Stromal micropapillary component as a novel unfavorable prognostic factor of lung adenocarcinoma 英文参考文献.docVIP

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Stromal micropapillary component as a novel unfavorable prognostic factor of lung adenocarcinoma 英文参考文献.doc

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Stromal micropapillary component as a novel unfavorable prognostic factor of lung adenocarcinoma 英文参考文献

Oheetal.DiagnosticPathology2012,7:3 /content/7/1/3 RESEARCH OpenAccess Stromalmicropapillarycomponentasanovel unfavorableprognosticfactoroflung adenocarcinoma MikiOhe1,2,5,TomoyukiYokose1*,YujiSakuma3,YoheiMiyagi3,NaoyukiOkamoto4,SachieOsanai1, ChikakoHasegawa1,HaruhikoNakayama2,YoichiKameda1,KouzoYamada2andTakeshiIsobe5 Abstract Background:Pulmonaryadenocarcinomaswithamicropapillarycomponenthavingsmallpapillarytuftsand lackingacentralfibrovascularcorearethoughttoresultinpoorprognosis.However,thecomponentconsistsof tumorcellsoftenfloatingwithinalveolarspaces(aerogenousmicropapillarycomponent[AMPC])ratherthan invadingfibroticstromaobservedinotherorganslikebreast(stromalinvasivemicropapillarycomponent[SMPC]). WepreviouslyobservedcasesoflungadenocarcinomawithpredominantSMPCthatwasassociatedwith micropapillarygrowthoftumorsinfibroticstromaobservedinotherorgans.Weevaluatedtheincidenceand clinicopathologicalcharacteristicsofSMPCinlungadenocarcinomacases. PatientsandMethods:Weinvestigatedtheclinicopathologicalcharacteristicsandprognosticsignificanceof SMPCinlungadenocarcinomacasesbyreviewing559patientswhohadundergonesurgicalresection.We examinedtheSMPCbyperformingimmunohistochemicalanalysiswith17antibodiesandbygeneticanalysiswith epidermalgrowthfactorreceptor(EGFR)andKRASmutations. Results:SMPC-positive(SMPC(+))tumorswereobservedin19cases(3.4%).ThepresenceofSMPCwassignificantly associatedwithtumorsize,advanced-stagedisease,lymphnodemetastasis,pleuralinvasion,lymphaticinvasion, andvascularinvasion.PatientswithSMPC(+)tumorshadsignificantlypooreroutcomesthanthosewithSMPC- negativetumors.MultivariateanalysisrevealedthatSMPCwasasignificantindependentprognosticfactoroflung adenocarcinoma,especiallyfordisease-freesurvivalofpathologicalstageIpatients(p=0.035).SMPCshowed significantlyhigherexpressionofE-cadherinandlowerexpressionofCD44thanthecorrespondingexpression levelsshownbyAMPCandshowedlowersurfactantapoproteinAandphospho-c-Metexpressionlevelthan correspondingexpressionlevel