International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma.
BACKGROUND
Adenocarcinoma is the most common histologic type of lung cancer. To address advances in oncology, molecular biology, pathology, radiology, and surgery of lung adenocarcinoma, an international multidisciplinary classification was sponsored by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society. This new adenocarcinoma classification is needed to provide uniform terminology and diagnostic criteria, especially for bronchioloalveolar carcinoma (BAC), the overall approach to small nonresection cancer specimens, and for multidisciplinary strategic management of tissue for molecular and immunohistochemical studies.


METHODS
An international core panel of experts representing all three societies was formed with oncologists/pulmonologists, pathologists, radiologists, molecular biologists, and thoracic surgeons. A systematic review was performed under the guidance of the American Thoracic Society Documents Development and Implementation Committee. The search strategy identified 11,368 citations of which 312 articles met specified eligibility criteria and were retrieved for full text review. A series of meetings were held to discuss the development of the new classification, to develop the recommendations, and to write the current document. Recommendations for key questions were graded by strength and quality of the evidence according to the Grades of Recommendation, Assessment, Development, and Evaluation approach.


RESULTS
The classification addresses both resection specimens, and small biopsies and cytology. The terms BAC and mixed subtype adenocarcinoma are no longer used. For resection specimens, new concepts are introduced such as adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) for small solitary adenocarcinomas with either pure lepidic growth (AIS) or predominant lepidic growth with ≤ 5 mm invasion (MIA) to define patients who, if they undergo complete resection, will have 100% or near 100% disease-specific survival, respectively. AIS and MIA are usually nonmucinous but rarely may be mucinous. Invasive adenocarcinomas are classified by predominant pattern after using comprehensive histologic subtyping with lepidic (formerly most mixed subtype tumors with nonmucinous BAC), acinar, papillary, and solid patterns; micropapillary is added as a new histologic subtype. Variants include invasive mucinous adenocarcinoma (formerly mucinous BAC), colloid, fetal, and enteric adenocarcinoma. This classification provides guidance for small biopsies and cytology specimens, as approximately 70% of lung cancers are diagnosed in such samples. Non-small cell lung carcinomas (NSCLCs), in patients with advanced-stage disease, are to be classified into more specific types such as adenocarcinoma or squamous cell carcinoma, whenever possible for several reasons: (1) adenocarcinoma or NSCLC not otherwise specified should be tested for epidermal growth factor receptor (EGFR) mutations as the presence of these mutations is predictive of responsiveness to EGFR tyrosine kinase inhibitors, (2) adenocarcinoma histology is a strong predictor for improved outcome with pemetrexed therapy compared with squamous cell carcinoma, and (3) potential life-threatening hemorrhage may occur in patients with squamous cell carcinoma who receive bevacizumab. If the tumor cannot be classified based on light microscopy alone, special studies such as immunohistochemistry and/or mucin stains should be applied to classify the tumor further. Use of the term NSCLC not otherwise specified should be minimized.


CONCLUSIONS
This new classification strategy is based on a multidisciplinary approach to diagnosis of lung adenocarcinoma that incorporates clinical, molecular, radiologic, and surgical issues, but it is primarily based on histology. This classification is intended to support clinical practice, and research investigation and clinical trials. As EGFR mutation is a validated predictive marker for response and progression-free survival with EGFR tyrosine kinase inhibitors in advanced lung adenocarcinoma, we recommend that patients with advanced adenocarcinomas be tested for EGFR mutation. This has implications for strategic management of tissue, particularly for small biopsies and cytology samples, to maximize high-quality tissue available for molecular studies. Potential impact for tumor, node, and metastasis staging include adjustment of the size T factor according to only the invasive component (1) pathologically in invasive tumors with lepidic areas or (2) radiologically by measuring the solid component of part-solid nodules.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. travisw@mskcc.org
William D
WD
Travis
Elisabeth
E
Brambilla
Masayuki
M
Noguchi
Andrew G
AG
Nicholson
Kim R
KR
Geisinger
Yasushi
Y
Yatabe
David G
DG
Beer
Charles A
CA
Powell
Gregory J
GJ
Riely
Paul E
PE
Van Schil
Kavita
K
Garg
John H M
JH
Austin
Hisao
H
Asamura
Valerie W
VW
Rusch
Fred R
FR
Hirsch
Giorgio
G
Scagliotti
Tetsuya
T
Mitsudomi
Rudolf M
RM
Huber
Yuichi
Y
Ishikawa
James
J
Jett
Montserrat
M
Sanchez-Cespedes
Jean-Paul
JP
Sculier
Takashi
T
Takahashi
Masahiro
M
Tsuboi
Johan
J
Vansteenkiste
Ignacio
I
Wistuba
Pan-Chyr
PC
Yang
Denise
D
Aberle
Christian
C
Brambilla
Douglas
D
Flieder
Wilbur
W
Franklin
Adi
A
Gazdar
Michael
M
Gould
Philip
P
Hasleton
Douglas
D
Henderson
Bruce
B
Johnson
David
D
Johnson
Keith
K
Kerr
Keiko
K
Kuriyama
Jin Soo
JS
Lee
Vincent A
VA
Miller
Iver
I
Petersen
Victor
V
Roggli
Rafael
R
Rosell
Nagahiro
N
Saijo
Erik
E
Thunnissen
Ming
M
Tsao
David
D
Yankelewitz
D000230:Adenocarcinoma / Q000145:classification* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000473:pathology; D009367:Neoplasm Staging; D012955:Societies, Medical
Br J Cancer. 2004 Dec 13;91(12):2018-25
15545971
Gen Thorac Cardiovasc Surg. 2009 Oct;57(10):534-9
19830516
Clin Cancer Res. 2010 Mar 1;16(5):1561-71
20179225
J Clin Oncol. 2004 Mar 1;22(5):811-9
14990636
Cancer. 2010 Feb 1;116(3):670-5
20029977
Am J Clin Pathol. 1999 Sep;112(3):391-402
10478146
Ann Thorac Surg. 2004 Nov;78(5):1728-33
15511463
Br J Cancer. 1999 Mar;79(9-10):1549-52
10188905
Radiology. 2004 Jun;231(3):866-71
15163822
Clin Cancer Res. 2005 Jun 1;11(11):4128-35
15930348
Cancer. 2009 Feb 1;115(3):581-6
19117348
Int J Clin Exp Pathol. 2010 Mar 25;3(4):348-66
20490327
N Engl J Med. 2009 Sep 3;361(10):947-57
19692680
J Clin Oncol. 2009 Jul 1;27(19):3217-24
19433683
Cancer. 2008 Dec 15;113(12):3440-9
18988293
J Thorac Cardiovasc Surg. 2006 Nov;132(5):1189-95
17059942
J Thorac Oncol. 2010 Feb;5(2):197-205
20101145
Ann Thorac Surg. 2002 May;73(5):1545-50; discussion 1550-1
12022547
Lung Cancer. 1998 Nov;22(2):103-17
10022218
J Thorac Cardiovasc Surg. 2004 Mar;127(3):857-61
15001917
Lung Cancer. 2001 Nov;34(2):169-75
11679175
Hum Pathol. 2010 Jan;41(1):20-5
19740516
N Engl J Med. 2006 Aug 10;355(6):570-80
16899777
J Mol Diagn. 2010 Mar;12(2):169-76
20093391
Mod Pathol. 2002 Jun;15(6):617-24
12065775
J Thorac Oncol. 2007 Sep;2(9):808-12
17805057
Lung Cancer. 2005 Oct;50(1):1-8
15950315
J Clin Oncol. 2009 Dec 20;27(36):6251-66
19917871
Clin Cancer Res. 2004 Nov 1;10(21):7311-7
15534107
AJR Am J Roentgenol. 1992 Aug;159(2):275-7
1321558
Cancer Res. 2007 Oct 15;67(20):9996-10003
17942933
Lung Cancer. 2000 Sep;29(3):179-88
10996420
Respir Res. 2000;1(3):163-9
11667981
Lung Cancer. 2009 Dec;66(3):379-85
19299033
Eur Radiol. 2000;10(8):1304-9
10939496
Chest. 2007 Sep;132(3 Suppl):202S-220S
17873169
J Thorac Oncol. 2009 Jul;4(7):792-801
19458556
J Thorac Oncol. 2007 Aug;2(8):706-14
17762336
PLoS One. 2010 Jul 22;5(7):e11712
20661423
Am J Clin Pathol. 2007 Jul;128(1):100-8
17580276
Cancer. 1999 Apr 15;85(8):1734-9
10223567
J Thorac Cardiovasc Surg. 2003 Jan;125(1):101-7
12538991
J Comput Assist Tomogr. 2005 May-Jun;29(3):361-8
15891508
J Thorac Oncol. 2010 Apr;5(4):442-7
20195168
Lung Cancer. 2010 Jun;68(3):478-83
19683826
Ann Thorac Cardiovasc Surg. 2006 Apr;12(2):83-8
16702928
Hum Pathol. 2002 Jul;33(7):697-702
12196920
Chest. 2008 Feb;133(2):441-7
18071015
Lung Cancer. 2011 Jun;72(3):309-15
21036415
Am J Surg Pathol. 2003 Jan;27(1):101-9
12502932
Br J Cancer. 2006 Nov 20;95(10):1390-5
17060940
Am J Clin Pathol. 2001 Sep;116(3):319-25
11554157
Histopathology. 2000 Jan;36(1):8-16
10632746
Ann Thorac Surg. 2006 Jun;81(6):1988-95
16731118
Mod Pathol. 2000 Sep;13(9):962-72
11007036
Med Oncol. 2010 Mar;27(1):9-15
19130320
Am J Surg Pathol. 1998 Nov;22(11):1343-50
9808126
Arch Pathol Lab Med. 2004 Apr;128(4):406-14
15043468
Histopathology. 2004 Nov;45(5):468-76
15500650
Clin Lung Cancer. 2008 Jan;9(1):24-9
18282354
Am J Surg Pathol. 1998 Apr;22(4):399-411
9537466
Radiology. 2007 Oct;245(1):267-75
17885195
J Clin Oncol. 2008 Sep 10;26(26):4268-75
18626007
Cancer Res. 2007 Jul 1;67(13):6007-11
17616654
Cancer Sci. 2007 Jul;98(7):985-91
17459062
J Thorac Oncol. 2009 Jan;4(1):22-9
19096302
Clin Cancer Res. 2006 Feb 1;12(3 Pt 1):710-7
16467080
J Thorac Oncol. 2009 Nov;4(11):1352-6
19861905
J Pathol. 1998 Mar;184(3):240-6
9614374
Br J Cancer. 2005 Jan 17;92(1):131-9
15597105
Adv Anat Pathol. 1998 Jul;5(4):205-15
9859753
N Engl J Med. 2006 Dec 14;355(24):2542-50
17167137
J Comput Biol. 2005 Jun;12(5):534-44
15952876
Nat Med. 2008 Aug;14(8):822-7
18641660
PLoS Med. 2006 Jul;3(7):e232
16800721
Am J Pathol. 2001 Nov;159(5):1941-8
11696455
J Thorac Oncol. 2009 Nov;4(11):1331-6
19701106
Radiology. 2000 Oct;217(1):251-6
11012453
Mod Pathol. 2009 May;22(5):709-17
19287461
Lung Cancer. 2010 Apr;68(1):66-71
19559496
Am J Surg Pathol. 2008 Jun;32(6):810-27
18391747
J Thorac Oncol. 2008 May;3(5):483-90
18449000
Am J Surg Pathol. 2009 Mar;33(3):462-9
19092635
Clin Cancer Res. 2009 Sep 1;15(17):5317-22
19706816
Br J Cancer. 2003 Jul 7;89(1):55-64
12838300
Am J Clin Pathol. 2004 May;121(5):644-53
15151204
Cell. 2005 Jun 17;121(6):823-35
15960971
Proc Natl Acad Sci U S A. 2008 Jul 22;105(29):10155-60
18632575
Appl Immunohistochem Mol Morphol. 2004 Sep;12(3):240-7
15551738
Am J Pathol. 1999 Jan;154(1):249-54
9916939
AJR Am J Roentgenol. 2003 Apr;180(4):955-64
12646435
J Clin Oncol. 2006 Nov 1;24(31):5079-90
17075127
Eur Respir J. 2001 Oct;18(4):705-19
11716177
J Clin Oncol. 2006 Sep 20;24(27):4517-20
16983123
BMJ. 2008 Apr 26;336(7650):924-6
18436948
Am J Clin Pathol. 2002 Mar;117(3):464-70
11888087
Oncologist. 2007 Jun;12(6):713-8
17602060
Clin Cancer Res. 2008 Nov 15;14(22):7423-9
19010859
Clin Cancer Res. 2006 Jan 1;12(1):43-8
16397022
Lung Cancer. 2010 Sep;69(3):272-8
20022659
Am J Surg Pathol. 2010 Aug;34(8):1155-62
20551825
Ann Diagn Pathol. 2001 Oct;5(5):274-84
11598855
Clin Lung Cancer. 2006 Mar;7(5):299
16640799
Histopathology. 2005 Jun;46(6):677-84
15910599
J Thorac Imaging. 1995 Spring;10(2):96-8
7769637
Hum Pathol. 2006 May;37(5):542-6
16647951
Radiology. 2005 Nov;237(2):395-400
16244247
Hum Pathol. 2001 Mar;32(3):274-81
11274635
J Clin Oncol. 2005 May 10;23(14):3279-87
15886315
J Thorac Cardiovasc Surg. 2009 Jun;137(6):1388-93
19464454
Cancer. 2005 May 1;103(9):1865-73
15770690
Cancer Cell. 2006 Mar;9(3):189-98
16530703
J Comput Assist Tomogr. 1999 Jul-Aug;23(4):641-3
10433300
J Thorac Cardiovasc Surg. 2011 Mar;141(3):662-70
21335122
Br J Cancer. 2005 Aug 8;93(3):355-63
16052218
Lung Cancer. 2009 Aug;65(2):170-5
19111932
Radiat Med. 2000 Nov-Dec;18(6):343-7
11153686
Clin Lung Cancer. 2010 Mar 1;11(2):126-31
20199979
Lung Cancer. 2007 Dec;58(3):329-41
17675180
Ann Thorac Surg. 2001 Mar;71(3):971-4
11269483
J Pathol. 2004 Jun;203(2):645-52
15141379
Clin Cancer Res. 2010 Oct 15;16(20):4938-45
20926401
J Clin Oncol. 2010 Feb 10;28(5):744-52
20038723
Radiology. 2001 Sep;220(3):803-9
11526285
J Thorac Oncol. 2009 Sep;4(9):1047-8
19704334
J Pathol. 2007 Jul;212(3):287-94
17534846
J Natl Cancer Inst. 2009 Apr 15;101(8):560-70
19351924
AJR Am J Roentgenol. 2010 Feb;194(2):398-406
20093602
J Thorac Oncol. 2008 Feb;3(2):111-6
18303429
J Thorac Cardiovasc Surg. 2005 May;129(5):991-6
15867771
Mod Pathol. 2007 May;20(5):514-21
17334347
Asian J Surg. 2010 Apr;33(2):89-93
21029945
Br J Cancer. 2006 Dec 4;95(11):1483-9
17106442
Chest. 2008 Jun;133(6):1402-1409
18339781
J Thorac Oncol. 2008 Jan;3(1):13-7
18166835
Mod Pathol. 2010 Feb;23(2):159-68
19855375
J Mol Diagn. 2008 May;10(3):242-8
18403609
Radiology. 2008 May;247(2):400-8
18430874
J Comput Assist Tomogr. 2010 May-Jun;34(3):413-7
20498546
J Clin Pathol. 2010 Dec;63(12):1066-70
20935334
Am J Surg Pathol. 2004 Feb;28(2):198-206
15043309
N Engl J Med. 2010 Jun 24;362(25):2380-8
20573926
Lung. 2009 May-Jun;187(3):207-8
19408043
J Thorac Oncol. 2009 Dec;4(12):1530-6
19755925
Virchows Arch. 2002 Jun;440(6):598-603
12070599
Br J Cancer. 2008 Jan 15;98(1):154-60
18087280
Clin Cancer Res. 2007 May 15;13(10):2946-54
17504995
J Clin Oncol. 2009 Mar 20;27(9):1394-400
19224850
Pathol Int. 2007 May;57(5):233-44
17493170
Am J Clin Pathol. 1999 May;111(5):610-22
10230351
Ann Thorac Surg. 1991 Mar;51(3):368-76; discussion 376-7
1998413
Pathol Annu. 1988;23 Pt 2:361-94
2849745
Lung Cancer. 2002 Jun;36(3):289-95
12009240
Clin Cancer Res. 2000 Oct;6(10):4055-63
11051256
Eur Radiol. 2002 Jan;12(1):181-9
11868096
Eur Radiol. 2005 Aug;15(8):1563-8
15846496
Am J Respir Crit Care Med. 2004 Jul 15;170(2):167-74
15087295
Ann Thorac Surg. 2006 Aug;82(2):408-15; discussion 415-6
16863738
J Clin Oncol. 2009 Sep 10;27(26):4247-53
19667264
Clin Cancer Res. 2006 Mar 1;12(5):1647-53
16533793
Jpn J Radiol. 2010 May;28(4):251-8
20512541
Am J Surg Pathol. 2002 Jun;26(6):767-73
12023581
Am J Surg Pathol. 1990 Oct;14(10):904-12
2403196
Lung Cancer. 2010 May;68(2):185-91
19581016
Lung Cancer. 2009 Feb;63(2):235-40
18571764
J Thorac Oncol. 2007 Jan;2(1):29-33
17410006
Mod Pathol. 2002 Jan;15(1):6-10
11796835
Br J Radiol. 2000 Dec;73(876):1252-9
11205667
Chest. 2007 Sep;132(3 Suppl):108S-130S
17873164
Clin Cancer Res. 2009 Aug 15;15(16):5184-90
19671847
Ann Thorac Surg. 2002 Feb;73(2):386-92; discussion 392-3
11845847
J Clin Oncol. 2004 Jun 1;22(11):2184-91
15169807
Nature. 2008 Oct 23;455(7216):1069-75
18948947
Proc Natl Acad Sci U S A. 2004 Sep 7;101(36):13306-11
15329413
J Clin Oncol. 2006 Nov 1;24(31):5034-42
17075123
Radiology. 2011 Jan;258(1):243-53
21045183
Clin Lung Cancer. 2009 Jul;10(4):281-9
19632948
Radiology. 1990 Jul;176(1):185-90
2162069
J Comput Assist Tomogr. 2005 Sep-Oct;29(5):621-5
16163031
ACP J Club. 2008 Dec 16;149(6):2
19071869
J Thorac Oncol. 2009 Jan;4(1):12-21
19096301
Cancer. 2010 Jul 1;116(13):3170-7
20564630
Radiology. 2010 Apr;255(1):218-24
20308458
Nucl Med Commun. 2000 Aug;21(8):707-14
11039452
Hum Pathol. 2002 Sep;33(9):921-6
12378518
Cancer. 2006 Nov 15;107(10):2468-73
17036361
J Thorac Oncol. 2007 Jan;2(1):22-8
17410005
Histopathology. 2004 Dec;45(6):580-6
15569048
Hum Pathol. 2002 Sep;33(9):915-20
12378517
J Thorac Oncol. 2010 Jun;5(6):830-6
20521350
Hum Pathol. 2007 May;38(5):702-9
17376511
Am J Surg Pathol. 2009 Dec;33(12):1752-64
19773638
J Mol Diagn. 2007 Jul;9(3):320-6
17591931
J Pathol. 2003 Jun;200(2):214-21
12754743
J Clin Oncol. 2006 Apr 10;24(11):1679-88
16549822
Arch Pathol Lab Med. 2009 Mar;133(3):470-7
19260752
Am J Surg Pathol. 1996 May;20(5):553-62
8619420
Mod Pathol. 2011 May;24(5):653-64
21252858
Surg Today. 2006;36(3):230-4
16493531
Jpn J Clin Oncol. 2006 Jul;36(7):403-9
16782729
Thorax. 1992 Dec;47(12):1041-3
1494768
Am J Respir Crit Care Med. 2008 Nov 15;178(10):1090; author reply 1090
18987348
N Engl J Med. 2006 Sep 7;355(10):983-91
16957145
Lung Cancer. 2009 Aug;65(2):161-5
19128855
J Thorac Oncol. 2009 Dec;4(12):1490-5
19844187
Lancet Oncol. 2010 Feb;11(2):121-8
20022809
Am J Clin Pathol. 2005 Jul;124(1):62-70
15923171
J Thorac Oncol. 2011 Mar;6(3):451-8
21266922
J Clin Oncol. 2009 May 20;27(15):2553-62
19289625
AJR Am J Roentgenol. 2001 Jun;176(6):1399-407
11373200
Cancer. 2002 Jan 1;94(1):188-96
11815976
PLoS Med. 2005 Jan;2(1):e17
15696205
Cancer. 2010 Apr 15;116(8):2011-9
20151423
J Thorac Oncol. 2010 Mar;5(3):333-9
20125041
J Thorac Oncol. 2010 Apr;5(4):436-41
20068475
Clin Cancer Res. 2008 May 1;14(9):2570-8
18451218
Lung Cancer. 2008 Jan;59(1):111-8
17904685
Hum Pathol. 2009 Aug;40(8):1152-8
19386350
Eur J Cancer. 2009 Sep;45(13):2298-303
19473833
Cancer. 2001 Jul 1;92(1):153-9
11443621
N Engl J Med. 2010 Oct 28;363(18):1734-9
20979473
J Thorac Oncol. 2008 May;3(5):457-66
18448996
Lung Cancer. 2008 Nov;62(2):202-14
18450320
J Thorac Oncol. 2008 Sep;3(9):971-8
18758298
Lung Cancer. 2001 Jul;33(1):17-25
11429192
Respiration. 2003 Jan-Feb;70(1):36-42
12584389
N Engl J Med. 2006 Oct 26;355(17):1763-71
17065637
AJR Am J Roentgenol. 1999 Dec;173(6):1623-9
10584811
Ann Thorac Surg. 2002 Apr;73(4):1071-5
11996243
Ann Thorac Surg. 2009 Oct;88(4):1106-11
19766789
Lung Cancer. 2008 May;60(2):175-82
18061305
Ann Thorac Surg. 2002 Nov;74(5):1635-9
12440622
J Clin Oncol. 2004 Mar 15;22(6):1103-9
15020612
J Clin Oncol. 2006 Oct 10;24(29):4731-7
16966686
BMJ. 2008 May 17;336(7653):1106-10
18483053
Ann Thorac Surg. 2004 Oct;78(4):1194-9
15464469
J Comput Assist Tomogr. 2004 Jan-Feb;28(1):17-23
14716227
J Thorac Oncol. 2010 Aug;5(8):1197-200
20661086
J Thorac Cardiovasc Surg. 2002 Nov;124(5):1014-20
12407387
J Pathol. 2006 May;209(1):78-87
16463270
Clin Lung Cancer. 2006 Mar;7(5):313-22
16640802
J Clin Pathol. 2000 Jul;53(7):537-40
10961178
Nat Med. 2002 Aug;8(8):816-24
12118244
Radiology. 1991 May;179(2):469-76
2014294
Chest. 2005 Nov;128(5):3276-83
16304272
Chest. 1996 May;109(5):1199-203
8625667
J Clin Pathol. 2004 Apr;57(4):383-7
15047742
Clin Cancer Res. 2009 Dec 15;15(24):7547-7552
19996214
Appl Immunohistochem Mol Morphol. 2007 Dec;15(4):415-20
18091384
Ann Oncol. 2009 Feb;20(2):298-304
18836087
Am J Respir Crit Care Med. 2009 Sep 1;180(5):445-53
19520905
Histol Histopathol. 2006 Jun;21(6):627-32
16528673
Am J Clin Pathol. 2003 May;119(5):696-702
12760288
Lung Cancer. 2009 May;64(2):171-8
18799230
Eur Respir J. 2008 Oct;32(4):924-30
18508816
J Mol Diagn. 2006 Jul;8(3):351-6
16825508
J Thorac Oncol. 2010 Apr;5(4):466-71
20357616
Virchows Arch. 2009 Aug;455(2):125-32
19652998
Radiology. 2009 Jul;252(1):263-72
19561260
Ann Thorac Surg. 1982 Jun;33(6):599-604
7092385
Ann Thorac Surg. 2003 Oct;76(4):1016-22
14529977
J Clin Oncol. 2008 Mar 20;26(9):1472-8
18349398
Pathol Int. 2005 Jul;55(7):419-24
15982217
Am J Surg Pathol. 1997 Jan;21(1):43-51
8990140
Pathol Res Pract. 2011 Mar 15;207(3):188-91
20727680
AJR Am J Roentgenol. 2003 Mar;180(3):817-26
12591704
J Clin Oncol. 2008 May 20;26(15):2442-9
18458038
Am J Surg Pathol. 2003 Jul;27(7):937-51
12826886
J Cell Mol Med. 2009 Aug;13(8B):1977-1986
19040416
Ann Thorac Surg. 1997 Sep;64(3):809-13
9307478
CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108
15761078
Am J Surg Pathol. 2007 Jan;31(1):26-32
17197916
Ann Oncol. 2006 Nov;17(11):1673-6
16980598
Appl Immunohistochem Mol Morphol. 2002 Jun;10(2):97-102
12051643
Cancer. 1995 Jun 15;75(12):2844-52
7773933
Arch Pathol Lab Med. 1990 Apr;114(4):363-8
2322096
Thorax. 2001 Apr;56(4):302-5
11254822
Br J Cancer. 2006 Jul 17;95(2):139-45
16786043
Science. 2004 Jun 4;304(5676):1497-500
15118125
Clin Cancer Res. 2006 Nov 1;12(21):6494-501
17085664
Interact Cardiovasc Thorac Surg. 2010 Mar;10(3):434-6
19955172
Mod Pathol. 2007 Jun;20(6):638-47
17431413
J Clin Oncol. 2008 Jul 20;26(21):3543-51
18506025
Mod Pathol. 2002 May;15(5):538-42
12011259
Am J Respir Crit Care Med. 2009 Sep 1;180(5):384-5
19700566
AJR Am J Roentgenol. 2010 Jan;194(1):266-9
20028932
J Clin Oncol. 2005 Feb 1;23(4):857-65
15681531
Cancer Res. 2009 Jul 15;69(14):5776-83
19584273
Clin Cancer Res. 2009 May 1;15(9):3023-8
19366827
Jpn J Clin Oncol. 2007 Dec;37(12):907-12
18089646
J Thorac Oncol. 2008 Nov;3(11):1245-50
18978558
Ann Surg Oncol. 2010 Mar;17(3):889-97
20183914
Ann Thorac Surg. 2003 May;75(5):1601-5; discussion 1605-6
12735586
N Engl J Med. 2009 Dec 3;361(23):2221-9
19955524
Mod Pathol. 2008 Aug;21(8):992-1001
18516041
Radiology. 2009 Dec;253(3):606-22
19952025
J Clin Oncol. 2009 Oct 1;27(28):e141-2; author reply e143-4
19720885
Radiology. 1990 Sep;176(3):749-53
2167502
Hum Pathol. 2010 Jan;41(1):94-102
19740513
Cancer Res. 2009 Nov 1;69(21):8341-8
19826035
J Clin Oncol. 2006 Apr 20;24(12):1807-13
16622257
Mod Pathol. 1992 Nov;5(6):634-8
1369799
Lung Cancer. 2009 May;64(2):148-54
18951650
Mod Pathol. 2012 Dec;25(12):1574-83
22814311
Lung Cancer. 2004 Apr;44(1):43-51
15013582
Am J Surg Pathol. 2008 Sep;32(9):1317-21
18636014
PLoS One. 2009;4(5):e5133
19415121
Lancet Oncol. 2008 Oct;9(10):962-72
18804418
Oncogene. 2009 Aug 6;28(31):2773-83
19525976
Mod Pathol. 1990 May;3(3):314-20
2362938
J Pathol. 2004 Jun;203(2):638-44
15141378
Chest. 2010 Jan;137(1):46-52
19376842
Clin Cancer Res. 2009 Jul 15;15(14):4554-60
19584155
Br J Cancer. 2005 Mar 28;92(6):1033-7
15756281
J Clin Oncol. 2006 Jul 20;24(21):3340-6
16785471
Am J Surg Pathol. 2002 Mar;26(3):358-64
11859208
Radiology. 2008 Mar;246(3):697-722
18195376
Invest Radiol. 2002 Dec;37(12):692-7
12447003
J Thorac Oncol. 2010 Apr;5(4):411-4
20357614
APMIS. 2006 May;114(5):381-5
16725015
Lancet. 1999 Jul 10;354(9173):99-105
10408484
Ann Thorac Surg. 2007 Sep;84(3):926-32; discussion 932-3
17720401
J Thorac Cardiovasc Surg. 2001 Aug;122(2):325-30
11479506
Radiology. 2008 Jul;248(1):278-87
18458247
Hum Pathol. 1992 Mar;23(3):273-9
1555838
Lung Cancer. 2008 Sep;61(3):328-39
18304690
Cancer Res. 2005 Sep 1;65(17):7568-72
16140919
Clin Cancer Res. 2009 Aug 15;15(16):5216-23
19671850
Carcinogenesis. 2008 May;29(5):895-904
18308762
Int J Surg Pathol. 2009 Jun;17(3):206-18
19443885
Am J Surg Pathol. 2005 May;29(5):660-5
15832091
Nature. 2007 Aug 2;448(7153):561-6
17625570
Histol Histopathol. 2008 Jan;23(1):33-40
17952855
J Thorac Oncol. 2008 May;3(5):472-6
18448998
Cancer Res. 2008 Apr 1;68(7):2106-11
18381415
Lung Cancer. 2010 Sep;69(3):323-9
20061047
Lung Cancer. 2009 May;64(2):179-86
18819724
J Thorac Oncol. 2006 Jun;1(5):413-6
17409892
Radiology. 2003 Oct;229(1):184-94
14519875
Cancer Sci. 2007 Jul;98(7):1006-13
17459054
Am J Pathol. 2009 May;174(5):1629-37
19342368
Eur J Cardiothorac Surg. 2003 May;23(5):818-23
12754039
Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3
7677489
Br J Cancer. 2008 Sep 16;99(6):911-22
19238632
J Clin Oncol. 2005 Oct 1;23(28):6838-45
15998906
Cancer. 2008 Sep 1;113(5):1107-8; author reply 1108-9
18618507
Radiology. 2010 Apr;255(1):14-5
20308439
Clin Cancer Res. 2002 Oct;8(10):3046-53
12374671
AJR Am J Roentgenol. 1999 Aug;173(2):465-9
10430155
Oncologist. 2009 Mar;14(3):253-63
19221167
Nature. 2007 Dec 6;450(7171):893-8
17982442
Radiology. 2007 Feb;242(2):555-62
17255425
J Clin Oncol. 2008 Jul 20;26(21):3552-9
18506026
Cold Spring Harb Symp Quant Biol. 2005;70:11-24
16869734
Int J Oncol. 1998 Mar;12(3):553-63
9472092
J Thorac Oncol. 2006 May;1(4):324-7
17409878
Int Surg. 2000 Apr-Jun;85(2):105-12
11071324
Eur Respir J. 2002 Oct;20(4):975-81
12412692
Cancer Epidemiol Biomarkers Prev. 2003 Sep;12(9):905-10
14504202
J Thorac Cardiovasc Surg. 2002 Aug;124(2):278-84
12167787
Lancet. 2009 Oct 24;374(9699):1432-40
19767093
Am J Respir Crit Care Med. 2005 Sep 15;172(6):729-37
15976377
Ann Thorac Surg. 2004 Jun;77(6):1911-5
15172235
Science. 2007 May 18;316(5827):1039-43
17463250
Mod Pathol. 2009 Apr;22(4):508-15
19234440
BMJ. 2008 May 10;336(7652):1049-51
18467413
Histopathology. 1990 Jan;16(1):101-3
2307410
Am J Surg Pathol. 2005 Jul;29(7):897-902
15958854
Mod Pathol. 2001 Feb;14(2):72-84
11235908
J Cardiovasc Surg (Torino). 2003 Oct;44(5):661-5
14735056
J Thorac Imaging. 2009 Feb;24(1):4-9
19242296
Br J Radiol. 2000 Sep;73(873):930-7
11064644
J Med Assoc Thai. 2005 Sep;88 Suppl 4:S322-9
16623049
PLoS Med. 2005 Mar;2(3):e73
15737014
Jpn J Thorac Cardiovasc Surg. 2005 Jan;53(1):29-35
15724499
J Pathol. 1996 Jul;179(3):254-9
8774479
Eur J Cardiothorac Surg. 2004 Dec;26(6):1211-5
15541986
J Natl Cancer Inst. 2005 Mar 2;97(5):339-46
15741570
Clin Cancer Res. 2009 May 1;15(9):3143-9
19383809
N Engl J Med. 2004 May 20;350(21):2129-39
15118073
Am J Clin Pathol. 2009 May;131(5):694-700
19369630
Am J Surg Pathol. 2004 Apr;28(4):442-52
15087663
J Comput Assist Tomogr. 2009 Jan-Feb;33(1):42-8
19188783
Am J Clin Pathol. 2010 Jun;133(6):922-34
20472851
Mod Pathol. 2005 Jun;18(6):816-21
15605076
J Thorac Cardiovasc Surg. 2006 Oct;132(4):769-75
17000286
Am J Clin Pathol. 2004 Mar;121(3):350-7
15023039
Diagn Cytopathol. 2009 Mar;37(3):178-83
19170169
Hum Pathol. 2008 Mar;39(3):324-30
18261622
J Thorac Oncol. 2008 Jan;3(1):6-12
18166834
Cancer. 2009 Apr 15;115(8):1723-33
19170230
Lung Cancer. 2005 Jul;49(1):25-33
15949587
APMIS. 2005 Jul-Aug;113(7-8):550-4
16086826
Eur J Radiol. 2004 Nov;52(2):144-50
15489071
Radiology. 2010 Apr;255(1):199-206
20123896
Diagn Mol Pathol. 1997 Aug;6(4):179-84
9360838
Mod Pathol. 2007 Feb;20(2):233-41
17192789
Am J Clin Pathol. 2004 Sep;122(3):421-7
15362373
N Engl J Med. 2007 Jan 4;356(1):11-20
17202451
Eur J Radiol. 2012 Jan;81(1):189-94
20965677
Lung Cancer. 2003 Dec;42(3):303-10
14644518
Cancer. 1986 Apr 15;57(8):1555-64
3004694
J Thorac Oncol. 2008 Apr;3(4):340-7
18379350
Lung Cancer. 2009 Sep;65(3):312-8
19168259
Cancer Res. 2002 Dec 1;62(23):7001-3
12460919
J Clin Oncol. 2007 Feb 10;25(5):587-95
17290067
Cancer Res. 1996 May 1;56(9):2224-8
8616876
Eur J Cardiothorac Surg. 2006 Jul;30(1):160-3
16723239
Am J Surg Pathol. 2000 Apr;24(4):598-606
10757409
N Engl J Med. 2010 Oct 28;363(18):1693-703
20979469
Radiology. 2007 Mar;242(3):882-8
17229875
BMJ. 2008 May 3;336(7651):995-8
18456631
J Clin Oncol. 2004 May 1;22(9):1589-97
15117980
Cancer. 1984 Aug 1;54(3):525-34
6329505
Br J Cancer. 2008 Mar 11;98(5):907-14
18283321
Cancer Prev Res (Phila). 2008 Aug;1(3):192-200
19138956
Chest. 2007 Sep;132(3 Suppl):131S-148S
17873165
Clin Cancer Res. 2001 Jun;7(6):1730-8
11410513
Ann Thorac Surg. 2004 Apr;77(4):1157-61; discussion 1161-2
15063225
J Clin Epidemiol. 2011 Apr;64(4):383-94
21195583
J Clin Invest. 2007 Nov;117(11):3436-44
17948124
J Clin Oncol. 2011 Jul 20;29(21):2866-74
21670455
Clin Cancer Res. 2010 Jun 15;16(12):3163-70
20423982
Clin Radiol. 2009 Feb;64(2):127-32
19103341
Am J Clin Pathol. 2009 Jan;131(1):129-33
19095576
J Natl Cancer Inst. 2005 May 4;97(9):643-55
15870435
J Thorac Cardiovasc Surg. 2007 Jun;133(6):1448-54
17532938
Chest. 2007 Sep;132(3):984-90
17573486
J Thorac Cardiovasc Surg. 2010 Apr;139(4):1001-6
19733863
Pathol Res Pract. 2006;202(10):751-6
16959434
J Thorac Oncol. 2006 Oct;1(8):787-95
17409961
J Nucl Med. 2000 Jan;41(1):85-92
10647609
J Nucl Med. 1998 Jun;39(6):1016-20
9627336
Clin Cancer Res. 2006 Jun 1;12(11 Pt 1):3344-54
16740756
J Clin Oncol. 2008 Feb 20;26(6):877-83
18281660
Lung Cancer. 2002 Apr;36(1):49-57
11891033
Carcinogenesis. 2008 May;29(5):957-63
18299280
J Surg Res. 2006 Jun 15;133(2):203-6
16376942
Am J Respir Crit Care Med. 2006 Sep 1;174(5):605-14
16931644