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Genetic and clinicopathologic characteristics of lung adenocarcinoma with tumor spread through air spaces

 Jae Seok Lee  ;  Eun Kyung Kim  ;  Moonsik Kim  ;  Hyo Sup Shim 
 Lung Cancer, Vol.123 : 121-126, 2018 
Journal Title
 Lung Cancer 
Issue Date
Adenocarcinoma ; Genetic ; Lung cancer ; Pathological ; Recurrence ; Spread through air spaces
OBJECTIVE: The World Health Organization Classification of Lung Tumors considers "Spread Through Air Spaces (STAS)" as a form of invasion in lung adenocarcinoma. However, its existence as an independent pathologic entity rather than an artifact caused by spreading through a knife surface is still controversial. Therefore, we performed comprehensive analyses on the genetic and clinicopathologic characteristics of lung adenocarcinoma with STAS. MATERIALS AND METHODS: A total of 316 surgically resected lung adenocarcinoma cases were analyzed retrospectively. Detailed analyses were performed on clinical-histological-molecular features. Tumor STAS was defined as tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. RESULTS: STAS was observed in 160 cases (50.6%). STAS was significantly related to lymphovascular invasion, lymph node metastasis, higher stage, and high-grade histologic subtype. STAS was frequently found in tumors with wild-type EGFR or ALK-rearrangement. Logistic regression analysis showed that STAS was significantly associated with absence of lepidic component, presence of micropapillary component, cribriform predominant type, lymphovascular invasion, and wild-type EGFR. Multivariate survival analysis demonstrated that STAS was independently associated with shorter recurrence-free survival. STAS was also associated with recurrences to extrathoracic sites as well as intrathoracic sites. CONCLUSION: STAS is associated with certain pathological and molecular subtypes. STAS might be a parameter for tumor aggressiveness in that it is strongly associated with poor prognostic factors and recurrence, including to extrathoracic sites.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Moonsik(김문식) ORCID logo https://orcid.org/0000-0002-5804-8790
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Lee, Jae Seok(이재석)
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