Why Do Pathological Stage IA Lung Adenocarcinomas Vary from Prognosis

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Why Do Pathological Stage IA Lung Adenocarcinomas Vary from Prognosis Why Do Pathological Stage IA Lung Adenocarcinomas Vary from Prognosis?: A Clinicopathologic Study of 176 Patients with Pathological Stage IA Lung Adenocarcinoma Based on the IASLC/ATS/ERS Classification  Jie Zhang, MD, MS, Jie Wu, MD, Qiang Tan, PhD, Lei Zhu, MD, Wen Gao, MD  Journal of Thoracic Oncology  Volume 8, Issue 9, Pages 1196-1202 (September 2013) DOI: 10.1097/JTO.0b013e31829f09a7 Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Adenocarcinoma in situ, this tumor shows lepidic growth consisting of alveolar wall thickening by atypical pneumocyte proliferation. No invasive growth area is seen (Hematoxylin and Eosin,×100). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Minimally invasive adenocarcinoma, this tumor consists of mostly lepidic growth but there is an invasive area not more than 5mm in diameter, with a papillary growth pattern (Hematoxylin and Eosin,×100). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Lepidic predominant, this tumor consists of mostly lepidic growth but there is an invasive area more than 5 mm in diameter, with an acinar growth pattern (Hematoxylin and Eosin,×40). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Acinar predominant, this tumor is composed of round-to-oval–shaped glands consisting of atypical epithelial cells showing nuclear hyperchromasia and prominent nucleoli (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 5 Papillary predominant, this tumor shows a papillary pattern with cuboidal cells growing along the surface of fibrovascular cores (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 6 Micropapillary predominant, this tumor shows glandular cells growing in small papillary tufts lacking fibrovascular cores (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 7 Solid predominant with mucin production, this tumor is composed of solid sheets of tumor cells with intracellular mucin production (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 8 Invasive mucinous adenocarcinoma, this tumor shows tall columnar mucinous cells line along the alveolar walls with penetration of fibrous stroma (Hematoxylin and Eosin, ×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 9 Colloid adenocarcinoma, this tumor consists of pools of mucin filling air spaces with well-differentiated malignant glands growing along the edges of the surrounding connective tissue (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 10 Fetal adenocarcinoma, this tumor shows adenoid structure similar to endometrial glands, lined by pseudo-stratified epithelial cells containing glycogen vacuoles (Hematoxylin and Eosin,×200). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 11 Five-year disease-free survival in the three groups: AIS and MIA, lepidic and acinar predominant, papillary, micropapillary, and solid predominant (p < 0.001). AIS, adenocarcinoma in situ; MIA, minimally invasive adenocarcinoma. Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 12 There was a significant difference in 5-year disease-free survival between men and women (p = 0.011). Journal of Thoracic Oncology 2013 8, 1196-1202DOI: (10.1097/JTO.0b013e31829f09a7) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions