首页> 外文期刊>Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer >A single institution-based retrospective study of surgically treated bronchioloalveolar adenocarcinoma of the lung: clinicopathologic analysis, molecular features, and possible pitfalls in routine practice.
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A single institution-based retrospective study of surgically treated bronchioloalveolar adenocarcinoma of the lung: clinicopathologic analysis, molecular features, and possible pitfalls in routine practice.

机译:一项基于单一机构的手术治疗的肺支气管肺泡腺癌的回顾性研究:临床病理分析,分子特征和常规操作中可能存在的陷阱。

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INTRODUCTION: Prognostic evaluation of bronchioloalveolar carcinoma (BAC) from a homogenous population of Caucasian patients. METHODS: Retrospective analysis of resected BAC reclassified according to the 2004 World Health Organization classification of lung tumors. Analyzed variables are clinicoradiologic presentation, histologic subtypes, stage, epidermal growth factor receptor (EGFR) and HER2eu immunohistochemical expression, EGFR exons 18, 19, and 21 mutations, K-RAS exon 2 mutation. Univariate and multivariate analyses of survival were performed. RESULTS: Of 40 patients analyzed, EGFR and HER2eu expression were detected in 72% and 20%, respectively. HER2eu expression significantly characterized mucinous BAC (46% versus 7%; p = 0.014). EGFR mutations were identified in 17% (30% in nonmucinous BAC and none in mucinous BAC; p = 0.083). K-RAS mutations were found in 42.5% (92% in mucinous BAC versus 18% in other types; p 0.0001). Early stages (IA+IB) nonmucinous BAC had excellent prognosis: 5 years overall survival of 91% (100% for stage IA). Sixty six percent (4 of 6) of patients with multifocal disease died (two mucinous BAC and one nonmucinous BAC with recurrent disease). Seventy one percent (5 of 7) of patients with pneumonic-like tumor (all mucinous BAC) died of recurrent/progressive disease. Stage (p = 0.004) and histologic classifications (p = 0.035) resulted as independent prognostic factors at multivariate analysis. CONCLUSIONS: Early stage nonmucinous BAC has excellent prognosis, whereas mucinous BAC presents a poor prognosis. Locally advanced nonmucinous BAC has a poor prognosis: the diagnosis of nonmucinous BAC in large tumors should be interpreted with caution given the possible presence of invasive areas in incompletely sampled tumor. Coexpression of EGFR and HER2eu in mucinous BAC could be considered for future trials on target therapies even in Caucasian population.
机译:简介:来自同种白种人患者的支气管肺泡癌(BAC)的预后评估。方法:对根据2004年世界卫生组织肺肿瘤分类重新分类的切除的BAC进行回顾性分析。分析变量为临床放射学表现,组织学亚型,分期,表皮生长因子受体(EGFR)和HER2 / neu免疫组织化学表达,EGFR外显子18、19和21突变,K-RAS外显子2突变。进行了生存的单因素和多因素分析。结果:在分析的40例患者中,分别以72%和20%检测到EGFR和HER2 / neu表达。 HER2 / neu表达显着表征了粘液性BAC(46%对7%; p = 0.014)。 EGFR突变的检出率为17%(在非粘液性BAC中为30%,在粘液性BAC中为零; p = 0.083)。发现K-RAS突变为42.5%(粘液性BAC中为92%,其他类型中为18%; P 0.0001)。早期(IA + IB)非粘液性BAC预后良好:5年总生存率为91%(IA期为100%)。患有多灶性疾病的患者有66%(6名患者中的4名)死亡(2例粘液性BAC和1例复发性非粘液性BAC)。患有肺炎样肿瘤(全部为黏液性BAC)的患者中有71%(占7个中的5个)死于复发/进行性疾病。在多变量分析中,作为独立的预后因素得出阶段(p = 0.004)和组织学分类(p = 0.035)。结论:早期非粘液性BAC预后良好,而粘液性BAC预后较差。局部晚期非粘液性BAC的预后较差:鉴于未完全取样的肿瘤中可能存在浸润区,应谨慎解释大肿瘤中非粘液性BAC的诊断。 EGFR和HER2 / neu在粘液性BAC中的共表达可考虑用于目标治疗的未来试验,即使在白种人中也是如此。

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