Prognostic value of bronchiolo-alveolar carcinoma component of small lung adenocarcinoma

作     者：Higashiyama, M Kodama, K Yokouchi, H Takami, K Mano, M Kido, S Kuriyama, K 

作者机构：Osaka Med Ctr Canc & Cardiovasc Dis Dept Thorac Surg Higashinari Ku Osaka 5378511 Japan Osaka Med Ctr Canc & Cardiovasc Dis Dept Pathol Higashinari Ku Osaka 5378511 Japan Osaka Med Ctr Canc & Cardiovasc Dis Dept Radiol Higashinari Ku Osaka 5378511 Japan 

出 版 物：《ANNALS OF THORACIC SURGERY》 (胸外科学纪事)

年 卷 期：1999年第68卷第6期

页      面：2069-2073页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Ministry of Health and Welfare  MOHW 

主　　题：腺癌/死亡率 腺癌/病理学 腺癌/继发性 腺癌/外科学 腺癌 细支气管肺泡/死亡率 腺癌 细支气管肺泡/病理学 腺癌 细支气管肺泡/继发性 腺癌 细支气管肺泡/外科学 肺肿瘤/死亡率 肺肿瘤/病理学 肺肿瘤/外科学 淋巴结切除术 肺切除术 预后 存活率 女(雌)性 人类 男(雄)性 中年人 

摘      要：Background. Bronchiolo-alveolar carcinoma (BAC) is often observed in lung adenocarcinoma, but its clinicopathological and prognostic significance, especially in small peripheral lung adenocarcinoma, remains undetermined. Methods. We assessed 206 consecutive cases of surgically resected small peripheral lung adenocarcinoma (less than 2 cm in diameter) recorded between 1973 and 1997. According to the component area of well differentiated BAC within maximally cut surface specimens of tumor tissue, we semiquantitatively classified the tumors into four types: those in which the BAC component comprised 0% (type I), 1% to 49% (type II), 50% to 99% (type III), and 100% (type IV) of the tumor tissue. Results. Forty tumors were classified as type I, 75 as type II, 74 as type III, and 17 as type IV. The tumors with less BAG, especially type I and II, showed a significantly more aggressive nodal involvement and tumor stage, and consequently a worse prognosis, while type IV tumors had no nodal involvement and the most favorable prognosis. The patients with type III showed clinicopathological characteristics somewhere between those of type II and type IV patients. Among stage I patients, however, those with type II had the worst prognosis, while those with type I showed as good a prognosis as the other two groups. Conclusions. This novel classification based on the degree of BAC involvement in small peripheral lung adenocarcinoma may reflect clinicopathological and prognostic characteristics. This classification may prove practical for planning therapeutic strategies, in particular surgical treatment. (C) 1999 by The Society of Thoracic Surgeons.