Tomohiro Ichikawa1, Keiju Aokage2, Masato Sugano3, Tomohiro Miyoshi2, Motohiro Kojima4, Satoshi Fujii4, Takeshi Kuwata3, Atsushi Ochiai5, Kenji Suzuki6, Masahiro Tsuboi2, Genichiro Ishii7. 1. Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan; Department of Thoracic Surgery, National Cancer Center Hospital, Kashiwa, Chiba, Japan; Departments of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan; Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan. 2. Department of Thoracic Surgery, National Cancer Center Hospital, Kashiwa, Chiba, Japan. 3. Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan. 4. Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan. 5. Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan. 6. Departments of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. 7. Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan. Electronic address: gishi@east.ncc.go.jp.
Abstract
OBJECTIVES: This study evaluated whether the proportion of cancer cells to non-cancerous stroma within the invasive area is associated with the prognosis of patients with lung adenocarcinoma. MATERIALS AND METHODS: A total of 127 patients with lung adenocarcinomas with tumors larger than 3 cm in total size were enrolled in this study. We classified the tumors according to the ratio of area occupied by cancer cells within the invasive area (Type A: more than 50% of the invasive area, Type B: 10-50%, and Type C: less than 10%) and analyzed the clinicopathological differences between Types A, B, and C. RESULTS: The invasive size of Type A tumors (n = 35) was significantly larger than those of the other two tumor types; however, there was no significant difference in the invasive size between Types B (n = 65) and C (n = 25) tumors. The recurrence-free survival time of patients with Type C tumors was significantly longer than those of patients with Type A and B (P < .001) tumors. Multivariate analysis revealed that Type C tumor was an independent favorable prognostic factor (P = .037) but that invasive size was not. The invasive area of Type C tumor was composed of a significantly higher proportion of collapsed elastic fibers than the invasive areas of Type A and B tumors (P < .001). CONCLUSION: A lower cancer cell to stroma ratio within the invasive area could be a significant prognostic factor in lung adenocarcinoma, suggesting that not only the invasive size but also the invasive character might be an important histologic prognostic parameter.
OBJECTIVES: This study evaluated whether the proportion of cancer cells to non-cancerous stroma within the invasive area is associated with the prognosis of patients with lung adenocarcinoma. MATERIALS AND METHODS: A total of 127 patients with lung adenocarcinomas with tumors larger than 3 cm in total size were enrolled in this study. We classified the tumors according to the ratio of area occupied by cancer cells within the invasive area (Type A: more than 50% of the invasive area, Type B: 10-50%, and Type C: less than 10%) and analyzed the clinicopathological differences between Types A, B, and C. RESULTS: The invasive size of Type A tumors (n = 35) was significantly larger than those of the other two tumor types; however, there was no significant difference in the invasive size between Types B (n = 65) and C (n = 25) tumors. The recurrence-free survival time of patients with Type C tumors was significantly longer than those of patients with Type A and B (P < .001) tumors. Multivariate analysis revealed that Type C tumor was an independent favorable prognostic factor (P = .037) but that invasive size was not. The invasive area of Type C tumor was composed of a significantly higher proportion of collapsed elastic fibers than the invasive areas of Type A and B tumors (P < .001). CONCLUSION: A lower cancer cell to stroma ratio within the invasive area could be a significant prognostic factor in lung adenocarcinoma, suggesting that not only the invasive size but also the invasive character might be an important histologic prognostic parameter.
Authors: Clifford W Sandlin; Song Gu; Jun Xu; Charuhas Deshpande; Michael D Feldman; Matthew C Good Journal: PLoS One Date: 2022-10-06 Impact factor: 3.752