Dataset Information

Is the size of the lepidic component negligible when measuring the size of the tumor to determine the stage of lung adenocarcinoma?

ABSTRACT:

Background

After applying the 8th edition of the TNM staging system, the invasive component size, not total tumor size, began to be used as a T descriptor for the stage. The aim of this study was to evaluate whether the size of the lepidic component can be negligible when using only the invasive component size as the T descriptor.

Methods

From 2010 to 2018, 613 consecutive patients were diagnosed as having stage IA lung adenocarcinoma and underwent anatomical lobectomy at a tertiary hospital. Pathologic specimens and medical records were reviewed retrospectively. Statistical analyses were conducted to find out whether the recurrence of stage IA lung adenocarcinoma was more affected by total tumor size (including lepidic component size) or invasive component size.

Results

The 5-year recurrence-free survival (RFS) rates of stage 0, stage IA1, stage IA2, and stage IA3 were 100%, 98.4%, 89.1%, and 81.7%, respectively. In multivariate analysis, total tumor size was not a risk factor for recurrence, whereas invasive component size was a significant risk factor for recurrence (Hazard ratio =1.658, P=0.043). In subgroup analysis, 5-year RFS rates of large lung adenocarcinoma (total tumor size >3 cm) and others (total tumor size ≤3 cm) in the same invasive component size group (stage IA2 and stage IA3) were not statistically different.

Conclusions

Invasive component size was a risk factor for recurrence of stage IA lung adenocarcinoma, while total tumor size was not a risk factor. Therefore, it seems to be appropriate to ignore the size of the lepidic component.

SUBMITTER: Moon Y

PROVIDER: S-EPMC8024845 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Is the size of the lepidic component negligible when measuring the size of the tumor to determine the stage of lung adenocarcinoma?

Moon Youngkyu Y

Journal of thoracic disease 20210301 3

<h4>Background</h4>After applying the 8th edition of the TNM staging system, the invasive component size, not total tumor size, began to be used as a T descriptor for the stage. The aim of this study was to evaluate whether the size of the lepidic component can be negligible when using only the invasive component size as the T descriptor.<h4>Methods</h4>From 2010 to 2018, 613 consecutive patients were diagnosed as having stage IA lung adenocarcinoma and underwent anatomical lobectomy at a tertia ...[more]

PMID: 33841936

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Project description:Objective Lung adenocarcinoma often includes noninvasive components with postoperative lepidic morphology on pathologic specimens that appear on preoperative high-resolution computed tomography (HRCT) images as ground-glass opacity (GGO). We aimed to disclose the role of GGO on the aggressiveness of pathologically confirmed pure invasive tumors in patients with early-stage lung adenocarcinoma. Methods The prognosis of 932 patients with clinical stage 0-IA and pathologic node-negative lung adenocarcinoma who underwent lobectomy at 3 institutions between 2010 and 2016 was investigated according to the status of GGO and lepidic components. Results The recurrence-free survival (RFS) of patients with pathologically confirmed pure invasive tumors was worse without (n = 81) than with (n = 43) GGO (69.7%; 95% confidence interval [CI], 57.3%-79.2% vs 90.5%; 95% CI, 76.6%-96.3%, P = .028). The RFS of patients with radiologically confirmed pure solid tumors was worse without (n = 81), than with (n = 173) a lepidic component (69.7%; 95% CI, 57.3%-79.2% vs 85.3%; 95% CI, 77.2%-90.7%, P = .0012). Multivariable Cox regression analysis of overall survival and RFS revealed that pure solid and pure invasive tumors, respectively, determined by HRCT and pathologic assessment together comprised an independent prognostic factor like vascular or pleural invasion for patients with early-stage lung adenocarcinoma. Conclusions Tumors of non–small cell lung cancer with pure solid and pure invasive components were more aggressive than those with some GGO and lepidic components. Complementary HRCT and pathologic findings can predict the malignant aggressiveness of adenocarcinoma. Graphical abstract Recurrence-free survival is significantly worse for patients with pure solid tumors on high-resolution computed tomography without than with lepidic components and for those with postoperative pathologic findings of pure invasive tumors without, than with ground-glass opacity components.

Project description:BackgroundNon-mucinous bronchioloalveolar carcinoma (BAC) is considered the early stage of lung adenocarcinoma and is classified as the lung adenocarcioma in situ (AIS) by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society. This study was designed to investigate the gene expression differences between AIS (formerly non-mucinous BAC) and invasive lepidic predominant adenocarcinoma (LPA, formerly non-mucinous BAC pattern with >5 mm invasion, mixed type adenocarcinoma with BAC features) and to investigate the mechanism of the progression of lung adenocarcinoma in situ to invasive adenocarcinoma.MethodsGene expression analysis was performed by using Agilent 4 × 44 K Whole Human Genome Oligo Microarray on 10 fresh frozen tissue samples of AIS and LPA, respectively. Real time RT-PCR was used to validate the differential expression of 13 genes selected by cDNA microarray on fresh frozen tissue samples from 41 patients with lung adenocarcinoma and 4 genes were confirmed. These 4 genes were then validated by western blotting. Immunohistochemical staining for these validated genes was performed on formalin-fixed, paraffin-embedded tissue samples from 81 cases of lung adenocarcinomna.ResultsWe identified a 13 gene expression signature by comparative analysis of gene expression. Expression of these genes strongly differed between AIS and LPA. Four genes (MMP-2, c-fos, claudin 1 (CLDN1) and claudin 10(CLDN10)) were correlated with the results of microarray and real time RT-PCR analyses for the gene-expression data in samples from 41 patients with lung adenocarcinoma. As confirmed by western blotting, the expression levels of MMP-2 and c-fos were higher in LPA than those in AIS; the expression levels of CLDN1 and CLDN10 in LPA were lower than those in AIS. Immunohistochemical staining for these genes in samples from 81 cases of lung adenocarcinoma demonstrated the expressions of CLDN1 and CLDN10 were correlated with overall survival of patients with lung adenocarcinoma.ConclusionsCLDN1 and CLDN10 may play important roles in the development of AIS to LPA. Overexpression of CLDN1 and CLDN10 indicates a favorable prognosis for overall survival in some patients with lung adenocarcinoma. Expression of CLDN10 may be regulated by the c-fos pathway.

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Dataset Information

Is the size of the lepidic component negligible when measuring the size of the tumor to determine the stage of lung adenocarcinoma?

Background

Methods

Results

Conclusions

Publications

Is the size of the lepidic component negligible when measuring the size of the tumor to determine the stage of lung adenocarcinoma?

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