Pulmonary adenocarcinoma with a micropapillary pattern: a clinicopathological, immunophenotypic and molecular analysis.

Abstract:

AIMS:To investigate the clinicopathological and molecular characteristics, immunohistochemical profile and prognosis of pulmonary adenocarcinoma with a micropapillary pattern (MPPAC). METHODS AND RESULTS:Eight hundred and eighty-six pulmonary adenocarcinomas were divided into two groups: micropapillary pattern (MPP)-positive (≥1% MPP) (n = 246) and MPP-negative (n = 640), and clinicopathological characteristics were analysed. Of these, 66 cases with extensive MPP (MPP ≥ 50%) were studied by immunohistochemistry for several markers, and mutational analysis of K-ras and epidermal growth factor receptor (EGFR) with the Scorpion Amplification Refractory Mutation System. Smoking, TNM stage, lymph node metastasis, lymphatic invasion, venous invasion, pleural invasion and differentiation grade were significantly associated with the prognosis of MPPAC (P < 0.05). Immunohistochemically, the positive rate in the MPP-positive group was 100% for E-cadherin, 100% for β-catenin, 93.9% for Muc-1, 57.6% for EGFR, 37.9% for p53, and 95.5% for Ki67. No differences were identified between MPP and non-MPP tissue within the same tumour with regard to K-ras and EGFR mutations. The 5-year survival rates of patients were significantly different between the MPP-positive group and the MPP-negative group (P = 0.005). By multivariate analysis, a MPP was an independent prognostic factor for lung adenocarcinomas. CONCLUSIONS:MPP represents a distinct histopathological variant with biological and prognostic significance.

journal_name

Histopathology

journal_title

Histopathology

authors

Zhang J,Liang Z,Gao J,Luo Y,Liu T

doi

10.1111/j.1365-2559.2011.04050.x

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

1204-14

issue

6

eissn

0309-0167

issn

1365-2559

journal_volume

59

pub_type

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