title: The utility of the proposed IASLC/ATS/ERS lung adenocarcinoma subtypes for disease prognosis and correlation of driver gene alterations.
abstract: BACKGROUND
  The present study aimed to determine the ability of the revised International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification of lung adenocarcinoma to predict patient survivals and driver gene alterations.
  
  
  METHODS
  A reclassification of 904 surgically resected adenocarcinomas was performed. The results were statistically analyzed to examine the correlation between the classification and overall survival (OS) using Cox regression analyses, and integrated discrimination improvement (IDI) analyses.
  
  
  RESULTS
  The 5-year OS rates for adenocarcinomas in situ (AIS) or minimally invasive adenocarcinoma (MIA) were 98%. Five-year OS rates of Lepidic-, acinar-, papillary-, micropapillary-, and solid-predominant adenocarcinomas was 93%, 67%, 74%, 62%, and 58%, respectively. The IDI estimates revealed that classification of ADC into the 7 subgroups had a higher estimated (0.0175) than did the combined histological grouping (AIS + MIA, lepidic + acinar + papillary, micropapillary + solid + others) (0.0111). Epidermal growth factor receptor mutations, KRAS gene mutations, and anaplastic lymphoma kinase gene alterations were statistically prevalent in papillary-predominant (P = 0.00001), invasive mucinous (P = 0.00001), and micropapillary- and acinar-predominant (P = 0.00001) adenocarcinomas, respectively.
  
  
  CONCLUSIONS
  The new classification reflects disease prognosis, and was also associated with driver gene alterations.
authors.affiliation: Division of Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan. Electronic address: ktsuta@ncc.go.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuta
authors.affiliation: Division of Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan; Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Kawago
authors.affiliation: Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, Tokyo, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inoue
authors.affiliation: Division of Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, Tokyo, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Takahashi
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shun-Ichi
authors.initials: SI
authors.lastname: Watanabe
authors.affiliation: Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Division of Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Koh
authors.initials: K
authors.lastname: Furuta
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Asamura
authors.affiliation: Division of Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D011905:Genes, ras; D014644:Genetic Variation; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D012955:Societies, Medical; D014178:Translocation, Genetic; D055815:Young Adult
chemical_list: D066246:ErbB Receptors
keywords: ALK; Adenocarcinoma of the lung; EGFR; IASLC classification; KRAS