Impact of Smoking on the Histological Subtype and Outcome of the Primary Lung Adenocarcinoma

XU Yan, TAN Wei-wei, FAN Ping, YANG Zong-ze, ZHANG Shu, XI Jia-lei, WANG Ya-xi, HU Xun

Abstract

To explore the effect of smoking on the histological subtype and prognosis of patients with lung adenocarcinoma (LAC) in China.  Methods  According to the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society(IASLC/ATS/ERS)classification, 266 donors with primary LAC were reclassified. The correlation between clinicopathological factors including smoking status and the histological subtype was analyzed, and survival analysis was used to analyze the prognosis of primary LAC.  Results  There were four main histological subtypes including acinar predominant adenocarcinoma (APA) 30.1%, papillary predominant adenocarcinoma (PPA) 26.7%, solid predominant adenocarcinoma (SPA) 25.9%, and lepidic predominant adenocarcinoma (LPA) 11.7%.Smoking was associated with the histological subtype.The proportion of smokers was significantly higher than non-smokers in the SPA group, and the proportion of non-smokers was higher in other subtypes group. Cox regression model showed that the histological subtype and TNM stage were the independent predictors of prognostic in all patients.TNM stage was the predictor of postoperative survival in both smokers and non-smokers, and histological subtypes was the predictor only in smokers (β=0.898, RR=2.455). Compared with the non-SPA group, the prognosis of the SPA group was significantly worse.  Conclusion  Smoking is associated with SPA subtype, which affect the prognosis of primary LAC.

 

Keywords: Smoking, Primary lung adenocarcinoma, Histological subtype, Prognosis

 

Full Text:

PDF


References


SIEGEL R L, MILLER К D, JEMAL A. Cancer statistics. CA Cancer J Clin,2015,65( 1) ;5-29.

JACOBSEN B, MULEY T, MEISTER M. et al. uPAR-related protein C4. 4A as a marker of solid growth pattern and poor prognosis in lung adenocarcinoma. J Thorac Oncol,2013,8(2): 152-160.

DEVESASS, BRAY F, VIZCAINO A P, et al. International lung cancer trends by histologic type; male: female differences diminishing and adenocarcinoma rates rising. Int J Cancer,2005,117(2) :294-299.

XU S, XI J, JIANG W, et al. Solid component and tumor size correlate with prognosis of stage I В lung adenocarcinoma. Ann Thorac Surg,2015,99(3);961 -967.

PYO J S, KIM J H. Clinicopathological significance of micropapillary pattern in lung adenocarcinoma. Pathol Oncol Res,2018,24(3):547-555.

ALBERG A J, FORD J G, SAMET J M, et al. Epidemiology of lung cancer; ACCP evidence-based clinical practice guidelines (2nd edition). Chest,2007,132(3 Suppl): 29S-55S.

NORDQUIST L T, SIMON G R, CANTOR A, et al. Improved survival in never-smokers vs current smokers with primary adenocarcinoma of the lung. Chest, 2004, 126 ( 2 ) ; 347-351.

YOSHINO I, KAWANO D, OBA T, et al. Smoking status as a prognostic factor in patients with stage 1 pulmonary adenocarcinoma. Ann Thorac Surg,2006,81(4): 1189-1193.

TOMITAM. AYABE T, CHOSA E, et al. Impact of smoking on outcome of resected lung adenocarcinoma. Gen Thorac Cardiovasc Surg,2015,63( 11) ;608-612.

B’CHIR F, LAOUANI A, KSIBI S, et al. Cigarette filter and the incidence of lung adenocarcinoma among Tunisian population. Lung Cancer,2007,57(1) :26-33.

HSIAO SH, LIN S E, CHOU Y T, et al. Histological subtype and smoking status, but not gender, are associated with epidermal growth factor receptor mutations in non- small-cell lung cancer. Mol Clin Oncol,2014,2(2);252-258.

CHANSKY K, DETTERBECK F C, NICHOLSON A G, et al. The IASLC Lung Cancer Staging Project; external validation of the revision of the TNM stage groupings in the eighth edition of the TNM classification of lung cancer. J Thorac Oncol,2017,12(7) ; 1109-1121.

LEE G, LEE H Y, JEONG J Y, et al. Clinical impact of minimal micropapillary pattern in invasive lung adenocarcinoma; prognostic significance and survival outcomes. Am J Surg Pathol,2015,39(5) :660-666.

TRAVIS W D, BRAMBILLA E, NOGUCHI M, et al. International Association for the Study of Lung Cancer/ American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol,2011,6(2);244-285.

RUSSELL P A, WAINER Z, WRIGHT G M, et al. Does lung adenocarcinoma subtype predict patient survival? A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification. J Thorac Oncol,2011,6(9); 1496-1504.

ZHOU F, ZHOU C. Lung cancer in never smokers-the East Asian experience. Transl Lung Cancer Res,2018,7(4) ;450- 463.

STRAND T E, ROST AD H. STR0M EH, et al. The percentage of lepidic growth is an independent prognostic factor in invasive adenocarcinoma of the lung. Diagn Pathol. 2015, 10; 94 [ 2019-03-10 ]. https://diagnosticpathology. biomedcentral. com/articles/10. 1186/sl3000-015-0335-8. doi: 10. 1186/sl 3000-015-0335-8.

KHARIWALA S S, HATSUKAMI D, HECHT S S. Tobacco carcinogen metabolites and DNA adducts as biomarkers in head and neck cancer; potential screening tools and prognostic indicators. Head Neck,2012,34(3):441-447.

LARSEN J E. MINNA J D. Molecular biology of lung cancer; clinical implications. Clin Chest Med, 2011, 32 (4 ); 703-740.

GOVINDAN R, DING L. GRIFFITH M, et al. Genomic landscape of non-small cell lung cancer in smokers and never- smokers. Cell,2012,150(6): 1121-1134.

CHAPMAN A M. SUN К Y. RUESTOW P, et al. Lung cancer mutation profile of EGFR, ALK. and KRAS: meta¬analysis and comparison of never and ever smokers. Lung Cancer,2016,102:122-134.

LI H, PAN Y, LI Y, et al. Frequency of well-identified oncogenic driver mutations in lung adenocarcinoma of smokers varies with histological subtypes and graduated smoking dose. Lung Cancer ,2013 ,79 (1): 8-13.

REKHTMAN N, ANG D C, RIELY G J, et al. KRAS mutations are associated with solid growth pattern and tumor- infiltrating leukocytes in lung adenocarcinoma. Mod Pathol. 2013,26(10);1307-1319.

TOMONAGAN, NAKAMURA Y, YAMAGUCHI H, et al. Analysis of intratumor heterogeneity of EGFR mutations in mixed type lung adenocarcinoma. Clin Lung Cancer,2013, 14(5):521-526.


Refbacks

  • There are currently no refbacks.