Evaluation of grading systems in stage I lung adenocarcinomas a retrospective cohort study /

AIMS: There is no internationally accepted grading system for lung adenocarcinoma despite the new WHO classification. The architectural grade, the Kadota grade and the Sica score were evaluated and compared with overall (OS) and disease-free survival (DFS). METHODS: Comprehensive histological subtyp...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Zombori Tamás
Furák József
Nyári Tibor András
Cserni Gábor
Tiszlavicz László
Dokumentumtípus: Cikk
Megjelent: 2018
Sorozat:JOURNAL OF CLINICAL PATHOLOGY 71 No. 2
doi:10.1136/jclinpath-2016-204302

mtmt:3254096
Online Access:http://publicatio.bibl.u-szeged.hu/13549
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490 0 |a JOURNAL OF CLINICAL PATHOLOGY  |v 71 No. 2 
520 3 |a AIMS: There is no internationally accepted grading system for lung adenocarcinoma despite the new WHO classification. The architectural grade, the Kadota grade and the Sica score were evaluated and compared with overall (OS) and disease-free survival (DFS). METHODS: Comprehensive histological subtyping was used in a series of resected stage I lung adenocarcinoma to identify subtypes of adenocarcinomas, the architectural grade, the Kadota grade, the Sica grade, the mitotic count, nuclear atypia, the presence of lymphovascular, vascular and airway propagation, necrosis, and micropapillary or solid growth pattern in any percentage. Statistical models fitted included Kaplan-Meier estimates and Cox proportional hazard regression models. RESULTS: 261 stage I adenocarcinomas were included. The 5-year survivals of different subtypes were as follows: lepidic (n=40, OS: 92.5%; DFS 91.6%), acinar (n=54, OS: 81.8%; DFS: 68.6%), papillary (n=49, OS: 73.6%; DFS: 61.0%), solid (n=95, OS: 64.7%; DFS: 57.8%) and micropapillary (n=23, OS: 34.8%; DFS: 33.5%). Concerning the architectural grade, there were significant differences between OS and DFS of low and intermediate (pOS=0.005, pDFS<0.001), low and high (pOS<0.001, pDFS<0.001) and intermediate and high grades (pOS=0.002, pDFS<0.001). Low-grade and intermediate grade tumours did not differ in survival according to Kadota grade and Sica grade. In the multivariable model, architectural grade was found to be an independent prognostic marker. In another model, architectural pattern proved to be superior to architectural grade. CONCLUSIONS: Of the three grading systems compared, the architectural grade makes the best distinction between the outcome of low-grade, intermediate-grade and high-grade stage I adenocarcinomas. 
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700 0 1 |a Nyári Tibor András  |e aut 
700 0 1 |a Cserni Gábor  |e aut 
700 0 1 |a Tiszlavicz László  |e aut 
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