Johanna M Mäkinen1,2, Kirsi Laitakari3, Shirley Johnson3, Riitta Mäkitaro3, Risto Bloigu4, Paavo Pääkkö5, Elisa Lappi-Blanco1,5, Riitta Kaarteenaho3,6. 1. Department of Pathology, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland. 2. Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland. 3. Department of Internal Medicine, Respiratory Research Unit, Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland. 4. Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland. 5. Department of Pathology, Oulu University Hospital, Oulu, Finland. 6. Unit of Medicine and Clinical Research, Pulmonary Division, University of Eastern Finland and Centre of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland.
Abstract
AIMS: Until the launch of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society adenocarcinoma classification in 2011, there were no uniform histological grading criteria for pulmonary adenocarcinomas. The current classification highlights the prognostic importance of the various histological growth patterns observed in these morphologically heterogeneous neoplasias. In this study, we aimed to evaluate the classic histological parameters of malignancy in correlation with the growth patterns and patient outcomes in a series of 112 surgically operated stage I-IV lung adenocarcinomas. METHODS AND RESULTS: Architectural growth pattern analysis was performed according to the current adenocarcinoma classification. Histological features including, for example, nuclear atypia, mitotic activity, tumour necrosis, and different patterns of invasion were assessed and correlated statistically with the architecture and the clinical data. A solid predominant histology was associated with increased levels of atypia (P = 0.027), mitotic activity (P < 0.001), necrosis (P < 0.001), and lymphovascular invasion (P = 0.001), and a non-predominant solid pattern was associated with intra-alveolar tumour spread (P = 0.004). The presence of a non-predominant lepidic tumour component showed inverse correlations with atypia (P = 0.002), mitotic rate (P = 0.009), and tumour necrosis (P < 0.001). Tumour size (P < 0.001), mitotic activity (P = 0.019), tumour necrosis (P = 0.002), lymphovascular invasion (P = 0.001) and visceral pleural involvement (P = 0.001) were all associated with reduced disease-specific survival. CONCLUSIONS: The classic histological features of malignancy correlate with tumour architecture and patient outcome, confirming the prognostic value of the growth pattern analysis and questioning the need for a parallel grading system in pulmonary adenocarcinoma.
AIMS: Until the launch of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society adenocarcinoma classification in 2011, there were no uniform histological grading criteria for pulmonary adenocarcinomas. The current classification highlights the prognostic importance of the various histological growth patterns observed in these morphologically heterogeneous neoplasias. In this study, we aimed to evaluate the classic histological parameters of malignancy in correlation with the growth patterns and patient outcomes in a series of 112 surgically operated stage I-IV lung adenocarcinomas. METHODS AND RESULTS: Architectural growth pattern analysis was performed according to the current adenocarcinoma classification. Histological features including, for example, nuclear atypia, mitotic activity, tumour necrosis, and different patterns of invasion were assessed and correlated statistically with the architecture and the clinical data. A solid predominant histology was associated with increased levels of atypia (P = 0.027), mitotic activity (P < 0.001), necrosis (P < 0.001), and lymphovascular invasion (P = 0.001), and a non-predominant solid pattern was associated with intra-alveolar tumour spread (P = 0.004). The presence of a non-predominant lepidic tumour component showed inverse correlations with atypia (P = 0.002), mitotic rate (P = 0.009), and tumour necrosis (P < 0.001). Tumour size (P < 0.001), mitotic activity (P = 0.019), tumour necrosis (P = 0.002), lymphovascular invasion (P = 0.001) and visceral pleural involvement (P = 0.001) were all associated with reduced disease-specific survival. CONCLUSIONS: The classic histological features of malignancy correlate with tumour architecture and patient outcome, confirming the prognostic value of the growth pattern analysis and questioning the need for a parallel grading system in pulmonary adenocarcinoma.
Authors: Zheng Wang; Lin Zhang; Lei He; Di Cui; Chenglong Liu; Liangyu Yin; Min Zhang; Lei Jiang; Yuyan Gong; Wang Wu; Bi Liu; Xiaoyu Li; David S Cram; Dongge Liu Journal: Chin J Cancer Res Date: 2020-06 Impact factor: 5.087
Authors: Andre L Moreira; Paolo S S Ocampo; Yuhe Xia; Hua Zhong; Prudence A Russell; Yuko Minami; Wendy A Cooper; Akihiko Yoshida; Lukas Bubendorf; Mauro Papotti; Giuseppe Pelosi; Fernando Lopez-Rios; Keiko Kunitoki; Dana Ferrari-Light; Lynette M Sholl; Mary Beth Beasley; Alain Borczuk; Johan Botling; Elisabeth Brambilla; Gang Chen; Teh-Ying Chou; Jin-Haeng Chung; Sanja Dacic; Deepali Jain; Fred R Hirsch; David Hwang; Sylvie Lantuejoul; Dongmei Lin; John W Longshore; Noriko Motoi; Masayuki Noguchi; Claudia Poleri; Natasha Rekhtman; Ming-Sound Tsao; Erik Thunnissen; William D Travis; Yasushi Yatabe; Anja C Roden; Jillian B Daigneault; Ignacio I Wistuba; Keith M Kerr; Harvey Pass; Andrew G Nicholson; Mari Mino-Kenudson Journal: J Thorac Oncol Date: 2020-06-17 Impact factor: 15.609