Jooae Choe, Sang Min Lee, Sohee Park, Sehoon Choi, Kyung-Hyun Do, Joon Beom Seo
{"title":"基于磨玻璃状混浊的 I 期肺腺癌淋巴管侵犯的预后价值","authors":"Jooae Choe, Sang Min Lee, Sohee Park, Sehoon Choi, Kyung-Hyun Do, Joon Beom Seo","doi":"10.1007/s00330-024-11048-0","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>There is still a debate regarding the prognostic implication of lymphovascular invasion (LVI) in stage I lung adenocarcinoma. Ground-glass opacity (GGO) on CT is known to correlate with a less invasive or lepidic component in adenocarcinoma, which may influence the strength of prognostic factors. This study aimed to explore the prognostic value of LVI in stage I lung adenocarcinoma based on the presence of GGO.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Stage I lung adenocarcinoma patients receiving lobectomy between 2010 and 2019 were retrospectively categorized as GGO-positive or GGO-negative (solid adenocarcinoma) on CT. Multivariable Cox regression analyses were performed for disease-free survival (DFS) and overall survival (OS) to evaluate the prognostic significance of pathologic LVI based on the presence of GGO.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of 924 patients included (mean age, 62.5 ± 9.2 years; 505 women), 525 (56.8%) exhibited GGO-positive adenocarcinoma and 116 (12.6%) were diagnosed with LVI. LVI was significantly more frequent in solid than GGO-positive adenocarcinoma (20.1% vs. 6.9%, <i>p</i> < 0.001). Multivariable analysis identified LVI and visceral pleural invasion (VPI) as significant prognostic factors for shorter DFS among solid adenocarcinoma patients (LVI, hazard ratio (HR): 1.89, <i>p</i> = 0.004; VPI, HR: 1.65, <i>p</i> = 0.003) but not GGO-positive patients (<i>p</i> = 0.76 and <i>p</i> = 0.87). In contrast, LVI was not a significant prognostic factor for OS in either group (<i>p</i> > 0.05).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In stage I lung adenocarcinoma, pathologic LVI was associated with DFS only in patients with solid lung adenocarcinoma.</p><h3 data-test=\"abstract-sub-heading\">Clinical relevance statement</h3><p>Lymphovascular invasion (LVI) significantly affects disease-free survival in solid-stage I lung adenocarcinoma patients, but not those with ground-glass opacity (GGO) adenocarcinoma. Risk stratification considering both GGO on CT and LVI may identify patients benefiting from increased surveillance.</p><h3 data-test=\"abstract-sub-heading\">Key Points</h3><ul>\n<li>\n<p><i>The presence of ground-glass opacity portends different prognoses for lung adenocarcinoma.</i></p>\n</li>\n<li>\n<p><i>In stage I lung adenocarcinoma, lymphovascular invasion (LVI) was significantly more frequent in solid adenocarcinomas than in ground-glass opacity (GGO)-positive adenocarcinomas.</i></p>\n</li>\n<li>\n<p><i>LVI was not associated with overall survival in patients with either solid adenocarcinomas or GGO adenocarcinomas</i>.</p>\n</li>\n</ul>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The prognostic value of lymphovascular invasion for stage I lung adenocarcinoma based on the presence of ground-glass opacity\",\"authors\":\"Jooae Choe, Sang Min Lee, Sohee Park, Sehoon Choi, Kyung-Hyun Do, Joon Beom Seo\",\"doi\":\"10.1007/s00330-024-11048-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Objectives</h3><p>There is still a debate regarding the prognostic implication of lymphovascular invasion (LVI) in stage I lung adenocarcinoma. Ground-glass opacity (GGO) on CT is known to correlate with a less invasive or lepidic component in adenocarcinoma, which may influence the strength of prognostic factors. This study aimed to explore the prognostic value of LVI in stage I lung adenocarcinoma based on the presence of GGO.</p><h3 data-test=\\\"abstract-sub-heading\\\">Materials and methods</h3><p>Stage I lung adenocarcinoma patients receiving lobectomy between 2010 and 2019 were retrospectively categorized as GGO-positive or GGO-negative (solid adenocarcinoma) on CT. Multivariable Cox regression analyses were performed for disease-free survival (DFS) and overall survival (OS) to evaluate the prognostic significance of pathologic LVI based on the presence of GGO.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Of 924 patients included (mean age, 62.5 ± 9.2 years; 505 women), 525 (56.8%) exhibited GGO-positive adenocarcinoma and 116 (12.6%) were diagnosed with LVI. LVI was significantly more frequent in solid than GGO-positive adenocarcinoma (20.1% vs. 6.9%, <i>p</i> < 0.001). Multivariable analysis identified LVI and visceral pleural invasion (VPI) as significant prognostic factors for shorter DFS among solid adenocarcinoma patients (LVI, hazard ratio (HR): 1.89, <i>p</i> = 0.004; VPI, HR: 1.65, <i>p</i> = 0.003) but not GGO-positive patients (<i>p</i> = 0.76 and <i>p</i> = 0.87). In contrast, LVI was not a significant prognostic factor for OS in either group (<i>p</i> > 0.05).</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>In stage I lung adenocarcinoma, pathologic LVI was associated with DFS only in patients with solid lung adenocarcinoma.</p><h3 data-test=\\\"abstract-sub-heading\\\">Clinical relevance statement</h3><p>Lymphovascular invasion (LVI) significantly affects disease-free survival in solid-stage I lung adenocarcinoma patients, but not those with ground-glass opacity (GGO) adenocarcinoma. Risk stratification considering both GGO on CT and LVI may identify patients benefiting from increased surveillance.</p><h3 data-test=\\\"abstract-sub-heading\\\">Key Points</h3><ul>\\n<li>\\n<p><i>The presence of ground-glass opacity portends different prognoses for lung adenocarcinoma.</i></p>\\n</li>\\n<li>\\n<p><i>In stage I lung adenocarcinoma, lymphovascular invasion (LVI) was significantly more frequent in solid adenocarcinomas than in ground-glass opacity (GGO)-positive adenocarcinomas.</i></p>\\n</li>\\n<li>\\n<p><i>LVI was not associated with overall survival in patients with either solid adenocarcinomas or GGO adenocarcinomas</i>.</p>\\n</li>\\n</ul>\",\"PeriodicalId\":12076,\"journal\":{\"name\":\"European Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00330-024-11048-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-024-11048-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The prognostic value of lymphovascular invasion for stage I lung adenocarcinoma based on the presence of ground-glass opacity
Objectives
There is still a debate regarding the prognostic implication of lymphovascular invasion (LVI) in stage I lung adenocarcinoma. Ground-glass opacity (GGO) on CT is known to correlate with a less invasive or lepidic component in adenocarcinoma, which may influence the strength of prognostic factors. This study aimed to explore the prognostic value of LVI in stage I lung adenocarcinoma based on the presence of GGO.
Materials and methods
Stage I lung adenocarcinoma patients receiving lobectomy between 2010 and 2019 were retrospectively categorized as GGO-positive or GGO-negative (solid adenocarcinoma) on CT. Multivariable Cox regression analyses were performed for disease-free survival (DFS) and overall survival (OS) to evaluate the prognostic significance of pathologic LVI based on the presence of GGO.
Results
Of 924 patients included (mean age, 62.5 ± 9.2 years; 505 women), 525 (56.8%) exhibited GGO-positive adenocarcinoma and 116 (12.6%) were diagnosed with LVI. LVI was significantly more frequent in solid than GGO-positive adenocarcinoma (20.1% vs. 6.9%, p < 0.001). Multivariable analysis identified LVI and visceral pleural invasion (VPI) as significant prognostic factors for shorter DFS among solid adenocarcinoma patients (LVI, hazard ratio (HR): 1.89, p = 0.004; VPI, HR: 1.65, p = 0.003) but not GGO-positive patients (p = 0.76 and p = 0.87). In contrast, LVI was not a significant prognostic factor for OS in either group (p > 0.05).
Conclusion
In stage I lung adenocarcinoma, pathologic LVI was associated with DFS only in patients with solid lung adenocarcinoma.
Clinical relevance statement
Lymphovascular invasion (LVI) significantly affects disease-free survival in solid-stage I lung adenocarcinoma patients, but not those with ground-glass opacity (GGO) adenocarcinoma. Risk stratification considering both GGO on CT and LVI may identify patients benefiting from increased surveillance.
Key Points
The presence of ground-glass opacity portends different prognoses for lung adenocarcinoma.
In stage I lung adenocarcinoma, lymphovascular invasion (LVI) was significantly more frequent in solid adenocarcinomas than in ground-glass opacity (GGO)-positive adenocarcinomas.
LVI was not associated with overall survival in patients with either solid adenocarcinomas or GGO adenocarcinomas.
期刊介绍:
European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field.
This is the Journal of the European Society of Radiology, and the official journal of a number of societies.
From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.