Radiological and clinical features of large consolidative-type pulmonary invasive mucinous adenocarcinoma

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-03-26 DOI:10.1111/crj.13743

Jiaqi Chen, Linlin Qi, Jianwei Wang, Liyan Xue, Qi Xue, Jia Jia, Guochao Zhang, Jianing Liu, Fenglan Li, Shulei Cui

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Abstract

Background

This study aimed to investigate the radiological, pathological, and prognostic characteristics of large consolidative-type pulmonary invasive mucinous adenocarcinomas (IMA).

Methods

We retrospectively reviewed 738 patients who confirmed IMA between January 2010 and August 2022, and two radiologists reviewed imaging data to determine subtypes. We included 41 patients with pathologically large consolidative-type IMA. We analyzed their radiological, pathological, and prognostic characteristics. The recurrence-free survival (RFS) and overall survival (OS) were determined using the Kaplan–Meier method.

Results

Most lesions were located in the lower lobe, with 46.3% patients showing multiple lesions. Halo, angiogram, vacuole, air bronchogram, and dead branch sign were observed in 97.6%, 73.2%, 63.4%, 61.0%, and 61.0% of the cases, respectively. Unevenly low enhancement was observed in 88.89% of patients. T3 and T4 pathological stages were observed in 50.0% and 30.6% of patients, respectively. Lymph node metastasis was observed in 16.7% patients, with no distant metastasis. Spread-through air spaces and intrapulmonary dissemination were observed in 27.8% and 19.4% patients, respectively. Moreover, Kirsten rat sarcoma viral oncogene mutations were found in 68.6% of cases, and no epidermal growth factor receptor mutations were seen. Among all mutation sites, G12V mutation is the most common, accounting for 40%. The average RFS and OS were 19.4 and 66.4 months, respectively, with 3-year RFS and OS rates of 30.0% and 75.0%, respectively. Pleural invasion and lymph node metastasis were independent risk factors for diagnosis.

Conclusion

Halo, vacuole, angiogram, and dead branch signs were frequently observed in consolidative-type IMA. Kirsten rat sarcoma viral oncogene mutations are common in consolidative-type IMA, especially site G12V, whereas epidermal growth factor receptor mutations were rare; therefore, gene immunotherapy was more difficult. Most patients were in stage T3–T4; however, lymph node metastasis was rare.

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大面积合并型肺浸润性黏液腺癌的放射学和临床特征。

背景：本研究旨在探讨大块整合型肺浸润性粘液腺癌（IMA）的放射学、病理学和预后特征：本研究旨在探讨大块整合型肺浸润性黏液腺癌（IMA）的放射学、病理学和预后特征：我们对2010年1月至2022年8月期间确诊为IMA的738例患者进行了回顾性研究，由两名放射科医生对影像学资料进行了审查，以确定亚型。我们纳入了 41 例病理上巨大的整合型 IMA 患者。我们分析了他们的放射学、病理学和预后特征。采用 Kaplan-Meier 法确定无复发生存期（RFS）和总生存期（OS）：大多数病灶位于下叶，46.3%的患者有多个病灶。分别有97.6%、73.2%、63.4%、61.0%和61.0%的病例观察到光晕、血管影、空泡、气管影和死枝征。88.89%的患者出现不均匀低增强。T3和T4病理分期的患者分别占50.0%和30.6%。16.7%的患者出现淋巴结转移，无远处转移。分别有 27.8% 和 19.4% 的患者出现气隙扩散和肺内播散。此外，68.6%的病例发现 Kirsten 大鼠肉瘤病毒癌基因突变，未发现表皮生长因子受体突变。在所有突变位点中，G12V突变最为常见，占40%。平均RFS和OS分别为19.4个月和66.4个月，3年RFS和OS分别为30.0%和75.0%。胸膜侵犯和淋巴结转移是确诊的独立危险因素：结论：在合并型IMA中经常观察到光晕、空泡、血管造影和枯枝征。Kirsten大鼠肉瘤病毒癌基因突变在整合型IMA中很常见，尤其是G12V位点，而表皮生长因子受体突变则很少见，因此基因免疫治疗较为困难。大多数患者处于T3-T4期，但淋巴结转移罕见。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)