دورية أكاديمية
Pulmonary Adenocarcinomas of Low Malignant Potential: Proposed Criteria to Expand the Spectrum Beyond Adenocarcinoma In Situ and Minimally Invasive Adenocarcinoma.
| العنوان: | Pulmonary Adenocarcinomas of Low Malignant Potential: Proposed Criteria to Expand the Spectrum Beyond Adenocarcinoma In Situ and Minimally Invasive Adenocarcinoma. |
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| المؤلفون: | Yambayev I; Departments of Pathology & Laboratory Medicine., Sullivan TB; Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory., Suzuki K; Surgery, Boston University School of Medicine, Boston Medical Center, Boston., Zhao Q; Departments of Pathology & Laboratory Medicine., Higgins SE; Departments of Pathology & Laboratory Medicine., Yilmaz OH; Departments of Pathology & Laboratory Medicine., Litle VR; Surgery, Boston University School of Medicine, Boston Medical Center, Boston., Moreira P; Surgery, Boston University School of Medicine, Boston Medical Center, Boston., Servais EL; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA., Stock CT; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA., Quadri SM; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA., Williamson C; Department of Surgery, Lahey Hospital & Medical Center, Burlington, MA., Rieger-Christ KM; Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory., Burks EJ; Departments of Pathology & Laboratory Medicine. |
| المصدر: | The American journal of surgical pathology [Am J Surg Pathol] 2021 Apr 01; Vol. 45 (4), pp. 567-576. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 7707904 Publication Model: Print Cited Medium: Internet ISSN: 1532-0979 (Electronic) Linking ISSN: 01475185 NLM ISO Abbreviation: Am J Surg Pathol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2015- > : Philadelphia, PA : Wolters Kluwer Health, Inc. Original Publication: New York, Masson. |
| مواضيع طبية MeSH: | Adenocarcinoma in Situ/*pathology , Adenocarcinoma of Lung/*pathology , Lung Neoplasms/*pathology, Adenocarcinoma in Situ/mortality ; Adenocarcinoma in Situ/surgery ; Adenocarcinoma of Lung/mortality ; Adenocarcinoma of Lung/surgery ; Aged ; Databases, Factual ; Female ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Mitosis ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies ; Tumor Burden ; United States |
| مستخلص: | Lung cancer screening has improved mortality among high-risk smokers but has coincidentally detected a fraction of nonprogressive adenocarcinoma historically classified as bronchoalveolar carcinoma (BAC). In the National Lung Screening Trial (NLST) the majority of BAC-comprising 29% of computed tomography-detected stage I lung adenocarcinoma-were considered overdiagnosis after extended follow-up comparison with the control arm. In the current classification, adenocarcinoma in situ and minimally invasive adenocarcinoma have replaced BAC but together comprise only ∼5% of stage I lung adenocarcinoma. Lepidic and subsets of papillary and acinar adenocarcinoma also infrequently recur. We, therefore, propose criteria for low malignant potential (LMP) adenocarcinoma among nonmucinous adenocarcinoma measuring ≤3 cm in total, exhibiting ≥15% lepidic growth, and lacking nonpredominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), >1 mitosis per 2 mm2, angiolymphatic or visceral pleural invasion, spread through air spaces or necrosis. We tested these criteria in a multi-institutional cohort of 328 invasive stage I (eighth edition) and in situ adenocarcinomas and observed 16% LMP and 7% adenocarcinoma in situ/minimally invasive adenocarcinoma which together (23%) approximated the frequency of overdiagnosed stage I BAC in the NLST. The LMP group had 100% disease-specific survival. The proposed LMP criteria, incorporating multiple histologic parameters, may be a clinically useful "low-grade" prognostic group. Validation of these criteria in additional retrospective cohorts and prospective screen-detected cohorts should be considered. Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.) |
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| تواريخ الأحداث: | Date Created: 20201112 Date Completed: 20210510 Latest Revision: 20210510 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1097/PAS.0000000000001618 |
| PMID: | 33177339 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1532-0979 |
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| DOI: | 10.1097/PAS.0000000000001618 |