Abstract
ObjectivesAccording to the IASLC/ATS/ERS 2011 classification, there are two new conceptions of lung adenocarcinoma, adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), which are very early stages of lung adenocarcinoma. This study aimed to analyze clinical features of AIS and MIA and determine the expression profile of PD-L1 in AIS and MIA.ResultsIn all 274 patients, 77 were diagnosed as AIS and 197 as MIA. We accidentally found 4 patients with recurrence, which were all MIA. The median age of the patients at diagnosis was both 52 years. 71.4% were female in AIS as while as 71.1% in MIA. 36.4% patients were observed with ever symptoms in AIS and 28.9% in MIA. 12.9% and 8.6% had smoking history respectively in AIS an MIA. All AIS and MIA cases were PD-L1 negative. There was significant association between symptoms and more mild progression of nodules in chest CT before surgery.Materials and MethodsWe analyzed some clinical features of 274 patients including age, sex, smoking history, family history, surgery, EGFR mutation, ALK, ROS-1, serum CEA level et al. The expression of PD-L1 was evaluated by immunohistochemical analysis in 37 specimens of MIA and 17 specimens of AIS.ConclusionsThere are no significant differences between AIS and MIA in clinical features. AIS and MIA almost do not express PD-L1 protein and without any lymph node metastasis. The surgery intervention is supposed to be as small as possible.
Highlights
Lung cancer is the second leading cancer type for the estimated new cancer cases and the leading cause of cancer death in the United States in 2016 [1]
The median age of the patients at diagnosis was both 52 years. 71.4% were female in adenocarcinoma in situ (AIS) as while as 71.1% in Minimally invasive adenocarcinoma (MIA). 36.4% patients were observed with ever symptoms in AIS and 28.9% in MIA. 12.9% and 8.6% had smoking history respectively in AIS an MIA
There are no significant differences between AIS and MIA in clinical features
Summary
Lung cancer is the second leading cancer type for the estimated new cancer cases and the leading cause of cancer death in the United States in 2016 [1]. According to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification 2011 (IASLA/ATS/ERS 2011) of lung www.impactjournals.com/oncotarget adenocarcinoma, adenocarcinoma in situ (AIS) is defined as a tumor that grows in a lepidic fashion along preexisting airway structures without detectable invasion. According to the National Comprehensive Cancer Network (NCCN) Guidelines Version 4.2017 NonSmall Cell Lung Cancer, for AIS or MIA patients, we usually give surgical exploration and resection plus mediastinal lymph node dissection or systematic lymph node sampling. The frequency of Epidermal Growth Factor Receptor (EGFR) mutation was AIS (62%), and MIA (60%) [4]. The researches specific for AIS/MIA are still not enough, especially for patients in China, and the number of AIS/MIA cases studied in existing reports is small. There is absolute need to do some research about AIS/ MIA of Chinese patients
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