Characterization of lung adenocarcinoma with a cribriform component reveals its association with spread through air spaces and poor outcomes

Ding, Qifeng; Chen, Donglai; Wang, Xiaofan; Wen, Junmiao; Chen, Chang; Zhang, Yongsheng; Xu, Zhonghua; Chen, Yongbing

doi:10.1016/j.lungcan.2019.06.027

Cited by 20 publications

(16 citation statements)

References 28 publications

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“…17,18 Positive STAS was observed to be associated with old age (>65 years), male sex, smoking, abnormal serum carcinoembryonic antigen level, larger tumor size, nonlepidic (micropapillary/solid) predominant, cribriform component, moderate/poor differentiation, visceral pleural invasion, lymphovascular invasion, presence of nodal and distant metastasis and higher T, N and pathological stage. [16][17][18][19][20][21] In survival analyses, STAS was an independent risk factor for worse recurrence-free survival (RFS) and overall survival (OS). 17,18,20 Similar results were identified in particular studies of stage I and stage III (N2) ADC.…”

Section: Clinicopathologic Features and Prognosis Of Stasmentioning

confidence: 99%

<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

Meng¹,

Yu²,

Gao³

et al. 2020

CMAR

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Background: Spread through air spaces (STAS) is a spreading phenomenon of lung cancers, which is defined as tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. To date, several articles have reviewed the studies concerning the significance of STAS; however, most articles focused on the prognosis without summarizing the significance of STAS on other aspects. In this review, we comprehensively summarized the current literature related to STAS, so as to explore the clinical significance of STAS from multiple perspectives. Main Body: This section provided a comprehensive overview of the significance of STAS from multiple perspectives and summarized current controversies and challenges in the diagnosis and clinical application. Conclusion: STAS is a conspicuous spreading phenomenon of lung cancers indicating worse prognosis; nevertheless, the treatment strategy for patients with STAS remains to be discussed. Further studies are needed to elaborate whether a STAS-positive patient who underwent limited resection needs a second operation or postoperative adjuvant treatment. Meanwhile, the internal mechanism of STAS formation is largely undiscovered. Whether the capability of detachment-migration-reattachment in STAS tumor cells is achieved at the time of primary tumorigenesis or in the progress of tumor development needs to be studied, and the related signal pathways or genetic alterations need to be explored. With this information, it may be possible to improve the prognosis of patients with STAS-positive lung cancers.

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Section: Clinicopathologic Features and Prognosis Of Stasmentioning

confidence: 99%

<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

Meng¹,

Yu²,

Gao³

et al. 2020

CMAR

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“…The disease-free survival (DFS) of patients with CPA is significantly decreased compared to the patients with LPA (HR = 2.99, 95 %CI: [1.16-7.68]). Prognostic significance of the cribriform growth pattern in lung adenocarcinoma has been also confirmed by other studies [11,12,15,[30][31][32]. By now, only one study pointed out that there were no differences between APA and CPA, but the credibility of the results may be unreliable due to the limited number of patients (n = 8) [33].…”

Section: The Prognosis Of Cribriform Growth Pattern In Lung Adenocarcmentioning

confidence: 59%

“…(D) The solid growth pattern had invasive solid tumor nests without glandular lumina. [8,9,11,[14][15][16], and was significantly associated with male and smoker (or ex-smoker) in the previous reports [8,9,12]. However, some recent studies pointed out that the rates of female and non-smoker are increasing in the patients with CPA [15,16].…”

Section: The Clinicopathological Features Of Cribriform Growth Pattermentioning

confidence: 82%

“…Cribriform growth pattern is often accompanied with mucus production or necrotic debris [7][8][9]. Cribriform growth pattern is mainly observed in APA and SPA [9,11,12]. By comparison with high-grade subtypes of lung adenocarcinoma, the nuclear grading of cribriform growth pattern is more similar to that of solid and micropapillary pattern [13].…”

Section: The Clinicopathological Features Of Cribriform Growth Pattermentioning

confidence: 99%

“…Meanwhile Ding. et al [12] regarded 5% as cribriform component present and found that the difference of cumulative incidence of recurrence (CIR) and OS were significant (5-year locoregional CIR: 57 % vs 20 %, P < 0.001; 5-year distant CIR: 31 % vs 9%, P < 0.001; 5-year OS: 8% vs 56 %, P < 0.001). Zhang et al [16] divided APA into without and with a cribriform growth pattern based on the cut-off value of 5%, and found a significant difference in OS and DFS between two groups (Mean OS: 66.6 months vs 36.1 months, P < 0.001; Mean DFS: 46.4 months vs 27.6 months, P = 0.005).…”

Section: The Prognosis Of Cribriform Growth Pattern In Lung Adenocarcmentioning

confidence: 99%

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Cribriform growth pattern in lung adenocarcinoma: More aggressive and poorer prognosis than acinar growth pattern

et al. 2020

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The predictive value of prognosis based on the histopathological subtype is a critical criterion in the new classification of lung adenocarcinoma published in 2011 by the International Association for the Study of Lung Cancer (IASLC), the American Thoracic Society (ATS), and the European Respiratory Society (ERS) (IASLC/ATS/ ERS). In this new classification, the differences of histopathology and prognosis are two considerable parameters to classify the subtypes of lung adenocarcinoma. Cribriform growth pattern is regarded as a variant of acinar growth pattern in lung adenocarcinoma, however, more and more studies pointed out that cribriform growth pattern is associated with more aggressive histopathological structures, higher proportion of recurrence rates, and shorter postoperative survival than acinar growth pattern. These features are similar to solid or micropapillary predominant adenocarcinoma. In this review, we summarized the clinicopathological features, prognosis, and genetic variations of cribriform growth pattern of lung adenocarcinoma, and provided a novel insight into the diagnosis and treatment of cribriform lung adenocarcinoma.

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Clinical implications and molecular features of tertiary lymphoid structures in stage I lung adenocarcinoma

Gao

Duan

et al. 2023

Cancer Medicine

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Aims We investigated the clinical implications and molecular features of TLS in stage I lung adenocarcinoma (LUAD). Methods We retrospectively reviewed the clinicopathological characteristics of 540 patients with p ‐stage I LUAD. Logistic regression analysis was applied to determining the relationships between clinicopathological features and the presence of TLS. TLS‐associated immune infiltration pattern and signature genes were characterized using the transcriptomic profiles of 511 LUADs from The Cancer Genome Atlas (TCGA) database. Results The presence of TLS was associated with a higher pT stage, low‐ and middle‐grade patterns, and the absence of tumor spreading through air spaces (STAS) and subsolid nodules. Multivariate Cox regression analysis identified that the presence of TLS was associated with favorable overall survival (OS) ( p < 0.001) and recurrence‐free survival (RFS) ( p < 0.001). Subgroup analysis showed that the most favorable OS ( p < 0.001) and RFS ( p < 0.001) favored the TLS + PD‐1‐ subgroup. The presence of TLS was characterized by abundance in antitumor immunocytes including activated CD8+ T and B cells as well as dentritic cells in TCGA cohort. Conclusion The presence of TLS was an independent favorable factor for patients with stage I LUAD. The presence TLS was featured by special immune profiles which might aid oncologists in determining personalized adjuvant treatment.

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Characterization of lung adenocarcinoma with a cribriform component reveals its association with spread through air spaces and poor outcomes

Cited by 20 publications

References 28 publications

<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

<p>Spread Through Air Spaces (STAS) in Lung Cancer: A Multiple-Perspective and Update Review</p>

Cribriform growth pattern in lung adenocarcinoma: More aggressive and poorer prognosis than acinar growth pattern

Clinical implications and molecular features of tertiary lymphoid structures in stage I lung adenocarcinoma

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