Relationship between Twist, Slug with Tumor Spread Through Air Spaces in Lung Adenocarcinoma

Abstract

Background: Tumor spread through air spaces (STAS) was recently reported as a novel risk factor for the prognosis of patients with resected lung adenocarcinoma that indicates invasive tumor behavior. The purpose of this study was to investigated the relationship between Twist, Slug with STAS in surgically resected lung adenocarcinoma and aimed to characterize the potential connection between epithelial-mesenchymal transition (EMT) and STAS. Methods: A total of 115 patients with resected lung adenocarcinomas were analyzed retrospectively to evaluate the relationship between Twist, Slug with STAS. Findings: STAS was observed in 56 (48.7%) patients. There were significant correlations between the presence of tumor STAS with Twist / Slug overexpression. The logistic model further revealed that pathological stage, Twist / Slug overexpression were independent risk factors for STAS. A multivariate analysis contained pathologic stage, STAS, Twist / Slug overexpression, showed that pathologic stage and STAS were independent prognostic factors for poor RFS/OS. The other multivariate model contained pathologic stage, Twist / Slug overexpression, showed that pathologic stage and Twist / Slug overexpression were independent prognostic factors for poor RFS/OS. Interpretation: STAS was correlated with overexpression of Twist / Slug, which could potentially provide information on the mechanism of STAS. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interest: The authors have no conflicts of interest to declare. Ethical Approval: The Institutional Review Board of Affiliated Hospital of Qingdao University approved this retrospective study (IRB#QYFYKY 2018-10-11-2). Informed consent was waived by the institutional review board because this was a retrospective study.