Clinicopathological and radiologic features of postoperative recurrence of lung adenocarcinoma with micropapillary/solid structure_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Fen ,  YU Tongfu , YUAN Mei , XU Hai , ZHONG Yan , ZHANG Teng , ZHU Jiajia

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P. R. China;

Corresponding?author：

YU Tongfu, Email: yu.tongfu@163.com

Keywords：

Micropapillary/solid pattern; adenocarcinoma; recurrence; pathology; computed tomography

DOI：

10.7507/1007-4848.202103093

Video：

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Objective To investigate the radiological and clinicopathological factors affecting the postoperative recurrence of early lung adenocarcinoma with micropapillary/solid structure.Methods A total of 198 patients undergoing surgical resection for early stage lung adenocarcinoma in the First Affiliated Hospital of Nanjing Medical University from January 2016 to August 2019 were enrolled, including 100 males and 98 females, aged 28-82 (53.5±9.5) years. All patients were allocated to a recurrence group (n=21) and a non-recurrence group (n=177) according to postoperative recurrence status. Correlations of imaging and clinical features and clinical outcomes were analyzed to determine prognostic significance.Results The mean follow-up time was 27.0±11.2 months. There was no statistical difference in the imaging features of tumor maximum diameter in mediastinal window (P=0.014), C/T ratio (P=0.001), bronchial positive sign (P=0.015), pathological features of vascular invasion (P=0.024) and postoperative chemotherapy (P<0.001) between the two groups. In multivariate analysis, vascular invasion was the only independent prognostic factor (OR=0.146, P=0.047).Conclusion Vascular invasion is an independent risk factor for postoperative recurrence of early-stage lung adenocarcinoma with micropapillary/solid structure.

Citation： WANG Fen, YU Tongfu, YUAN Mei, XU Hai, ZHONG Yan, ZHANG Teng, ZHU Jiajia. Clinicopathological and radiologic features of postoperative recurrence of lung adenocarcinoma with micropapillary/solid structure. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(6): 693-697. doi: 10.7507/1007-4848.202103093 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Yi E, Bae MK, Cho S, et al. Pathological prognostic factors of recurrence in early stage lung adenocarcinoma. ANZ J Surg, 2018, 88(4): 327-331.
3.	Shimizu R, Kinoshita T, Sasaki N, et al. Clinicopathological factors related to recurrence patterns of resected non-small cell lung cancer. J Clin Med, 2020, 9(8): 2473.
4.	Tsutsumida H, Nomoto M, Goto M, et al. A micropapillary pattern is predictive of a poor prognosis in lung adenocarcinoma, and reduced surfactant apoprotein A expression in the micropapillary pattern is an excellent indicator of a poor prognosis. Mod Pathol, 2007, 20(6): 638-647.
5.	Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
6.	MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
7.	李淑靜, 張晨光, 李敬玉, 等. MSCT 對肺內單發亞實性結節與支氣管及血管關系探討. 實用放射學雜志, 2016, 32(8): 1198-1201.
8.	Samejima J, Yokose T, Ito H, et al. Prognostic significance of blood and lymphatic vessel invasion in pathological stage ⅠA lung adenocarcinoma in the 8th edition of the TNM classification. Lung Cancer, 2019, 137: 144-148.
9.	Ettinger DS, Wood DE, Aggarwal C, et al. NCCN guidelines insights: Non-small cell lung cancer, version 1.2020. J Natl Compr Canc Netw, 2019, 17(12): 1464-1472.
10.	Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
11.	Razi SS, Nguyen D, Villamizar N. Lobectomy does not confer survival advantage over segmentectomy for non-small cell lung cancer with unsuspected nodal disease. J Thorac Cardiovasc Surg, 2020, 159(6): 2469-2483.
12.	Neri S, Menju T, Sowa T, et al. Prognostic impact of microscopic vessel invasion and visceral pleural invasion and their correlations with epithelial-mesenchymal transition, cancer stemness, and treatment failure in lung adenocarcinoma. Lung Cancer, 2019, 128: 13-19.
13.	Choi SH, Jeong JY, Lee SY, et al. Clinical implication of minimal presence of solid or micropapillary subtype in early-stage lung adenocarcinoma. Thorac Cancer, 2021, 12(2): 235-244.
14.	Roh MS, Lee JI, Choi PJ, et al. Relationship between micropapillary component and micrometastasis in the regional lymph nodes of patients with stage Ⅰ lung adenocarcinoma. Histopathology, 2004, 45(6): 580-586.
15.	楊含, 羅素霞. 六種腫瘤標志物在肺癌診斷中的價值及其臨床應用. 現代腫瘤醫學, 2016, 24(4): 577-581.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Yi E, Bae MK, Cho S, et al. Pathological prognostic factors of recurrence in early stage lung adenocarcinoma. ANZ J Surg, 2018, 88(4): 327-331.
3. Shimizu R, Kinoshita T, Sasaki N, et al. Clinicopathological factors related to recurrence patterns of resected non-small cell lung cancer. J Clin Med, 2020, 9(8): 2473.
4. Tsutsumida H, Nomoto M, Goto M, et al. A micropapillary pattern is predictive of a poor prognosis in lung adenocarcinoma, and reduced surfactant apoprotein A expression in the micropapillary pattern is an excellent indicator of a poor prognosis. Mod Pathol, 2007, 20(6): 638-647.
5. Asamura H, Hishida T, Suzuki K, et al. Radiographically determined noninvasive adenocarcinoma of the lung: Survival outcomes of Japan Clinical Oncology Group 0201. J Thorac Cardiovasc Surg, 2013, 146(1): 24-30.
6. MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
7. 李淑靜, 張晨光, 李敬玉, 等. MSCT 對肺內單發亞實性結節與支氣管及血管關系探討. 實用放射學雜志, 2016, 32(8): 1198-1201.
8. Samejima J, Yokose T, Ito H, et al. Prognostic significance of blood and lymphatic vessel invasion in pathological stage ⅠA lung adenocarcinoma in the 8th edition of the TNM classification. Lung Cancer, 2019, 137: 144-148.
9. Ettinger DS, Wood DE, Aggarwal C, et al. NCCN guidelines insights: Non-small cell lung cancer, version 1.2020. J Natl Compr Canc Netw, 2019, 17(12): 1464-1472.
10. Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.
11. Razi SS, Nguyen D, Villamizar N. Lobectomy does not confer survival advantage over segmentectomy for non-small cell lung cancer with unsuspected nodal disease. J Thorac Cardiovasc Surg, 2020, 159(6): 2469-2483.
12. Neri S, Menju T, Sowa T, et al. Prognostic impact of microscopic vessel invasion and visceral pleural invasion and their correlations with epithelial-mesenchymal transition, cancer stemness, and treatment failure in lung adenocarcinoma. Lung Cancer, 2019, 128: 13-19.
13. Choi SH, Jeong JY, Lee SY, et al. Clinical implication of minimal presence of solid or micropapillary subtype in early-stage lung adenocarcinoma. Thorac Cancer, 2021, 12(2): 235-244.
14. Roh MS, Lee JI, Choi PJ, et al. Relationship between micropapillary component and micrometastasis in the regional lymph nodes of patients with stage Ⅰ lung adenocarcinoma. Histopathology, 2004, 45(6): 580-586.
15. 楊含, 羅素霞. 六種腫瘤標志物在肺癌診斷中的價值及其臨床應用. 現代腫瘤醫學, 2016, 24(4): 577-581.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinicopathological and radiologic features of postoperative recurrence of lung adenocarcinoma with micropapillary/solid structure

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