Original articles

Clinical characteristics of different pathological subtypes of T1 invasive lung adenocarcinoma and analysis of prognosis

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  • Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2017-08-20

  Online published: 2018-02-25

Abstract

Objective: To study the clinicopathological features and prognostic significance of different pathological subtypes of T1 invasive lung adenocarcinoma for providing a reference for the monitoring and treatment strategy of lung adenocarcinoma. Methods: A total of 120 patients undergone surgical treatment and confirmed by postoperative pathology as invasive lung adenocarcinoma with tumor diameter less than or equal to 3 cm from Jan. 2009 to Jan, 2011 were enrolled. The patients were divided into five groups according to dominant pathological subtypes: lepidic group,acinar group, papillary group, micro-papillary group, and solid group. The clinical and pathological data of the patients were analyzed retrospectively. Kaplan-Meier method was used to calculate survival rate. Log-Rank test was used to compare survival difference. COX regression analysis was used to determine the risk factors of prognosis. Result: There were no significant differences in age, sex, CEA level and tumor differentiation between the five groups(P>0.05). Meanwhile, there were significant differences in invasion of visceral pleura, lymph node metastasis, TNM stage and recurrence or metastasis after operation between the five groups(P<0.05). Among the five subtypes, lymph node metastasis rate (62.5%) and postoperative recurrence rate (41.6%) were the highest in micro-papillary group. Survival analysis showed that lipidic group had the best prognosis, the 5 year survival rate was 96.0%; the prognosis of micro-papillary group was the worst, and the 5 year survival rate was 66.7%. The difference was statistically significant(P<0.05). Pathological subtypes, lymph node metastasis and TNM staging were the risk factors influencing the prognosis of stage T1 invasive lung adenocarcinoma. Different pathological subtypes and lymph node metastasis were the independent prognostic factors (OR>1). Conclusions: The prognosis of T1 invasive adenocarcinoma of lung is related to pathological subtype and lymph node metastasis. Micro-papillary subtypes indicate higher lymph node metastasis and poor prognosis. More aggressive treatment and observation might be needed after operation of micro-papillary subtype of invasive lung adenocarcinoma.

Cite this article

DU Hailei, CHE Jiaming, ZHU Lianggang, LI Hecheng, HANG Junbiao . Clinical characteristics of different pathological subtypes of T1 invasive lung adenocarcinoma and analysis of prognosis[J]. Journal of Diagnostics Concepts & Practice, 2018 , 17(01) : 82 -86 . DOI: 10.16150/j.1671-2870.2018.01.015

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