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Micropapillary histological subtype in lung adenocarcinoma of 2 cm or less: impact on recurrence and clinical predictors

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Abstract

Objective

This study examined the clinical and radiological characteristics of adenocarcinoma having the micropapillary histological subtype.

Methods

We included 233 patients who were operated from 2001 to 2012 for lung adenocarcinoma of 2 cm or less. The pathology was reviewed according to the 2015 WHO classification. We defined adenocarcinoma with a micropapillary component as adenocarcinoma in which the area of the micropapillary histological subtype exceeded 5% of the tumor. The difference in cumulative incidence of recurrence (CIR) in the presence of death as a competing risk between two groups was assessed using the methods of Gray.

Results

Twenty-one cases (9.0%) had a micropapillary component. The micropapillary component was associated with a higher frequency of lymphatic invasion (28.6 vs. 7.5% in adenocarcinoma without a micropapillary component; P = 0.008) and vascular invasion (38.1 vs. 15.1%, P = 0.014) and lymph node metastasis (31.3 vs. 5.2%, P = 0.003). The median follow-up period was 6.5 years. CIR at 5 years was 23.8% [95% confidence interval (CI), 8.3–43.7%] for adenocarcinoma with a micropapillary component, and 11.4% (95% CI, 7.4–16.2%) for adenocarcinoma without a micropapillary component (P = 0.033). Adenocarcinoma with a micropapillary component was more frequent in solid nodules (17.8%, 16/90) on high-resolution computed tomography (HRCT) than in either ground-glass nodules (1.5%, 1/67) or part-solid nodules (5.3%, 4/76) (P = 0.001). The HRCT finding was the only preoperative factor that was associated with a micropapillary component in the multivariate analysis.

Conclusions

The micropapillary component in adenocarcinoma should be regarded as indicative of a high-grade malignancy and was associated with the HRCT finding.

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Acknowledgements

This work was supported by the Japan Surgical Society [Young Researcher Award].

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Authors and Affiliations

  1. Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Yukihiro Yoshida, Jun-ichi Nitadori & Jun Nakajima

  2. Department of Pathology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Aya Shinozaki-Ushiku & Masashi Fukayama

  3. Department of Radiology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Jiro Sato

  4. Department of Clinical Trial Data Management, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Tempei Miyaji & Takuhiro Yamaguchi

Authors
  1. Yukihiro Yoshida
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  2. Jun-ichi Nitadori
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  3. Aya Shinozaki-Ushiku
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  7. Masashi Fukayama
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  8. Jun Nakajima
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Correspondence to Yukihiro Yoshida.

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Yoshida, Y., Nitadori, Ji., Shinozaki-Ushiku, A. et al. Micropapillary histological subtype in lung adenocarcinoma of 2 cm or less: impact on recurrence and clinical predictors. Gen Thorac Cardiovasc Surg 65, 273–279 (2017). https://doi.org/10.1007/s11748-017-0747-3

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  • DOI: https://doi.org/10.1007/s11748-017-0747-3

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