Identification of Factors for the Preoperative Prediction of Tumour Subtype and Prognosis in Patients with T1 Lung Adenocarcinoma

Abstract

Aims. Identification of factors that can predict the subtypes of lung adenocarcinoma preoperatively is important for selecting the appropriate surgical procedure and for predicting postoperative survival. Methods. We retrospectively evaluated 87 patients with lung adenocarcinomas ≤30 mm. Results. Preoperative radiological findings, serum CEA level, serum microRNA-183 (miR-183) level, and tumour size differed significantly between patients with adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA) and those with invasive adenocarcinoma (IAC). Receiver operating characteristic curves and univariate analysis revealed that patients who were older than 57 years or had a pure solid nodule or a tumour with mixed ground-glass opacity (mGGO), a tumour >11 mm, a serum CEA level >2.12 ng/mL, or a serum miR-183 level >1.233 (2−ΔΔCt) were more likely to be diagnosed with IAC than with AIS or MIA. The combination of all five factors had an area under the curve of 0.946, with a sensitivity of 89.13% and a specificity of 95.12%. Moreover, patients with a cut-off value >0.499 for the five-factor combination had poor overall survival. Conclusions. The five-factor combination enables clinicians to distinguish AIS or MIA from IAC, thereby aiding in selecting the appropriate treatment, and to predict the prognosis of lung adenocarcinoma patients.

Oncogenic role of miR‑183‑5p in lung adenocarcinoma: A comprehensive study of qPCR, in�vitro experiments and bioinformatic analysis

“…miR-183-5p was reported to be overexpressed in LUAD and to correlate with the tumor progression as well as poor prognosis of LUAD ( 14 ). In a study of Zhu et al , miR-183-5p exhibited a significant ability to distinguish between non-invasive and invasive LUAD ( 15 ). An in vitro study by Zhu et al declared that miR-183-5p targets PTPN4 to promote the migratory and invasive capacity of LUAD cells ( 16 ).…”

Epidermal Growth Factor Receptor Mutations and Their Prognostic Value with Carcinoembryonic Antigen in Pathological T1 Lung Adenocarcinoma

“…The CEA level was higher in EGFR mutated patients than in the wild-type patients [1.83 (1.22, 2.91) versus 1.61 (1.05, 2.54), P = 0.0209, Figure 1 ]. Mutations were more likely to occur in patients with carcinoembryonic antigen ≥ 2.12 ng/mL ( P = 0.030), a threshold identified in our previous survey [ 15 ]. Mutations were also associated with tumour size pT1b and pT1c ( P < 0.001), pleural invasion ( P = 0.016), histology ( P < 0.001), lymphatic metastasis ( P = 0.026), and stage ( P < 0.001).…”

“…We surveyed the prognostic value of EGFR mutations in a cohort of 573 patients from East China who underwent surgical resection of pathological T1 lung carcinoma. In particular, we analysed EGFR mutations in patients with preoperational carcinoembryonic antigen levels ≥ 2.12 ng/mL, a key prognostic threshold identified in our previous study [ 15 ]. The data suggest that although disease-free and overall survival was comparable between patients with or without EGFR mutations, patients with exon 21 mutations had extended overall survival in comparison with patients with exon 19 deletion.…”

“…On the basis of our previous study, we stratified the patients by serum carcinoembryonic antigen levels [ 15 ]. The new data indicate that serum carcinoembryonic antigen levels ≥ 2.12 ng/mL are associated with EGFR mutations, as previously observed in lung cancer [ 13 , 26 , 27 ].…”

“…Moreover, carcinoembryonic antigen levels were reported to be independently prognostic in lung adenocarcinoma patients without EGFR mutations [ 14 ]. Indeed, we also found that lung adenocarcinoma patients with carcinoembryonic antigen levels above 2.12 ng/mL have a poor prognosis [ 15 ]. Nevertheless, other surveys indicated that carcinoembryonic antigen levels are normal in most patients with early-stage lung cancer.…”