Abstract
BackgroundThis study aimed to comprehensively investigate the effect of spread through air spaces (STAS) on clinicopathologic features, molecular characteristics, immunohistochemical expression, and prognosis in lung adenocarcinomas (ADC) and squamous cell carcinomas (SQCC) based on the 8th edition AJCC/UICC staging system.MethodsIn total, 303 ADC and 121 SQCC cases were assessed retrospectively. Immunohistochemical staining was performed for E-cadherin, vimentin, Ki67, survivin, Bcl-2, and Bim. Correlations between STAS and other parameters were analyzed statistically.ResultsSTAS was observed in 183 (60.4%) ADC and 39 (32.2%) SQCC cases. In ADC, the presence of STAS was associated with wild-type EGFR, ALK and ROS1 rearrangements, low E-cadherin expression, and high vimentin and Ki67 expression. In SQCC, STAS was associated with low E-cadherin expression and high vimentin and survivin expression. Based on univariate analysis, STAS was associated with significantly shorter disease-free survival (DFS) and overall survival (OS) in ADC. In SQCC, STAS tended to be associated with shorter OS. By multivariate analysis, STAS was an independent poor prognostic factor in ADC for DFS but not OS. Stratified analysis showed that STAS was correlated with shorter DFS for stage I, II, IA, IB, and IIA ADC based on univariate analysis and was an independent risk factor for DFS in stage I ADC cases based on multivariate analysis.ConclusionsOur findings revealed that STAS is an independent negative prognostic factor for stage I ADC using the new 8th edition AJCC/UICC staging system. Stage I patients with STAS should be followed up more closely and might need different treatment strategies.
Highlights
This study aimed to comprehensively investigate the effect of spread through air spaces (STAS) on clinicopathologic features, molecular characteristics, immunohistochemical expression, and prognosis in lung adenocarcinomas (ADC) and squamous cell carcinomas (SQCC) based on the 8th edition American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system
The clinicopathologic features and prognostic significance of Spread through air spaces (STAS) have been investigated, the published studies were mainly conducted according to the 7th edition of American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system; few studies have analyzed the association between STAS and pathological stage (p-stage) using the new 8th edition AJCC/UICC staging system
In this study, we investigated the association between STAS and clinicopathologic features, molecular alterations, the expression of immunohistochemical markers, and prognostic significance in both ADC and SQCC based on Chinese patients
Summary
This study aimed to comprehensively investigate the effect of spread through air spaces (STAS) on clinicopathologic features, molecular characteristics, immunohistochemical expression, and prognosis in lung adenocarcinomas (ADC) and squamous cell carcinomas (SQCC) based on the 8th edition AJCC/UICC staging system. The clinicopathologic features and prognostic significance of STAS have been investigated, the published studies were mainly conducted according to the 7th edition of American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system; few studies have analyzed the association between STAS and pathological stage (p-stage) using the new 8th edition AJCC/UICC staging system. STAS has been reported to be significant with respect to the prediction of survival for early-stage tumors, few studies have analyzed the significance of STAS based on a single subdivided stage exclusively
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