Stepwise progression of invasive mucinous adenocarcinoma based on radiological and biological characteristics

医学 腺癌 克拉斯 病态的 内科学 病理 胃肠病学 癌症 结直肠癌
作者
Eisuke Goto,Kazuya Takamochi,Satsuki Kishikawa,Takuo Hayashi,Takuya Ueda,Aritoshi Hattori,Mariko Fukui,Takeshi Matsunaga,Kenji Suzuki
出处
期刊:Lung Cancer [Elsevier BV]
卷期号:184: 107348-107348 被引量:3
标识
DOI:10.1016/j.lungcan.2023.107348
摘要

Invasive mucinous lung adenocarcinoma (IMA) has unique radiological findings and pathological characteristics. IMA is classified into solitary and pneumonic types; however, it is unclear whether these are biologically identical.A single-center retrospective analysis was performed for 70 IMA patients (solitary type [n = 38] and pneumonic type [n = 32]) who underwent pulmonary resection between January 2010 and December 2018. We compared clinical and biological characteristics between the two types.The frequencies of genetic alternations such as EGFR, KRAS, BRAF, GNAS, ERBB2, TP53, NRG1, and MET were not different. Immunohistochemically, expression of MUC1 was significantly more common in the pneumonic type (5.0% versus 20.0%, p = 0.01) and diffuse MUC6 positive in the solitary type (39.0% versus 13.0%, p = 0.02). We further classified solitary types into those with or without ground-glass opacity (GGO) and pneumonic types into those with or without crazy-paving appearance (CPA), and evaluated their surgical outcomes. Five-year overall survival and relapse free survival rates were 95.8%/86.6%, 64.3%/70.7%, 74.6%/68.9%, and 50.0%/28.6% in patients with solitary type with GGO, solitary type without GGO, pneumonic type without CPA, and pneumonic type with CPA, respectively.There were no differences in genetic alternations; however, mucin expression pattern was different. Surgical outcomes were different according to the presence of GGO in the solitary type and the presence of CPA in the pneumonic type. These findings suggested a stepwise progression from solitary to pneumonic IMA.
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