Prognostic impact and clinicopathological correlations of the cribriform pattern in pulmonary adenocarcinoma

• Verfasst von: Warth, Arne [VerfasserIn]
• Verfasst von: Muley, Thomas [VerfasserIn]
• Verfasst von: Kossakowski, Claudia [VerfasserIn]
• Verfasst von: Stenzinger, Albrecht [VerfasserIn]
• Verfasst von: Schirmacher, Peter [VerfasserIn]
• Verfasst von: Dienemann, Hendrik [VerfasserIn]
• Verfasst von: Weichert, Wilko [VerfasserIn]
• Titel: Prognostic impact and clinicopathological correlations of the cribriform pattern in pulmonary adenocarcinoma
• Verf.angabe: Arne Warth, Thomas Muley, Claudia Kossakowski, Albrecht Stenzinger, Peter Schirmacher, Hendrik Dienemann, and Wilko Weichert
• Umfang: 7 S.
• Fussnoten: Gesehen am 28.07.2017
• Titel Quelle: Enthalten in: Journal of thoracic oncology
• Jahr Quelle: 2015
• Band/Heft Quelle: 10(2015), 4, S. 638-644
• ISSN Quelle: 1556-1380
• DOI: doi:10.1097/JTO.0000000000000490
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1561298530

Abstract

A novel classification of pulmonary adenocarcinoma (ADC) distinguishing five growth patterns has been established by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society. There is evidence that an additional cribriform pattern associates with a distinct clinical behavior. We evaluated the predominant growth pattern of 674 resected ADC as recommended by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society, including the cribriform pattern. The predominant pattern type was correlated with clinical, molecular, and survival data. Two hundred forty-eight (36.8%) of the pulmonary ADC were solid, 207 (30.6%) were acinar, 101 (15%) were papillary, 55 (8.2%) were micropapillary, 35 (5.2%) were lepidic, and 28 cases (4.2%) were cribriform predominant (cpADC). Minor cribriform components were frequently observed (28.6% of all cases). cpADC showed the second highest proliferative capacity of all patterns, no somatic mutations in the epidermal growth factor receptor (p = 0.001) and a high rate of KRAS mutations. Overall survival (OS) of patients with cpADC (mean OS: 62.7 months) ranged in between survival times of patients with acinar (mean OS: 71.3 months) and solid predominant ADC (mean OS: 54.5 months); cpADC was associated with the worst disease-free survival (DFS) of all patterns (mean DFS: 36.9 months). Both associations were confirmed by multivariate analysis (p < 0.01 for both OS and DFS). Hazard ratios for cpADC were 1.72 for OS and 2.99 for DFS, with lepidic predominant ADC set as reference (hazard ratio: 1). Our data support the introduction of cpADC as a novel category into future morphology based on pulmonary ADC classifications. Further international studies are required to validate the reported clinicopathological associations of the cribriform pattern.