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Shinji Sumiyoshi



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    P2.09 - Pathology (Not CME Accredited Session) (ID 958)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.09-32 - Detached Epithelial Cell Cluster Size in Lung Adenocarcinoma is a Marker of Poor Prognosis (ID 12884)

      16:45 - 18:00  |  Author(s): Shinji Sumiyoshi

      • Abstract

      Background

      Various types of detached epithelial cell clusters (DECs) are occasionally seen within lung adenocarcinoma (L-ADC): small clusters containing a small number of tumor cells (type 1); medium-sized clusters comprising 5-20 tumor cells (type 2); and large clusters comprising more than 20 tumor cells (type 3). In general, type 2 DEC is considered a micropapillary pattern (MP-p). Although MP-p is known to be a sign of worse prognosis than other growth patterns, the prognostic significance of type 1 and 3 DEC structures are not well known. This study aimed to analyze the prognostic significance of DEC by histologically reviewing 921 resected L-ADCs.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We investigated the presence of DEC, the DEC pattern (type 1, 2, or 3), and their associations with clinicopathological parameters. Furthermore, we studied the prognostic significance of DEC in resected L-ADCs.

      4c3880bb027f159e801041b1021e88e8 Result

      Two hundred sixty-four tumors (28.6%) were DEC-positive. These DEC-positive tumors were significantly associated with higher levels of T factor (P < 0.001), node positivity (P < 0.001), higher tumor stage (P < 0.001), lymphovascular invasion (P < 0.001), and the presence of spread through air spaces (STAS) (P < 0.001). On the other hand, no association was observed between DEC positivity and EGFR, KRAS, or ALK gene alterations. Patients with DEC-positive tumors had significantly worse prognoses than those with DEC-negative tumors, as assessed by both overall survival and disease-free survival (P < 0.001 for both). Furthermore, patients with tumors showing type 3 DEC had the worst prognoses, followed by patients type 2 DEC. Patients with type 1 or no DEC had significantly better prognoses (P < 0.001).

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      8eea62084ca7e541d918e823422bd82e Conclusion

      The present study indicated that DECs are significant prognostic markers of L-ADC outcomes. These results suggest that patients with DEC in resected L-ADCs may require additional treatment after resection.

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