Prognosis of the second predominant subtype in lung adenocarcinoma: a retrospective single-center cohort study

Abstract

Background: The histologic classification of lung adenocarcinoma (LUAD) was mainly divided into three pathological subtype groups: the low-grade predominant subtype group (lepidic), the intermediategrade predominant subtype group (papillary and acinar), and the high-grade predominant subtype group (micropapillary and solid). Previous studies have focused on the prognostic impact of predominant subtypes of lung adenocarcinoma. In this investigation, we investigated the effect of the second predominant subtype on prognosis. Methods:The data of LUAD postoperative patients were retrospectively collected. Exclusion criteria included cases in which the pathologic results revealed a single characteristic, the presence of invasive mucinous LUAD, or if the first predominant and the second predominant groups could not be distinguished.Categorical variables were compared with the two-tailed Pearson χ 2 test and continuous variables with the Student's t-test. Follow-up was conducted by telephone and other methods. Independent prognostic factors of the second major subtype were determined by the Kaplan-Meier method and log-rank test. The Cox proportional risk regression model was used to analyze the possible prognostic factors.Results: Among 293 patients, the mean age was 61.9 years and 47.1% were male. The results revealed that when the predominant group was the low-grade group, the second predominant groups had no significant influence on overall survival (OS) (P=0.15) but significantly influenced disease free survival (DFS) (P=0.037).Subsequently, when the predominant group was the intermediate-grade group, the second predominant groups significantly influenced OS (P=0.024) but had no significant influence on DFS (P=0.3). Moreover, when the predominant group was the high-grade group, the second predominant groups significantly influenced OS (P=0.033) but had no significant influence on DFS (P=0.31). Conclusions:The independent prognostic effect of the second predominant group was not identified for OS and DFS of lung adenocarcinoma. The effects of the second predominant subtype groups on OS and DFS were not evenly distributed among different predominant subtype groups, and the low-grade second predominant subtype exhibited some protective effects on the middle-grade predominant subtypes.

Construction of subtype classifiers and validation of a prognostic risk model based on hypoxia-associated lncRNAs for lung adenocarcinoma

“…Lung adenocarcinoma (LUAD) is a global lethal malignancy with extensive molecular heterogeneity ( 1 , 2 ). Since 2015, the World Health Organization (WHO) has classified LUAD into inert invasive, microinvasive, and predominantly adnexal.…”

Clinical significance of TMEM229A Q200del mutation in lung adenocarcinoma

“…To get a better explanation for the underlying mechanisms beyond tumorigenesis and malignant discrepancy, several studies were performed to assess the molecular mechanisms and genetic changes of LUAD subtypes, especially on micropapillary lung adenocarcinoma [8][9][10][11]. Two recent studies indicated that patients with micropapillary components had induced the disruption of the catenincadherin complex, contributing to its intracellular adherence [12,13]. In addition, our previous study demonstrated that micropapillary lung adenocarcinoma had a signi cantly higher tumor mutation burden, such as EGFR mutations, ROS1 fusions.…”