Distinctive histopathological features of lepidic growth predominant node-negative adenocarcinomas 3-5cm in size

Yusuke Takahashi, Genichiro Ishii, Keiju Aokage, Tomoyuki Hishida, Junji Yoshida, Kanji Nagai

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Introduction: Adenocarcinoma of the lung is a morphologically heterogeneous group of tumors which includes a variable portion of different histologic subtype components: lepidic growth (LG), and acinar, papillary and solid subtypes. Among these, LG is a non-invasive component which is one of the major histological subtypes in small-sized adenocarcinoma (2. cm or less). However, in large adenocarcinomas (3-5. cm in size), the clinicopathological significance of LG components remains unclear. Methods: A series of 135 lung adenocarcinomas 3-5. cm in size, without lymph node involvement, were reviewed and classified according to their percentage of LG components. We examined the correlation between the percentage of LG components and clinicopathological factors of these tumors. Results: There were 41 (30.4%) tumors with 50% or more LG (LG-predominant group). Female gender (p= 0.039), smoking history of <20 pack-years (p= 0.039), absence of pleural invasion (p= 0.003), and absence of vascular invasion (p< 0.001) were significantly more frequently observed in the LG-predominant group. LG-predominant tumors showed a significantly higher percentage of non-cancerous cell collapse area to tumor area compared with non-LG predominant tumors (p< 0.001). The outcome of the LG-predominant type patients was significantly better than that of the non-LG predominant type patients in both recurrence-free survival (p< 0.001) and overall survival (p< 0.001). Multivariate analysis showed that LG-predominant tumor to be an independent favorable prognostic factor (HR = 0.285, 95% confidence interval: 0.148-0.547, p= 0.014). Conclusion: Node-negative LG-predominant adenocarcinomas of 3-5. cm in size showed less invasiveness compared to non-LG predominant tumors. And LG-predominant type patients had excellent surgical outcome.

Original languageEnglish
Pages (from-to)118-124
Number of pages7
JournalLung Cancer
Volume79
Issue number2
DOIs
Publication statusPublished - 2013 Feb
Externally publishedYes

Fingerprint

Adenocarcinoma
Growth
Neoplasms
Survival
Blood Vessels
Multivariate Analysis
Lymph Nodes
Smoking
Confidence Intervals

Keywords

  • Adenocarcinoma
  • Collapse area
  • Lepidic growth component
  • Pleural invasion
  • Prognostic indicator
  • Vascular invasion

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Distinctive histopathological features of lepidic growth predominant node-negative adenocarcinomas 3-5cm in size. / Takahashi, Yusuke; Ishii, Genichiro; Aokage, Keiju; Hishida, Tomoyuki; Yoshida, Junji; Nagai, Kanji.

In: Lung Cancer, Vol. 79, No. 2, 02.2013, p. 118-124.

Research output: Contribution to journalArticle

Takahashi, Yusuke ; Ishii, Genichiro ; Aokage, Keiju ; Hishida, Tomoyuki ; Yoshida, Junji ; Nagai, Kanji. / Distinctive histopathological features of lepidic growth predominant node-negative adenocarcinomas 3-5cm in size. In: Lung Cancer. 2013 ; Vol. 79, No. 2. pp. 118-124.
@article{fea780ef0665474da122016bc9ee639d,
title = "Distinctive histopathological features of lepidic growth predominant node-negative adenocarcinomas 3-5cm in size",
abstract = "Introduction: Adenocarcinoma of the lung is a morphologically heterogeneous group of tumors which includes a variable portion of different histologic subtype components: lepidic growth (LG), and acinar, papillary and solid subtypes. Among these, LG is a non-invasive component which is one of the major histological subtypes in small-sized adenocarcinoma (2. cm or less). However, in large adenocarcinomas (3-5. cm in size), the clinicopathological significance of LG components remains unclear. Methods: A series of 135 lung adenocarcinomas 3-5. cm in size, without lymph node involvement, were reviewed and classified according to their percentage of LG components. We examined the correlation between the percentage of LG components and clinicopathological factors of these tumors. Results: There were 41 (30.4{\%}) tumors with 50{\%} or more LG (LG-predominant group). Female gender (p= 0.039), smoking history of <20 pack-years (p= 0.039), absence of pleural invasion (p= 0.003), and absence of vascular invasion (p< 0.001) were significantly more frequently observed in the LG-predominant group. LG-predominant tumors showed a significantly higher percentage of non-cancerous cell collapse area to tumor area compared with non-LG predominant tumors (p< 0.001). The outcome of the LG-predominant type patients was significantly better than that of the non-LG predominant type patients in both recurrence-free survival (p< 0.001) and overall survival (p< 0.001). Multivariate analysis showed that LG-predominant tumor to be an independent favorable prognostic factor (HR = 0.285, 95{\%} confidence interval: 0.148-0.547, p= 0.014). Conclusion: Node-negative LG-predominant adenocarcinomas of 3-5. cm in size showed less invasiveness compared to non-LG predominant tumors. And LG-predominant type patients had excellent surgical outcome.",
keywords = "Adenocarcinoma, Collapse area, Lepidic growth component, Pleural invasion, Prognostic indicator, Vascular invasion",
author = "Yusuke Takahashi and Genichiro Ishii and Keiju Aokage and Tomoyuki Hishida and Junji Yoshida and Kanji Nagai",
year = "2013",
month = "2",
doi = "10.1016/j.lungcan.2012.10.013",
language = "English",
volume = "79",
pages = "118--124",
journal = "Lung Cancer",
issn = "0169-5002",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Distinctive histopathological features of lepidic growth predominant node-negative adenocarcinomas 3-5cm in size

AU - Takahashi, Yusuke

AU - Ishii, Genichiro

AU - Aokage, Keiju

AU - Hishida, Tomoyuki

AU - Yoshida, Junji

AU - Nagai, Kanji

PY - 2013/2

Y1 - 2013/2

N2 - Introduction: Adenocarcinoma of the lung is a morphologically heterogeneous group of tumors which includes a variable portion of different histologic subtype components: lepidic growth (LG), and acinar, papillary and solid subtypes. Among these, LG is a non-invasive component which is one of the major histological subtypes in small-sized adenocarcinoma (2. cm or less). However, in large adenocarcinomas (3-5. cm in size), the clinicopathological significance of LG components remains unclear. Methods: A series of 135 lung adenocarcinomas 3-5. cm in size, without lymph node involvement, were reviewed and classified according to their percentage of LG components. We examined the correlation between the percentage of LG components and clinicopathological factors of these tumors. Results: There were 41 (30.4%) tumors with 50% or more LG (LG-predominant group). Female gender (p= 0.039), smoking history of <20 pack-years (p= 0.039), absence of pleural invasion (p= 0.003), and absence of vascular invasion (p< 0.001) were significantly more frequently observed in the LG-predominant group. LG-predominant tumors showed a significantly higher percentage of non-cancerous cell collapse area to tumor area compared with non-LG predominant tumors (p< 0.001). The outcome of the LG-predominant type patients was significantly better than that of the non-LG predominant type patients in both recurrence-free survival (p< 0.001) and overall survival (p< 0.001). Multivariate analysis showed that LG-predominant tumor to be an independent favorable prognostic factor (HR = 0.285, 95% confidence interval: 0.148-0.547, p= 0.014). Conclusion: Node-negative LG-predominant adenocarcinomas of 3-5. cm in size showed less invasiveness compared to non-LG predominant tumors. And LG-predominant type patients had excellent surgical outcome.

AB - Introduction: Adenocarcinoma of the lung is a morphologically heterogeneous group of tumors which includes a variable portion of different histologic subtype components: lepidic growth (LG), and acinar, papillary and solid subtypes. Among these, LG is a non-invasive component which is one of the major histological subtypes in small-sized adenocarcinoma (2. cm or less). However, in large adenocarcinomas (3-5. cm in size), the clinicopathological significance of LG components remains unclear. Methods: A series of 135 lung adenocarcinomas 3-5. cm in size, without lymph node involvement, were reviewed and classified according to their percentage of LG components. We examined the correlation between the percentage of LG components and clinicopathological factors of these tumors. Results: There were 41 (30.4%) tumors with 50% or more LG (LG-predominant group). Female gender (p= 0.039), smoking history of <20 pack-years (p= 0.039), absence of pleural invasion (p= 0.003), and absence of vascular invasion (p< 0.001) were significantly more frequently observed in the LG-predominant group. LG-predominant tumors showed a significantly higher percentage of non-cancerous cell collapse area to tumor area compared with non-LG predominant tumors (p< 0.001). The outcome of the LG-predominant type patients was significantly better than that of the non-LG predominant type patients in both recurrence-free survival (p< 0.001) and overall survival (p< 0.001). Multivariate analysis showed that LG-predominant tumor to be an independent favorable prognostic factor (HR = 0.285, 95% confidence interval: 0.148-0.547, p= 0.014). Conclusion: Node-negative LG-predominant adenocarcinomas of 3-5. cm in size showed less invasiveness compared to non-LG predominant tumors. And LG-predominant type patients had excellent surgical outcome.

KW - Adenocarcinoma

KW - Collapse area

KW - Lepidic growth component

KW - Pleural invasion

KW - Prognostic indicator

KW - Vascular invasion

UR - http://www.scopus.com/inward/record.url?scp=84872136199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872136199&partnerID=8YFLogxK

U2 - 10.1016/j.lungcan.2012.10.013

DO - 10.1016/j.lungcan.2012.10.013

M3 - Article

VL - 79

SP - 118

EP - 124

JO - Lung Cancer

JF - Lung Cancer

SN - 0169-5002

IS - 2

ER -