Acinar-Predominant Pattern Correlates With Poorer Prognosis in Invasive Mucinous Adenocarcinoma of the Lung

Abstract Objectives Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma with several growth patterns, such as lepidic acinar and papillary. However, to our knowledge, no study regarding prognostic and clinicopathologic aspects of IMAs with different growth patterns has been re...

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Bibliographic Details
Published in:American journal of clinical pathology 2018-03, Vol.149 (5), p.373-378
Main Authors: Lin, Gengpeng, Li, Hui, Kuang, Jianyi, Tang, Kejing, Guo, Yubiao, Han, Anjia, Xie, Canmao
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma of Lung - classification
Adenocarcinoma of Lung - diagnostic imaging
Adenocarcinoma of Lung - pathology
Adenocarcinoma, Mucinous - classification
Adenocarcinoma, Mucinous - diagnostic imaging
Adenocarcinoma, Mucinous - pathology
Adult
Aged
Carcinoma, Acinar Cell - classification
Carcinoma, Acinar Cell - diagnostic imaging
Carcinoma, Acinar Cell - pathology
Computed tomography
Female
Growth patterns
Humans
Invasiveness
Kaplan-Meier Estimate
Lung cancer
Lung Neoplasms - classification
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - pathology
Lungs
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Male
Medical prognosis
Metastases
Metastasis
Middle Aged
Neoplasm Staging
Prognosis
Statistical analysis
Survival analysis
Tomography, X-Ray Computed
Young Adult
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Summary:Abstract Objectives Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma with several growth patterns, such as lepidic acinar and papillary. However, to our knowledge, no study regarding prognostic and clinicopathologic aspects of IMAs with different growth patterns has been reported. Methods Of 2,236 patients with primary lung adenocarcinoma, 16 were identified as having lepidic-predominant IMA and 10 as having acinar-predominant IMA. Data regarding the clinicopathologic characteristics, computed tomography (CT) features, and prognosis were collected. Results No statistically significant difference was noted in sex, age, smoker proportion, and T classification between both groups. The proportion of lymph node metastasis was significantly higher in acinar-predominant IMA (P = .046). Both groups shared many signs in CT findings. Air bronchogram was a relatively specific sign for lepidic-predominant IMA. Survival analysis showed that acinar-predominant IMA had a poorer prognosis (P = .0294). Conclusions Lepidic-predominant and acinar-predominant IMA are two different subtypes of IMA. Acinar-predominant IMA is associated with lymph node metastasis and a poorer prognosis.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqx170