Feasibility of intraoperative assessment of STAS in pathologic stage 1 lung adenocarcinomas in Chinese patients.

IF 3.5 2区 医学 Q2 ONCOLOGY Ejso Pub Date : 2024-10-08 DOI:10.1016/j.ejso.2024.108747
FangPing Xu, ZhiHua Liu, JinHai Yan, Lixu Yan, ZhenBin Qiu, Yan Ge, ShanShan Lv, WenZhao Zhong
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Abstract

Background: Intraoperative assessment of tumor spread through air spaces (STAS) in early-stage lung adenocarcinomas (ADC) has been proposed to stratify patients for surgical management. However, data on the accuracy and reproducibility of detecting STAS on frozen sections (FS) and the prognostic value of STAS on FS remain limited and contradictory.

Methods: We conducted a retrospective study on the feasibility of intraoperative assessment of STAS by comparing the STAS patterns identified on FS and permanent sections from 524 patients diagnosed with pathologic stage 1 lung ADC. We also evaluated the association between STAS with patients' clinicopathological characteristics and their postoperative survival outcomes.

Results: STAS was identified in 117 out of 524 patients (22.3 %) on permanent sections. Patients with STAS identified on permanent sections experienced shorter progression-free survival (PFS; P = 0.042) and overall survival (OS; P = 0.005) compared to those without. STAS was identified in 87 out of 509 patients on FS. Patients with STAS detected on FS also had shorter PFS (P = 0.010) and OS (P < 0.001) than those without. Compared to permanent sections, STAS detection on FS yielded 66.7 % (74/111) sensitivity, 96.7 % (385/398) specificity, 85.1 % (74/87) positive predictive value, 91.2 % (385/422) negative predictive value, and 90.2 % (459/509) overall agreement. The kappa coefficient was 0.688 (P < 0.001).

Conclusions: Our results from a large series of Chinese patients with stage 1 lung ADC indicated that STAS was associated with poorer survival outcomes on both FS and permanent sections. FS is a highly specific method for assessing STAS in stage 1 lung ADC, but caution is warranted regarding false-positive results.

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对中国患者病理分期为1期的肺腺癌进行STAS术中评估的可行性。
背景:有人建议在术中评估早期肺腺癌(ADC)肿瘤通过气隙扩散(STAS)的情况,以便对患者进行分层手术治疗。然而,有关在冰冻切片(FS)上检测 STAS 的准确性和可重复性以及 STAS 在 FS 上的预后价值的数据仍然有限且相互矛盾:我们进行了一项关于术中评估 STAS 可行性的回顾性研究,比较了从 524 例确诊为病理 1 期肺 ADC 患者的冰冻切片和永久切片上发现的 STAS 模式。我们还评估了STAS与患者临床病理特征及其术后生存结果之间的关联:结果:524 例患者中有 117 例(22.3%)在永久切片上发现了 STAS。在永久切片上发现 STAS 的患者与未发现 STAS 的患者相比,无进展生存期(PFS;P = 0.042)和总生存期(OS;P = 0.005)更短。在509例永久性切片患者中,有87例发现了STAS。在FS检查中发现STAS的患者的PFS(P = 0.010)和OS(P 结论:STAS患者的PFS(P = 0.010)和OS(P = 0.005)均较短:我们对大量中国肺部 ADC 1 期患者的研究结果表明,STAS 与 FS 和永久切片上较差的生存结果有关。FS 是评估肺 ADC 1 期 STAS 的高度特异性方法,但需要警惕假阳性结果。
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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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