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Modified Histologic Classification as a Prognostic Factor in Pulmonary Adenocarcinoma

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Author(s)
Ilseon HwangKeon Uk ParkKun Young Kwon
Keimyung Author(s)
Hwang, Il SeonKwon, Kun YoungPark, Keon Uk
Department
Dept. of Pathology (병리학)
Dept. of Internal Medicine (내과학)
Journal Title
International Journal of Surgical Pathology
Issued Date
2014
Volume
22
Issue
3
Abstract
Background. The histologic pattern of pulmonary adenocarcinoma is highly heterogeneous and considered to be an
important prognostic factor. The predominant histologic pattern is emphasized in the 2011 International Association for
the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society classification, but few studies
present a detailed investigation of the histologic changes and prognosis pulmonary adenocarcinoma using resected
specimens. Methods. We examined 125 cases of surgically resected pulmonary adenocarcinoma and carefully observed
histologic patterns. Invasive adenocarcinoma was divided into 3 groups according to a modified histologic classification
system: group 1 had a lepidic or papillary predominant pattern with ≤10% solid or micropapillary pattern; group 2 had an
acinar predominant pattern with ≤10% of the solid or micropapillary pattern; and group 3 had a solid or micropapillary
predominant pattern, or any predominant pattern with >10% solid or micropapillary pattern. Results. Proportions of
predominant lepidic, papillary, acinar, solid, and micropapillary patterns were 11 (9.3%), 8 (6.8%), 54 (45.8%), 38 (32.2%),
and 7 (5.9%), respectively. Vague areas between 2 different patterns were frequently observed, which were considered
as transitional areas for one pattern to the other pattern (gradual dedifferentiation). Modified histologic classification was
significantly associated with disease-free and overall survival rate (P = .026 and .010, respectively) using the Kaplan–Meier
survival test, and an independent prognostic factor (P = .016) in overall survival using the Cox regression test. Conclusion.
Pulmonary adenocarcinoma demonstrates heterogeneous histologic patterns with gradual dedifferentiation, and this
modified histologic classification is an important prognostic factor for patients with pulmonary adenocarcinoma.
Keywords
lung, adenocarcinoma, histologic pattern, prognosis, gradual dedifferentiation
Keimyung Author(s)(Kor)
황일선
권건영
박건욱
Publisher
School of Medicine
Citation
Ilseon Hwang et al. (2014). Modified Histologic Classification as
a Prognostic Factor in Pulmonary
Adenocarcinoma. International Journal of Surgical Pathology, 22(3), 212–220. doi: 10.1177/1066896914525230
Type
Article
ISSN
1066-8969
Source
http://journals.sagepub.com/doi/abs/10.1177/1066896914525230?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
10.1177/1066896914525230
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35938
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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