A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee.
Adenocarcinoma
Lung
Model
Prognosis
Tumor grading
Journal
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
ISSN: 1556-1380
Titre abrégé: J Thorac Oncol
Pays: United States
ID NLM: 101274235
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
13
05
2020
revised:
05
06
2020
accepted:
08
06
2020
pubmed:
21
6
2020
medline:
2
2
2021
entrez:
21
6
2020
Statut:
ppublish
Résumé
A grading system for pulmonary adenocarcinoma has not been established. The International Association for the Study of Lung Cancer pathology panel evaluated a set of histologic criteria associated with prognosis aimed at establishing a grading system for invasive pulmonary adenocarcinoma. A multi-institutional study involving multiple cohorts of invasive pulmonary adenocarcinomas was conducted. A cohort of 284 stage I pulmonary adenocarcinomas was used as a training set to identify histologic features associated with patient outcomes (recurrence-free survival [RFS] and overall survival [OS]). Receiver operating characteristic curve analysis was used to select the best model, which was validated (n = 212) and tested (n = 300, including stage I-III) in independent cohorts. Reproducibility of the model was assessed using kappa statistics. The best model (area under the receiver operating characteristic curve [AUC] = 0.749 for RFS and 0.787 for OS) was composed of a combination of predominant plus high-grade histologic pattern with a cutoff of 20% for the latter. The model consists of the following: grade 1, lepidic predominant tumor; grade 2, acinar or papillary predominant tumor, both with no or less than 20% of high-grade patterns; and grade 3, any tumor with 20% or more of high-grade patterns (solid, micropapillary, or complex gland). Similar results were seen in the validation (AUC = 0.732 for RFS and 0.787 for OS) and test cohorts (AUC = 0.690 for RFS and 0.743 for OS), confirming the predictive value of the model. Interobserver reproducibility revealed good agreement (k = 0.617). A grading system based on the predominant and high-grade patterns is practical and prognostic for invasive pulmonary adenocarcinoma.
Identifiants
pubmed: 32562873
pii: S1556-0864(20)30468-8
doi: 10.1016/j.jtho.2020.06.001
pmc: PMC8362286
mid: NIHMS1729369
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1599-1610Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA016087
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA214195
Pays : United States
Informations de copyright
Copyright © 2020 International Association for the Study of Lung Cancer. All rights reserved.
Références
Pathol Int. 2012 Dec;62(12):785-91
pubmed: 23252867
Mod Pathol. 2012 Aug;25(8):1117-27
pubmed: 22499226
J Thorac Oncol. 2013 Jan;8(1):52-61
pubmed: 23242438
Lung Cancer. 2016 Nov;101:82-87
pubmed: 27794412
J Cancer Res Clin Oncol. 2020 Mar;146(3):801-807
pubmed: 31884561
Eur J Cancer. 2015 Sep;51(14):1897-903
pubmed: 26235745
Cancer. 2010 Apr 15;116(8):2011-9
pubmed: 20151423
Am J Surg Pathol. 2013 Jul;37(7):1100-8
pubmed: 23681071
J Clin Oncol. 2012 May 1;30(13):1438-46
pubmed: 22393100
Arch Pathol Lab Med. 2020 Mar;144(3):335-343
pubmed: 32101058
Histopathology. 2017 Sep;71(3):425-436
pubmed: 28401582
Transl Lung Cancer Res. 2017 Oct;6(5):501-507
pubmed: 29114466
J Thorac Oncol. 2019 Jan;14(1):72-86
pubmed: 30253972
Histopathology. 2020 Aug;77(2):173-180
pubmed: 31943337
BMC Urol. 2011 Oct 06;11:21
pubmed: 21978318
Oncol Rev. 2017 Mar 10;11(1):317
pubmed: 28382188
Am J Surg Pathol. 2010 Aug;34(8):1155-62
pubmed: 20551825
Oncotarget. 2016 Jun 7;7(23):35241-56
pubmed: 27153551
J Natl Cancer Inst. 2013 Aug 21;105(16):1212-20
pubmed: 23926067
Am J Clin Pathol. 2018 May 31;150(1):65-73
pubmed: 29746612
J Thorac Oncol. 2017 Dec;12(12):1788-1797
pubmed: 28882585
J Clin Oncol. 2015 Oct 20;33(30):3439-46
pubmed: 25918286
Thorac Cancer. 2018 Oct;9(10):1255-1261
pubmed: 30079987
J Thorac Oncol. 2013 Jan;8(1):37-44
pubmed: 23242436
Mod Pathol. 2011 May;24(5):653-64
pubmed: 21252858
J Thorac Oncol. 2015 May;10(5):806-814
pubmed: 25629637
J Thorac Oncol. 2019 Feb;14(2):245-254
pubmed: 30336325
Hum Pathol. 2019 Dec;94:51-57
pubmed: 31655171
J Thorac Oncol. 2019 Nov;14(11):1948-1961
pubmed: 31352072
J Thorac Oncol. 2015 Apr;10(4):638-44
pubmed: 25634008
Histopathology. 2019 Nov;75(5):649-659
pubmed: 31107973
Mod Pathol. 2014 May;27(5):690-700
pubmed: 24186133
Pathol Oncol Res. 2016 Apr;22(2):349-56
pubmed: 26563277
Fam Med. 2005 May;37(5):360-3
pubmed: 15883903
Mod Pathol. 2012 Dec;25(12):1574-83
pubmed: 22814311
Hum Pathol. 2014 Feb;45(2):213-20
pubmed: 24439219
Am J Surg Pathol. 2014 Apr;38(4):448-60
pubmed: 24472852
Mol Clin Oncol. 2020 Jan;12(1):69-74
pubmed: 31814978
J Thorac Oncol. 2015 Apr;10(4):673-81
pubmed: 25514800
Radiol Med. 2020 Mar;125(3):257-264
pubmed: 31823295