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Liu C, Wang LC, Chen HS, Yeh YC, Hsu PK, Huang CS, Hsieh CC, Hsu HS. Outcomes of patients with different lepidic percentage and tumor size of stage I lung adenocarcinoma. Thorac Cancer 2022; 13:2005-2013. [PMID: 35680127 PMCID: PMC9284188 DOI: 10.1111/1759-7714.14477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 12/25/2022] Open
Abstract
Background To evaluate the long‐term outcomes after surgical resection for stage I lung adenocarcinoma based on the percentage of lepidic component (LC) and invasive tumor size (IS). Methods The clinicopathological characteristics of 1049 patients with stage I lung adenocarcinoma who underwent surgery between 2006 and 2016 were retrospectively reviewed. Tumors were categorized into groups: A (LC ≥ 50%) and B (LC < 50%). Groups A0 and A1 consisted of minimally invasive adenocarcinomas (MIA) and other lepidic‐predominant invasive adenocarcinomas, respectively. Group B was categorized into B1 (IS ≤ 1 cm), B2 (1 < IS≤2 cm), and B3 (2 < IS≤3 cm) by invasive tumor size and divided into subgroups (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]) according to the presence[lep+] or absence[lep−] of LCs. Cumulative incidence of recurrence (CIR) and cancer‐specific survival (CSS) were examined. Results LC decreased with increasing IS. Only 24 (8.5%) tumors in group A had an IS >1 cm. 10‐year CIR and CSS were 15.2% and 86.0%. LC and IS were found to be independent predictors of CSS. Patients in group A had 1.4% 10‐year CIR and 100% 10‐year CSS. In group B, a significantly higher CIR and worse CSS were observed as IS increased (p < 0.001), but LC was not a predictor for CSS (p = 0.593). No significant differences in CIR or CSS were found in presence of LC or not when LC < 50% (B1[lep+]/[lep−], B2[lep+]/[lep−], and B3[lep+]/[lep−]: p = 0.36/0.48, p = 0.82/0.94, and p = 0.90/0.37, respectively). Conclusions LC≥50% tumors demonstrated excellent prognosis regardless of IS. The outcomes of LC < 50% tumors were well predicted by IS, corresponding to the T‐staging system. The predictive value of LC for prognosis became insignificant.
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Affiliation(s)
- Chia Liu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Lei-Chi Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Shan Chen
- Department of Health Care Administration, Chang Jung Christian University, Tainan City, Taiwan
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Kuei Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Chien-Sheng Huang
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Chih-Cheng Hsieh
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
| | - Han-Shui Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taiwan
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Vessel invasion as a predictive factor for recurrence after surgery in stage I lung adenocarcinoma. Respir Investig 2021; 60:227-233. [PMID: 34933825 DOI: 10.1016/j.resinv.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/14/2021] [Accepted: 11/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients with early-stage lung cancer who underwent R0 resection often encounter disease recurrence, especially during the early phase; thus, it is deemed vital to determine the predictive factors for recurrence after surgery. In this study, we aimed to identify the independent variables associated with recurrence after complete surgical resection of pathological stage I lung adenocarcinoma. METHODS We retrospectively reviewed the medical records of 169 patients who underwent pulmonary resection for primary lung adenocarcinoma pathological stage I with curative intent lung cancer surgery from 2015 to December 2018 at our institution for information on the recurrence of the disease. RESULTS Per the multivariate analysis, the presence of micropapillary pattern and vessel invasion were found to be independent predictors of disease recurrence after surgery (odds ratio [OR]: 9.36, 95% confidence interval [CI]: 2.42-36.2, P = 0.0012; and OR: 4.50, 95% CI: 1.52-13.4, P = 0.0068, respectively). Vessel invasion was also found to be an independent predictor of disease recurrence after surgery within a year (OR 11.4, 95% CI 3.08-42.5, P = 0.0003). CONCLUSIONS The presence of vessel invasion may help in distinguishing patients with the highest risk of early-phase disease recurrence after surgery. Patients with stage I adenocarcinoma with vessel invasion should undergo intensive surveillance after surgery.
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Long non-coding RNA LINC00485 acts as a microRNA-195 sponge to regulate the chemotherapy sensitivity of lung adenocarcinoma cells to cisplatin by regulating CHEK1. Cancer Cell Int 2019; 19:240. [PMID: 31528122 PMCID: PMC6739919 DOI: 10.1186/s12935-019-0934-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 08/18/2019] [Indexed: 11/17/2022] Open
Abstract
Background Long non-coding RNAs (lncRNAs) are a family of non-protein-coding RNAs, which have the ability to influence the chemo-resistance of lung adenocarcinoma (LAC). In this study, we explored the mechanism by which LINC00485 competitively binds to microRNA-195 (miR-195) in the regulation of the chemotherapy sensitivity in LAC by regulating checkpoint kinase 1 (CHEK1). Methods Microarray analysis was used to screen out LAC related genes, and interaction between CHEK1 and miR-195, as well as that between miR-195 and LINC00485, was further confirmed by RNA-pull down and RIP. LINC00485 expression in LAC cells (A549 and H1299) was determined. The cells were then introduced with miR-195, anta-miR-195, LINC00485 or si-LINC00485 to identify the role of miR-195 and LINC00485 in LAC through evaluating the expression of CHEK1, CHEK1, Bax, Bcl-2, VEGF and HIF-1α in LAC cells by either RT-qPCR or Western blot analysis. After being treated with different concentration of cisplatin, cell proliferation, colony formation and apoptosis were assessed. Results LINC00485 acted as a competitive endogenous RNA against miR-195, and miR-195 directly targeted CHEK1. The expression of LINC00485 was higher in LAC cells. The down-regulation of LINC00485 or the up-regulation of miR-195 decreased the expression of CHEK1, Bcl-2, VEGF and HIF-1α, while also increasing the expression of Bax. Moreover, the over-expression of miR-195, or the silencing of LINC00485 enhanced the sensitivity of LAC cells to cisplatin, thereby promoting the apoptosis of LAC cells while suppressing the proliferation. Conclusion LINC00485 competitively binds to miR-195 to elevate CHEK1 expression in LAC cells, suggesting that LINC00485 is a novel direction for therapeutic strategies of LAC.
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A comprehensive evaluation of clinicopathologic characteristics, molecular features and prognosis in lung adenocarcinoma with solid component. J Cancer Res Clin Oncol 2018; 144:725-734. [DOI: 10.1007/s00432-018-2588-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
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Clinicopathological Significance of Micropapillary Pattern in Lung Adenocarcinoma. Pathol Oncol Res 2017; 24:547-555. [DOI: 10.1007/s12253-017-0274-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/22/2017] [Indexed: 02/06/2023]
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Borczuk AC. Prognostic considerations of the new World Health Organization classification of lung adenocarcinoma. Eur Respir Rev 2017; 25:364-371. [PMID: 27903658 DOI: 10.1183/16000617.0089-2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/23/2016] [Indexed: 01/19/2023] Open
Abstract
The 2015 World Health Organization (WHO) lung adenocarcinoma classification divides tumours into categories of indolent pre-invasive, minimally invasive and predominantly lepidic and, by examining predominant patterns of invasion, allows for further stratification into intermediate and high-grade tumours. The impact of the 2015 classification on prognosis was reviewed by a PubMed search for search terms "adenocarcinoma", "lung pathology" and "prognosis" and relevant publications reviewed. These were sorted for data on stage and survival as impacted by histological classification, and survival studies were separated into all stage versus stage 1 studies. Predictive aspects of histological classification were also examined, but molecular correlates were not. The separation of adenocarcinoma in situ and minimally invasive adenocarcinoma from invasive subtypes as distinct prognostic entities and the prognostic significance, for disease specific and overall survival for low- and high-grade categories, are discussed. The impact on stage at presentation including risk of node metastasis by histology is examined, as well as histology in relation to recurrence after surgery. Early data with regard to the value of predominant histology in the prediction of chemotherapy response will also be explored.
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Yao S, Zhi X, Wang R, Qian K, Hu M, Zhang Y. Retrospective study of adjuvant icotinib in postoperative lung cancer patients harboring epidermal growth factor receptor mutations. Thorac Cancer 2016; 7:543-548. [PMID: 27766784 PMCID: PMC5130296 DOI: 10.1111/1759-7714.12365] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/27/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) mutations occur in about 50% of Asian patients with non-small cell lung cancer (NSCLC). Patients with advanced NSCLC and EGFR mutations derive clinical benefit from treatment with EGFR-tyrosine kinase inhibitors (TKIs). This study assessed the efficacy and safety of adjuvant icotinib without chemotherapy in EGFR-mutated NSCLC patients undergoing resection of stage IB-IIIA. METHODS Our retrospective study enrolled 20 patients treated with icotinib as adjuvant therapy. Survival factors were evaluated by univariate and Cox regression analysis. RESULTS The median follow-up time was 30 months (range 24-41). At the data cut-off, five patients (25%) had recurrence or metastasis and one patient had died of the disease. The two-year disease-free survival (DFS) rate was 85%. No recurrence occurred in the high-risk stage IB subgroup during the follow-up period. In univariate analysis, the micropapillary pattern had a statistically significant effect on DFS ( P = 0.040). Multivariate logistic regression analysis showed that there was no independent predictor. Drug related adverse events (AEs) occurred in nine patients (45.0%). The most common AEs were skin-related events and diarrhea, but were relatively mild. No grade 3 AEs or occurrences of intolerable toxicity were observed. CONCLUSIONS Icotinib as adjuvant therapy is effective in patients harboring EGFR mutations after complete resection, with an acceptable AE profile. Further trials with larger sample sizes might confirm the efficiency of adjuvant TKI in selected patients.
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Affiliation(s)
- Shuyang Yao
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Ruotian Wang
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Kun Qian
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Mu Hu
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Thoracic Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
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Cao Y, Zhu LZ, Jiang MJ, Yuan Y. Clinical impacts of a micropapillary pattern in lung adenocarcinoma: a review. Onco Targets Ther 2015; 9:149-58. [PMID: 26770064 PMCID: PMC4706128 DOI: 10.2147/ott.s94747] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Lung adenocarcinoma with a micropapillary pattern (MPPAC) has recently drawn increased attention among researchers. Micropapillary-predominant adenocarcinoma (MPA), which is defined by micropapillary pattern (MPP), is the primary histological pattern observed semiquantitatively in 5% increments on resection specimens, and MPA was formally determined to be a new histological subtype according to the new multidisciplinary classification in 2011. According to published studies, MPPAC is most common in males and nonsmokers and is associated with lymphatic invasion, pleural invasion, and lymph node metastases. MPPAC often presents as part-solid and lobulated nodules in computed tomography scans. MPP tends to have a higher maximum standardized uptake value as determined by fluorodeoxyglucose positron emission tomography combined with computed tomography, indicating a high risk of recurrence. Molecular markers, including vimentin, napsin A, phosphorylated c-Met, cytoplasmic maspin, Notch-1, MUC1, and tumoral CD10, may have higher expression in MPPAC than other subtypes; conversely, markers such as MUC4 and surfactant apoprotein A have lower expression in MPPAC. MPPAC with EGFR mutations can benefit from treatment with EGFR tyrosine kinase inhibitors. Furthermore, a complete lobectomy may be more suitable than limited resection for MPPAC because of the low sensitivity of intraoperative frozen sections and the high risk of lymph node metastasis. MPA benefits more from adjuvant chemotherapy than do other histological subtypes, whereas MPA does not benefit from adjuvant radiotherapy. Of note, MPP is associated with poor prognosis in early-stage lung adenocarcinoma, but the prognostic value of MPP is controversial in advanced-stage lung adenocarcinoma.
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Affiliation(s)
- Ying Cao
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Li-Zhen Zhu
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Meng-Jie Jiang
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Ying Yuan
- Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
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Shi X, Pang Q, Zhao G, Zhao L, Wang P. [Advances of Pulmonary Adenocarcinoma with Micropapillary Pattern]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2015; 18:701-5. [PMID: 26582227 PMCID: PMC6000319 DOI: 10.3779/j.issn.1009-3419.2015.11.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
伴微乳头结构(micropapillary pattern, MPP)肺腺癌是一种临床少见的具有高度侵袭性的恶性肿瘤,近年来因其高死亡率被人们所重视。2011年关于肺腺癌的病理新分类将其作为一种独立的病理类型,此后针对该类肺癌个体化治疗的相关研究逐渐展开。近期的相关研究发现,伴MPP肺腺癌在转移机制、临床病理学、影像学、治疗及预后方面具有显著异质性。本文对伴MPP肺腺癌转移机制及相关临床研究进展进行探讨。
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Affiliation(s)
- Xiangyu Shi
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Qingsong Pang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Gang Zhao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Lujun Zhao
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Ping Wang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
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Noda Y, Goshima S, Kanematsu M, Watanabe H, Kawada H, Kawai N, Ono H, Bae KT. F-18 FDG uptake on positron emission tomography as a predictor for lymphovascular invasion in patients with lung adenocarcinoma. Ann Nucl Med 2015; 30:11-7. [PMID: 26337532 DOI: 10.1007/s12149-015-1023-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/25/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the contributory value of Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in the prediction of lymphovascular tumor invasion in patients with lung adenocarcinoma. MATERIALS AND METHODS We evaluated F-18 FDG-PET/CT images in 84 patients with histopathologically proven lung adenocarcinoma (37 men and 47 women, age range 39-83 years, mean age 67.0 ± 8.9 years). The maximum standardized uptake values (SUVmax) of the carcinomas were measured from the PET images. The Mann-Whitney U test was conducted to compare the median SUVmax between the tumor groups with and without lymphovascular invasion. In the subgroup patients with no lymph-node metastasis, we also compared the median SUVmax between the tumor groups with and without lymphatic invasion. RESULTS The tumors with lymphovascular invasion had a significantly (P < 0.0001) greater median SUVmax than those without invasion. In the subgroup patients with no lymph-node metastasis, the median SUVmax was higher in tumors with lymphatic invasion than those without (P = 0.0004). The sensitivity, specificity, and area under the receiver operating characteristic curve for the detection of tumors with lymphovascular invasion were 89, 75 %, and 0.82, respectively, with a cutoff SUVmax value of 2.32. CONCLUSION The SUVmax of lung adenocarcinoma is a potential imaging biomarker for predicting tumor lymphovascular invasion.
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Affiliation(s)
- Yoshifumi Noda
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Satoshi Goshima
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Masayuki Kanematsu
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.,Departments of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Haruo Watanabe
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroshi Kawada
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuyuki Kawai
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiromi Ono
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Kyongtae T Bae
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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