Validation of the novel International Association for the Study of Lung Cancer grading system and prognostic value of filigree micropapillary and discohesive growth pattern in invasive pulmonary adenocarcinoma. (January 2023)

• Record Type: Journal Article
• Authors: Zhang, Yuan; Zhang, Yanjun; Hu, Yi; Zhang, Shu; Zhu, Min; Hu, Bin; Guo, Xiaojuan; Lu, Jun; Zhang, Yuhui
• Is Part Of: Lung cancer. Volume 175(2023)
• Page Start: 79
• Page End: 87
• Publication Date: 2023-01
• Subjects: Lung adenocarcinoma -- Prognosis -- IASLC grading system -- Filigree micropapillary -- Discohesive growth pattern; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2022.11.022
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: The IASLC grading system has high performance in predicting prognosis stratification. Filigree micropapillary and Disco-p indicated a prognostic impact on DFS. Filigree micropapillary and Disco-p was a risk factor for recurrence and metastasis. Abstract: Introduction: The Pathology Committee of the International Association for the Study of Lung Cancer (IASLC) proposed a new histological grading system based on the combination of predominant and high-grade patterns in 2020. Materials and Methods: Pathological sections from 631 patients with stage I-III invasive lung adenocarcinoma were reviewed. We then determined the histological grade according to the new grading system and confirmed the pathological features that included the filigree micropapillary and discohesive growth pattern. Applying of the novel IASLC grading system in prognosis stratification was verified and the clinical significance of the pathological characteristics was explored. Results: Cox multivariable analysis revealed that in the stage I-III invasive lung adenocarcinoma, the IASLC grading system was significantly associated with disease-free survival (DFS) [hazard ratio (HR) = 1.419; 95 % confidence interval (CI): 1.040–1.937; P = 0.027] and overall survival (OS) (HR = 1.899; 95 % CI: 1.168–3.087; P = 0.010). In patients with IASLC Grades 1 and 2, the simultaneous presence of filigree micropapillary and discohesive growth pattern was significantly correlated with DFS (HR = 1.899; 95 % CI:1.168–3.087; P = 0.010). However, the filigree micropapillary and discohesive growth pattern did not affect the OS (HR = 2.786; P = 0.317). The competitive risk model revealed that in the stage I cohort, the simultaneous presence of filigree micropapillary and discohesive growth pattern was a risk factor for recurrence and metastasis [sub- distribution HR (SHR) = 1.987; 95 %CI: 1.122–3.518; P = 0.019]. Conclusion: Our study verified that the new prognostic stratification system was an effective stratification tool. Filigree micropapillary and discohesive growth pattern may also be risk factors for DFS, postoperative recurrence and metastasis.