Lung adenocarcinoma with mixed bronchioloalveolar and invasive components: Clinicopathological features, subclassification by extent of invasive foci, and immunohistochemical characterization

Hiroshi Terasaki, Toshiro Niki, Yoshihiro Matsuno, Tesshi Yamada, Arafumi Maeshima, Hisao Asamura, Naofumi Hayabuchi, Setsuo Hirohashi

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

A significant proportion of small lung adenocarcinomas consists of two components: bronchioloalveolar carcinoma (BAC) and invasive carcinoma. The purpose of this study was to compare their clinicopathologic features with those of BAC and those of invasive cancer without BAC, and to define "early invasive" lesions based on the extent of invasive foci. We reviewed 484 lesions of resected lung adenocarcinoma and classified them into three groups according to tumor growth pattern: group 1 (n = 102, BAC), group 2 (n = 216, adenocarcinoma consisting of BAC and invasive carcinoma), and group 3 (n = 166, invasive adenocarcinoma without BAC component). Group 2 was further subdivided according to the extent of the invasive area: group 2a (n = 54), BAC with invasive foci ≤5 mm; group 2b (n = 162), BAC with invasive foci >5 mm. These groups were compared with regard to their clinicopathologic features, expression of Ki-67 and p53, and expression of laminin-5, a putative marker for tumor invasion. The positivity rates of vascular, lymphatic, and pleural invasion in each group were as follows: 0%, 0%, and 0% in group 1; 5.5%, 14.8%, and 1.9% in group 2a; 45.7%, 41.4%, and 25.9% in group 2b; and 84.9%, 61.4%, and 60.8% in group 3. Notably, no lymph node metastasis occurred in either group 2a or group 1, but it was observed in 24.1% of group 2b and 47.0% of group 3. The mean Ki-67 labeling index, the frequency of p53 overexpression, and the frequency of laminin-5 overexpression increased from group 1 (11%, 4%, and 0%) to group 2a (16%, 20%, and 7%) to group 2b (24%, 41%, and 23%) to group 3 (35%, 38%, and 38%). In contrast, no clear differences were observed when lesions were subdivided according to size. Based on the distribution pattern of Ki-67-positive tumor cells, lesions were classified into two groups: marginal type (63%) and nonmarginal type (37%). The latter showed a significantly higher labeling index than the former. Moreover, the proportion of the marginal type clearly decreased from group 1 (85%) and group 2a (87%) to group 2b (55%) to group 3 (19%). Group 2 lesions showed characteristics intermediate between the BAC and invasive adenocarcinoma. According to the extent of the invasive area, we were able to define a subgroup of mixed-type adenocarcinomas (group 2a) that could be regarded as early invasive cancer because they showed low rates of vascular, lymphatic, and pleural invasion, and no nodal involvement.

Original languageEnglish
Pages (from-to)937-951
Number of pages15
JournalAmerican Journal of Surgical Pathology
Volume27
Issue number7
DOIs
Publication statusPublished - 2003 Jul 1
Externally publishedYes

Fingerprint

Bronchiolo-Alveolar Adenocarcinoma
Adenocarcinoma
Blood Vessels
Neoplasms
Carcinoma
Adenocarcinoma of lung
Tumor Biomarkers
Lymph Nodes
Neoplasm Metastasis

Keywords

  • Bronchioloalveolar carcinoma
  • Ki-67
  • Laminin-5.
  • Lung adenocarcinoma
  • P53

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Lung adenocarcinoma with mixed bronchioloalveolar and invasive components : Clinicopathological features, subclassification by extent of invasive foci, and immunohistochemical characterization. / Terasaki, Hiroshi; Niki, Toshiro; Matsuno, Yoshihiro; Yamada, Tesshi; Maeshima, Arafumi; Asamura, Hisao; Hayabuchi, Naofumi; Hirohashi, Setsuo.

In: American Journal of Surgical Pathology, Vol. 27, No. 7, 01.07.2003, p. 937-951.

Research output: Contribution to journalArticle

Terasaki, Hiroshi ; Niki, Toshiro ; Matsuno, Yoshihiro ; Yamada, Tesshi ; Maeshima, Arafumi ; Asamura, Hisao ; Hayabuchi, Naofumi ; Hirohashi, Setsuo. / Lung adenocarcinoma with mixed bronchioloalveolar and invasive components : Clinicopathological features, subclassification by extent of invasive foci, and immunohistochemical characterization. In: American Journal of Surgical Pathology. 2003 ; Vol. 27, No. 7. pp. 937-951.
@article{b3edcd4c5e6c4ac3ae1258a3a7fb3a16,
title = "Lung adenocarcinoma with mixed bronchioloalveolar and invasive components: Clinicopathological features, subclassification by extent of invasive foci, and immunohistochemical characterization",
abstract = "A significant proportion of small lung adenocarcinomas consists of two components: bronchioloalveolar carcinoma (BAC) and invasive carcinoma. The purpose of this study was to compare their clinicopathologic features with those of BAC and those of invasive cancer without BAC, and to define {"}early invasive{"} lesions based on the extent of invasive foci. We reviewed 484 lesions of resected lung adenocarcinoma and classified them into three groups according to tumor growth pattern: group 1 (n = 102, BAC), group 2 (n = 216, adenocarcinoma consisting of BAC and invasive carcinoma), and group 3 (n = 166, invasive adenocarcinoma without BAC component). Group 2 was further subdivided according to the extent of the invasive area: group 2a (n = 54), BAC with invasive foci ≤5 mm; group 2b (n = 162), BAC with invasive foci >5 mm. These groups were compared with regard to their clinicopathologic features, expression of Ki-67 and p53, and expression of laminin-5, a putative marker for tumor invasion. The positivity rates of vascular, lymphatic, and pleural invasion in each group were as follows: 0{\%}, 0{\%}, and 0{\%} in group 1; 5.5{\%}, 14.8{\%}, and 1.9{\%} in group 2a; 45.7{\%}, 41.4{\%}, and 25.9{\%} in group 2b; and 84.9{\%}, 61.4{\%}, and 60.8{\%} in group 3. Notably, no lymph node metastasis occurred in either group 2a or group 1, but it was observed in 24.1{\%} of group 2b and 47.0{\%} of group 3. The mean Ki-67 labeling index, the frequency of p53 overexpression, and the frequency of laminin-5 overexpression increased from group 1 (11{\%}, 4{\%}, and 0{\%}) to group 2a (16{\%}, 20{\%}, and 7{\%}) to group 2b (24{\%}, 41{\%}, and 23{\%}) to group 3 (35{\%}, 38{\%}, and 38{\%}). In contrast, no clear differences were observed when lesions were subdivided according to size. Based on the distribution pattern of Ki-67-positive tumor cells, lesions were classified into two groups: marginal type (63{\%}) and nonmarginal type (37{\%}). The latter showed a significantly higher labeling index than the former. Moreover, the proportion of the marginal type clearly decreased from group 1 (85{\%}) and group 2a (87{\%}) to group 2b (55{\%}) to group 3 (19{\%}). Group 2 lesions showed characteristics intermediate between the BAC and invasive adenocarcinoma. According to the extent of the invasive area, we were able to define a subgroup of mixed-type adenocarcinomas (group 2a) that could be regarded as early invasive cancer because they showed low rates of vascular, lymphatic, and pleural invasion, and no nodal involvement.",
keywords = "Bronchioloalveolar carcinoma, Ki-67, Laminin-5., Lung adenocarcinoma, P53",
author = "Hiroshi Terasaki and Toshiro Niki and Yoshihiro Matsuno and Tesshi Yamada and Arafumi Maeshima and Hisao Asamura and Naofumi Hayabuchi and Setsuo Hirohashi",
year = "2003",
month = "7",
day = "1",
doi = "10.1097/00000478-200307000-00009",
language = "English",
volume = "27",
pages = "937--951",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Lung adenocarcinoma with mixed bronchioloalveolar and invasive components

T2 - Clinicopathological features, subclassification by extent of invasive foci, and immunohistochemical characterization

AU - Terasaki, Hiroshi

AU - Niki, Toshiro

AU - Matsuno, Yoshihiro

AU - Yamada, Tesshi

AU - Maeshima, Arafumi

AU - Asamura, Hisao

AU - Hayabuchi, Naofumi

AU - Hirohashi, Setsuo

PY - 2003/7/1

Y1 - 2003/7/1

N2 - A significant proportion of small lung adenocarcinomas consists of two components: bronchioloalveolar carcinoma (BAC) and invasive carcinoma. The purpose of this study was to compare their clinicopathologic features with those of BAC and those of invasive cancer without BAC, and to define "early invasive" lesions based on the extent of invasive foci. We reviewed 484 lesions of resected lung adenocarcinoma and classified them into three groups according to tumor growth pattern: group 1 (n = 102, BAC), group 2 (n = 216, adenocarcinoma consisting of BAC and invasive carcinoma), and group 3 (n = 166, invasive adenocarcinoma without BAC component). Group 2 was further subdivided according to the extent of the invasive area: group 2a (n = 54), BAC with invasive foci ≤5 mm; group 2b (n = 162), BAC with invasive foci >5 mm. These groups were compared with regard to their clinicopathologic features, expression of Ki-67 and p53, and expression of laminin-5, a putative marker for tumor invasion. The positivity rates of vascular, lymphatic, and pleural invasion in each group were as follows: 0%, 0%, and 0% in group 1; 5.5%, 14.8%, and 1.9% in group 2a; 45.7%, 41.4%, and 25.9% in group 2b; and 84.9%, 61.4%, and 60.8% in group 3. Notably, no lymph node metastasis occurred in either group 2a or group 1, but it was observed in 24.1% of group 2b and 47.0% of group 3. The mean Ki-67 labeling index, the frequency of p53 overexpression, and the frequency of laminin-5 overexpression increased from group 1 (11%, 4%, and 0%) to group 2a (16%, 20%, and 7%) to group 2b (24%, 41%, and 23%) to group 3 (35%, 38%, and 38%). In contrast, no clear differences were observed when lesions were subdivided according to size. Based on the distribution pattern of Ki-67-positive tumor cells, lesions were classified into two groups: marginal type (63%) and nonmarginal type (37%). The latter showed a significantly higher labeling index than the former. Moreover, the proportion of the marginal type clearly decreased from group 1 (85%) and group 2a (87%) to group 2b (55%) to group 3 (19%). Group 2 lesions showed characteristics intermediate between the BAC and invasive adenocarcinoma. According to the extent of the invasive area, we were able to define a subgroup of mixed-type adenocarcinomas (group 2a) that could be regarded as early invasive cancer because they showed low rates of vascular, lymphatic, and pleural invasion, and no nodal involvement.

AB - A significant proportion of small lung adenocarcinomas consists of two components: bronchioloalveolar carcinoma (BAC) and invasive carcinoma. The purpose of this study was to compare their clinicopathologic features with those of BAC and those of invasive cancer without BAC, and to define "early invasive" lesions based on the extent of invasive foci. We reviewed 484 lesions of resected lung adenocarcinoma and classified them into three groups according to tumor growth pattern: group 1 (n = 102, BAC), group 2 (n = 216, adenocarcinoma consisting of BAC and invasive carcinoma), and group 3 (n = 166, invasive adenocarcinoma without BAC component). Group 2 was further subdivided according to the extent of the invasive area: group 2a (n = 54), BAC with invasive foci ≤5 mm; group 2b (n = 162), BAC with invasive foci >5 mm. These groups were compared with regard to their clinicopathologic features, expression of Ki-67 and p53, and expression of laminin-5, a putative marker for tumor invasion. The positivity rates of vascular, lymphatic, and pleural invasion in each group were as follows: 0%, 0%, and 0% in group 1; 5.5%, 14.8%, and 1.9% in group 2a; 45.7%, 41.4%, and 25.9% in group 2b; and 84.9%, 61.4%, and 60.8% in group 3. Notably, no lymph node metastasis occurred in either group 2a or group 1, but it was observed in 24.1% of group 2b and 47.0% of group 3. The mean Ki-67 labeling index, the frequency of p53 overexpression, and the frequency of laminin-5 overexpression increased from group 1 (11%, 4%, and 0%) to group 2a (16%, 20%, and 7%) to group 2b (24%, 41%, and 23%) to group 3 (35%, 38%, and 38%). In contrast, no clear differences were observed when lesions were subdivided according to size. Based on the distribution pattern of Ki-67-positive tumor cells, lesions were classified into two groups: marginal type (63%) and nonmarginal type (37%). The latter showed a significantly higher labeling index than the former. Moreover, the proportion of the marginal type clearly decreased from group 1 (85%) and group 2a (87%) to group 2b (55%) to group 3 (19%). Group 2 lesions showed characteristics intermediate between the BAC and invasive adenocarcinoma. According to the extent of the invasive area, we were able to define a subgroup of mixed-type adenocarcinomas (group 2a) that could be regarded as early invasive cancer because they showed low rates of vascular, lymphatic, and pleural invasion, and no nodal involvement.

KW - Bronchioloalveolar carcinoma

KW - Ki-67

KW - Laminin-5.

KW - Lung adenocarcinoma

KW - P53

UR - http://www.scopus.com/inward/record.url?scp=0038001501&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038001501&partnerID=8YFLogxK

U2 - 10.1097/00000478-200307000-00009

DO - 10.1097/00000478-200307000-00009

M3 - Article

C2 - 12826886

AN - SCOPUS:0038001501

VL - 27

SP - 937

EP - 951

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 7

ER -