopathologically diagnosed with pulmonary IMA in the current study between January 2014 and December 2021. The clinical pathological and radiological data were collected for analysis to evaluate the radiological patterns and pathological and molecular characteristics of IMA.
UNASSIGNED: A total of 136 patients were included in the study, of whom 58 were male and 78 were female. The patients had an average age of 63.0±9.7 years. The tumors were classified into the following three pathological types: pure mucinous (76 cases) featured by only mucinous cells observed under the microscope; mixed mucinous (23 cases) featured as an attached-wall, papillary, acinar, and solid tumor cells with more than 10% mucinous cells.; and mucinous-absent (29 cases) featured with the absence of mucous cells, but still can detect more than 10% of mucin expresses. In terms of the morphological classification based on the CT scans, 88 (64.7%) cases were identified as the nodular type, 31 (22.8%) as the inflammatory type, 15 (11.1%) as the mass-like type, and two (1.5%) as the diffuse type. For the molecular features, patients afflicted with IMA showed much lower levels of thyroid transcription factor-1 (15%) than those with usual adenocarcinoma (over 80%). However, cytokeratin 20 was more common in IMA (50%) than the usual adenocarcinoma (about 5%). The K-RAS mutation was prevalent in 75% of IMA, which contrasted sharply to its occurrence in a mere 15% of the usual adenocarcinoma. Epidermal growth factor receptor mutations were rarer in IMA (less than 5%) than the usual adenocarcinoma (about 50%).
UNASSIGNED: The pathological and imaging features enrich our understanding of the disease\'s heterogeneity, which will contribute to more personalized diagnostic and therapeutic strategies.
摘要：
■肺浸润性黏液腺癌（IMA）是一种少见的肺癌亚型，易误诊为炎性结节，结核病,肺弥漫性病变,或错构瘤由于缺乏临床特异性。本研究旨在明确IMA的病理和影像学特征,有利于提高诊断和治疗效果。
■一项回顾性研究是在2014年1月至2021年12月的本研究中，通过招募组织病理学诊断为肺IMA的患者进行的。收集临床病理和放射学数据进行分析，以评估IMA的放射学模式以及病理和分子特征。
■总共136名患者被纳入研究，其中58人为男性，78人为女性。患者的平均年龄为63.0±9.7岁。肿瘤分为以下三种病理类型：纯粘液性（76例），仅在显微镜下观察到粘液性细胞；混合粘液性（23例），乳头状，腺泡,和实体瘤细胞有10%以上的黏液细胞。；粘液缺失（29例）以粘液细胞缺失为特征，但仍能检测到10%以上的粘蛋白表达。在基于CT扫描的形态学分类方面，88例(64.7%)被确定为结节型，31（22.8%）为炎症类型，15（11.1％）为质量样类型，和两个（1.5％）作为扩散类型。对于分子特征，IMA患者的甲状腺转录因子-1水平(15%)远低于普通腺癌患者(80%以上).然而,细胞角蛋白20在IMA中（50％）比通常的腺癌（约5％）更常见。K-RAS突变在75%的IMA中普遍存在，与仅15％的普通腺癌形成鲜明对比。与通常的腺癌（约50％）相比，IMA中的表皮生长因子受体突变很少（小于5％）。
■病理和影像学特征丰富了我们对疾病异质性的认识，这将有助于更个性化的诊断和治疗策略。
■一项回顾性研究是在2014年1月至2021年12月的本研究中，通过招募组织病理学诊断为肺IMA的患者进行的。收集临床病理和放射学数据进行分析，以评估IMA的放射学模式以及病理和分子特征。
■总共136名患者被纳入研究，其中58人为男性，78人为女性。患者的平均年龄为63.0±9.7岁。肿瘤分为以下三种病理类型：纯粘液性（76例），仅在显微镜下观察到粘液性细胞；混合粘液性（23例），乳头状，腺泡,和实体瘤细胞有10%以上的黏液细胞。；粘液缺失（29例）以粘液细胞缺失为特征，但仍能检测到10%以上的粘蛋白表达。在基于CT扫描的形态学分类方面，88例(64.7%)被确定为结节型，31（22.8%）为炎症类型，15（11.1％）为质量样类型，和两个（1.5％）作为扩散类型。对于分子特征，IMA患者的甲状腺转录因子-1水平(15%)远低于普通腺癌患者(80%以上).然而,细胞角蛋白20在IMA中（50％）比通常的腺癌（约5％）更常见。K-RAS突变在75%的IMA中普遍存在，与仅15％的普通腺癌形成鲜明对比。与通常的腺癌（约50％）相比，IMA中的表皮生长因子受体突变很少（小于5％）。
■病理和影像学特征丰富了我们对疾病异质性的认识，这将有助于更个性化的诊断和治疗策略。
