Proposal of a revised International Association for the Study of Lung Cancer grading system in pulmonary non-mucinous adenocarcinoma: The importance of the lepidic proportion

被引：9

作者：

Park, Byung Jo ^{[1
]}

Woo, Wongi ^{[1
,2
]}

Cha, Yoon Jin ^{[3
]}

Shim, Hyo Sup ^{[4
]}

Yang, Young Ho ^{[1
]}

Moon, Duk Hwan ^{[2
]}

Kim, Bong Jun ^{[2
]}

Kim, Ha Eun ^{[1
]}

Kim, Dae Joon ^{[1
]}

Paik, Hyo Chae ^{[1
]}

Lee, Jin Gu ^{[1
]}

Lee, Sungsoo ^{[2
]}

Lee, Chang Young ^{[1
]}

机构：

[1] Yonsei Univ, Coll Med, Severance Hosp, Dept Thorac & Cardiovasc Surg, 50-1 Yonsei Ro, Seoul 03722, South Korea

[2] Yonsei Univ, Gangnam Severance Hosp, Dept Thorac & Cardiovasc Surg, Coll Med, 211 Eonju Ro, Seoul 06273, South Korea

[3] Yonsei Univ, Gangnam Severance Hosp, Dept Pathol, Coll Med, 211 Eonju Ro, Seoul 06273, South Korea

[4] Yonsei Univ, Coll Med, Severance Hosp, Dept Pathol, 50-1 Yonsei Ro, Seoul 03722, South Korea

来源：

LUNG CANCER | 2023年 / 175卷

关键词：

Adenocarcinoma; Lung; Predictive model; Histological labeling; Area under curve; Concordance index; IN-SITU; CLASSIFICATION; INVASION; VALIDATION; RECURRENCE; CRIBRIFORM; PROGNOSIS; SUBTYPES; PATTERN; IMPACT;

D O I：

10.1016/j.lungcan.2022.11.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: We aimed to measure the validity of the International Association for the Study of Lung Cancer (IASLC) grading system in Korean patients and propose a modification for an increase of its predictability, especially in grade 2 patients.Materials and Methods: From 2012 to 2017, histopathologic characteristics of 1358 patients with invasive pul-monary adenocarcinoma (stage I-III) from two institutions were retrospectively reviewed and re-classified ac-cording to the IASLC grading system. Considering the amount of the lepidic proportion, the validity of the revised model (Lepidic-10), derived from the training cohort (hospital A), was measured using the validation cohort (hospital B). Its predictability was compared to that of the IASLC system.Results: Of the 1358 patients, 259 had a recurrence, and 189 died during follow-up. The Harrell's concordance index and area under the curve of the IASLC system were 0.685 and 0.699 for recurrence-free survival (RFS) and 0.669 and 0.679 for death, respectively. From the training cohort, the IASLC grade 2 patients were divided into grades 2a and 2b (Lepidic-10 model) with a 10 % lepidic pattern. This new model further distinguished patients in both institutions that had better performance than the IASLC grading (Hospital A, p < 0.001 for RFS and death; Hospital B, p = 0.0215 for RFS, p = 0.0429 for death).Conclusion: The IASLC grading system was easily applicable; its clinical use in predicting the prognosis of Korean patients with pulmonary adenocarcinoma was validated. Furthermore, the introduction of the lepidic proportion as an additional criterion to differentiate grade 2 patients improved its predictability.

引用

页码：1 / 8

页数：8

共 30 条

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