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Prognostic implication of predominant histologic subtypes of lymph node metastases in surgically resected lung adenocarcinoma.

Suda K, Sato K, Shimizu S, Tomizawa K, Takemoto T, Iwasaki T, Sakaguchi M, Mitsudomi T - Biomed Res Int (2014)

Bottom Line: The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD.However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far.Additionally, we analyzed prognostic implications of these predominant histologic subtypes.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama 589-8511, Japan.

ABSTRACT
The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD. However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far. In this study, we compared predominant subtypes between primary lung tumors and lymph node metastatic lesions in 24 patients with surgically treated lung adenocarcinoma with lymph node metastases. Additionally, we analyzed prognostic implications of these predominant histologic subtypes. We observed several discordance patterns between predominant subtypes in primary lung tumors and lymph node metastases. Concordance rates were 22%, 64%, and 100%, respectively, in papillary-, acinar-, and solid-predominant primary lung tumors. We observed that the predominant subtype in the primary lung tumor (HR 12.7, P = 0.037), but not that in lymph node metastases (HR 0.18, P = 0.13), determines outcomes in patients with surgically resected lung AD with lymph node metastases.

No MeSH data available.


Related in: MedlinePlus

Representative photo-micrographs of primary lung tumors and metastatic lesions of lymph nodes. All of these four patients had papillary-predominant primary lung tumors (left), but developed lymph node metastases that were papillary-predominant (a), acinar-predominant (b), solid-predominant (c), and micropapillary-predominant (d), as shown on the right. Colored bar graphs indicate the proportion of histologic subtypes. In primary lung tumors (left), proportions of each histologic subtype present are estimated in 5% increments. Histologic subtypes in metastatic lymph nodes (right) were recorded as a binary variable.
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fig1: Representative photo-micrographs of primary lung tumors and metastatic lesions of lymph nodes. All of these four patients had papillary-predominant primary lung tumors (left), but developed lymph node metastases that were papillary-predominant (a), acinar-predominant (b), solid-predominant (c), and micropapillary-predominant (d), as shown on the right. Colored bar graphs indicate the proportion of histologic subtypes. In primary lung tumors (left), proportions of each histologic subtype present are estimated in 5% increments. Histologic subtypes in metastatic lymph nodes (right) were recorded as a binary variable.

Mentions: In comparing predominant histologic subtypes between primary lung tumors and lymph node metastases, several discordant patterns were observed. Of 9 patients with papillary-predominant primary tumors, only 2 showed the same histology in their lymph node metastases; whereas the others had 3 acinar-, 3 solid- and 1 micropapillary-predominant metastases in their lymph nodes (Figures 1 and 2). In 11 patients with acinar-predominant primary lung tumors, 7 retained the same histology in metastatic lymph nodes, while the other 4 patients had solid-predominant node metastases (Figure 2). However, all 4 patients with solid-predominant primary lung tumors developed node metastases with the same predominant subtype (Figure 2).


Prognostic implication of predominant histologic subtypes of lymph node metastases in surgically resected lung adenocarcinoma.

Suda K, Sato K, Shimizu S, Tomizawa K, Takemoto T, Iwasaki T, Sakaguchi M, Mitsudomi T - Biomed Res Int (2014)

Representative photo-micrographs of primary lung tumors and metastatic lesions of lymph nodes. All of these four patients had papillary-predominant primary lung tumors (left), but developed lymph node metastases that were papillary-predominant (a), acinar-predominant (b), solid-predominant (c), and micropapillary-predominant (d), as shown on the right. Colored bar graphs indicate the proportion of histologic subtypes. In primary lung tumors (left), proportions of each histologic subtype present are estimated in 5% increments. Histologic subtypes in metastatic lymph nodes (right) were recorded as a binary variable.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4209754&req=5

fig1: Representative photo-micrographs of primary lung tumors and metastatic lesions of lymph nodes. All of these four patients had papillary-predominant primary lung tumors (left), but developed lymph node metastases that were papillary-predominant (a), acinar-predominant (b), solid-predominant (c), and micropapillary-predominant (d), as shown on the right. Colored bar graphs indicate the proportion of histologic subtypes. In primary lung tumors (left), proportions of each histologic subtype present are estimated in 5% increments. Histologic subtypes in metastatic lymph nodes (right) were recorded as a binary variable.
Mentions: In comparing predominant histologic subtypes between primary lung tumors and lymph node metastases, several discordant patterns were observed. Of 9 patients with papillary-predominant primary tumors, only 2 showed the same histology in their lymph node metastases; whereas the others had 3 acinar-, 3 solid- and 1 micropapillary-predominant metastases in their lymph nodes (Figures 1 and 2). In 11 patients with acinar-predominant primary lung tumors, 7 retained the same histology in metastatic lymph nodes, while the other 4 patients had solid-predominant node metastases (Figure 2). However, all 4 patients with solid-predominant primary lung tumors developed node metastases with the same predominant subtype (Figure 2).

Bottom Line: The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD.However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far.Additionally, we analyzed prognostic implications of these predominant histologic subtypes.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama 589-8511, Japan.

ABSTRACT
The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD. However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far. In this study, we compared predominant subtypes between primary lung tumors and lymph node metastatic lesions in 24 patients with surgically treated lung adenocarcinoma with lymph node metastases. Additionally, we analyzed prognostic implications of these predominant histologic subtypes. We observed several discordance patterns between predominant subtypes in primary lung tumors and lymph node metastases. Concordance rates were 22%, 64%, and 100%, respectively, in papillary-, acinar-, and solid-predominant primary lung tumors. We observed that the predominant subtype in the primary lung tumor (HR 12.7, P = 0.037), but not that in lymph node metastases (HR 0.18, P = 0.13), determines outcomes in patients with surgically resected lung AD with lymph node metastases.

No MeSH data available.


Related in: MedlinePlus