Clinicopathological, Immunohistochemical, and Genetic Features of Primary Lung Adenocarcinoma Occurring in the Setting of Usual Interstitial Pneumonia Pattern

Kyohei Masai, Koji Tsuta, Noriko Motoi, Kouya Shiraishi, Koh Furuta, Shigeki Suzuki, Keisuke Asakura, Kazuo Nakagawa, Hiroyuki Sakurai, Shun Ichi Watanabe, Nobuyoshi Hiraoka, Hisao Asamura

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction An association between usual interstitial pneumonia (UIP) and carcinogenesis has been well established. However, few detailed analyses have investigated the clinicopathological, immunohistochemical, and genetic features of patients with primary lung adenocarcinoma (ADC) with UIP (UIP-ADC). Methods We identified 44 patients with ADC in the setting of UIP (the UIP-ADC group) (1.9%) from 2309 patients with primary ADC and compared clinicopathological, immunohistochemical, and genetic features between the UIP-ADC group and patients with ADC without UIP (the non-UIP-ADC group). Results Clinicopathological features of UIP-ADC included an older age at occurrence; male predominance; smoking history; predilection for the lower lobe; large tumor size; high incidence of lymph vessel invasion, pleural invasion, and lymph node metastasis; and poor survival rate. However, the cause of death of patients with UIP-ADC was largely influenced by respiratory complications. Histologically, patients in the UIP-ADC group could be stratified according to invasive mucinous-predominant subtype. Genetically, patients in the UIP-ADC group had lower EGFR and higher KRAS mutation rates compared with patients in the non-UIP-ADC group. Conclusions UIP-ADC was associated with a poor prognosis owing to the high frequency of perioperative complications rather than the malignancy of the tumor itself. There was a high prevalence of the invasive mucinous-predominant subtype in cases of UIP-ADC. UIP-ADC also had a low prevalence of EGFR mutations and a high prevalence of KRAS mutations. These findings suggest that UIP-ADC should be distinct from non-UIP-ADC.

Original languageEnglish
Pages (from-to)2141-2149
Number of pages9
JournalJournal of Thoracic Oncology
Volume11
Issue number12
DOIs
Publication statusPublished - 2016

Fingerprint

Idiopathic Pulmonary Fibrosis
Adenocarcinoma
Interstitial Lung Diseases
Adenocarcinoma of lung
Neoplasms
Mutation
Lymph
Mutation Rate

Keywords

  • Adenocarcinoma
  • EGFR
  • IPF
  • KRAS
  • Pulmonary fibrosis
  • UIP

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Clinicopathological, Immunohistochemical, and Genetic Features of Primary Lung Adenocarcinoma Occurring in the Setting of Usual Interstitial Pneumonia Pattern. / Masai, Kyohei; Tsuta, Koji; Motoi, Noriko; Shiraishi, Kouya; Furuta, Koh; Suzuki, Shigeki; Asakura, Keisuke; Nakagawa, Kazuo; Sakurai, Hiroyuki; Watanabe, Shun Ichi; Hiraoka, Nobuyoshi; Asamura, Hisao.

In: Journal of Thoracic Oncology, Vol. 11, No. 12, 2016, p. 2141-2149.

Research output: Contribution to journalArticle

Masai, Kyohei ; Tsuta, Koji ; Motoi, Noriko ; Shiraishi, Kouya ; Furuta, Koh ; Suzuki, Shigeki ; Asakura, Keisuke ; Nakagawa, Kazuo ; Sakurai, Hiroyuki ; Watanabe, Shun Ichi ; Hiraoka, Nobuyoshi ; Asamura, Hisao. / Clinicopathological, Immunohistochemical, and Genetic Features of Primary Lung Adenocarcinoma Occurring in the Setting of Usual Interstitial Pneumonia Pattern. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 12. pp. 2141-2149.
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abstract = "Introduction An association between usual interstitial pneumonia (UIP) and carcinogenesis has been well established. However, few detailed analyses have investigated the clinicopathological, immunohistochemical, and genetic features of patients with primary lung adenocarcinoma (ADC) with UIP (UIP-ADC). Methods We identified 44 patients with ADC in the setting of UIP (the UIP-ADC group) (1.9{\%}) from 2309 patients with primary ADC and compared clinicopathological, immunohistochemical, and genetic features between the UIP-ADC group and patients with ADC without UIP (the non-UIP-ADC group). Results Clinicopathological features of UIP-ADC included an older age at occurrence; male predominance; smoking history; predilection for the lower lobe; large tumor size; high incidence of lymph vessel invasion, pleural invasion, and lymph node metastasis; and poor survival rate. However, the cause of death of patients with UIP-ADC was largely influenced by respiratory complications. Histologically, patients in the UIP-ADC group could be stratified according to invasive mucinous-predominant subtype. Genetically, patients in the UIP-ADC group had lower EGFR and higher KRAS mutation rates compared with patients in the non-UIP-ADC group. Conclusions UIP-ADC was associated with a poor prognosis owing to the high frequency of perioperative complications rather than the malignancy of the tumor itself. There was a high prevalence of the invasive mucinous-predominant subtype in cases of UIP-ADC. UIP-ADC also had a low prevalence of EGFR mutations and a high prevalence of KRAS mutations. These findings suggest that UIP-ADC should be distinct from non-UIP-ADC.",
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T1 - Clinicopathological, Immunohistochemical, and Genetic Features of Primary Lung Adenocarcinoma Occurring in the Setting of Usual Interstitial Pneumonia Pattern

AU - Masai, Kyohei

AU - Tsuta, Koji

AU - Motoi, Noriko

AU - Shiraishi, Kouya

AU - Furuta, Koh

AU - Suzuki, Shigeki

AU - Asakura, Keisuke

AU - Nakagawa, Kazuo

AU - Sakurai, Hiroyuki

AU - Watanabe, Shun Ichi

AU - Hiraoka, Nobuyoshi

AU - Asamura, Hisao

PY - 2016

Y1 - 2016

N2 - Introduction An association between usual interstitial pneumonia (UIP) and carcinogenesis has been well established. However, few detailed analyses have investigated the clinicopathological, immunohistochemical, and genetic features of patients with primary lung adenocarcinoma (ADC) with UIP (UIP-ADC). Methods We identified 44 patients with ADC in the setting of UIP (the UIP-ADC group) (1.9%) from 2309 patients with primary ADC and compared clinicopathological, immunohistochemical, and genetic features between the UIP-ADC group and patients with ADC without UIP (the non-UIP-ADC group). Results Clinicopathological features of UIP-ADC included an older age at occurrence; male predominance; smoking history; predilection for the lower lobe; large tumor size; high incidence of lymph vessel invasion, pleural invasion, and lymph node metastasis; and poor survival rate. However, the cause of death of patients with UIP-ADC was largely influenced by respiratory complications. Histologically, patients in the UIP-ADC group could be stratified according to invasive mucinous-predominant subtype. Genetically, patients in the UIP-ADC group had lower EGFR and higher KRAS mutation rates compared with patients in the non-UIP-ADC group. Conclusions UIP-ADC was associated with a poor prognosis owing to the high frequency of perioperative complications rather than the malignancy of the tumor itself. There was a high prevalence of the invasive mucinous-predominant subtype in cases of UIP-ADC. UIP-ADC also had a low prevalence of EGFR mutations and a high prevalence of KRAS mutations. These findings suggest that UIP-ADC should be distinct from non-UIP-ADC.

AB - Introduction An association between usual interstitial pneumonia (UIP) and carcinogenesis has been well established. However, few detailed analyses have investigated the clinicopathological, immunohistochemical, and genetic features of patients with primary lung adenocarcinoma (ADC) with UIP (UIP-ADC). Methods We identified 44 patients with ADC in the setting of UIP (the UIP-ADC group) (1.9%) from 2309 patients with primary ADC and compared clinicopathological, immunohistochemical, and genetic features between the UIP-ADC group and patients with ADC without UIP (the non-UIP-ADC group). Results Clinicopathological features of UIP-ADC included an older age at occurrence; male predominance; smoking history; predilection for the lower lobe; large tumor size; high incidence of lymph vessel invasion, pleural invasion, and lymph node metastasis; and poor survival rate. However, the cause of death of patients with UIP-ADC was largely influenced by respiratory complications. Histologically, patients in the UIP-ADC group could be stratified according to invasive mucinous-predominant subtype. Genetically, patients in the UIP-ADC group had lower EGFR and higher KRAS mutation rates compared with patients in the non-UIP-ADC group. Conclusions UIP-ADC was associated with a poor prognosis owing to the high frequency of perioperative complications rather than the malignancy of the tumor itself. There was a high prevalence of the invasive mucinous-predominant subtype in cases of UIP-ADC. UIP-ADC also had a low prevalence of EGFR mutations and a high prevalence of KRAS mutations. These findings suggest that UIP-ADC should be distinct from non-UIP-ADC.

KW - Adenocarcinoma

KW - EGFR

KW - IPF

KW - KRAS

KW - Pulmonary fibrosis

KW - UIP

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