title: Impact of the IASLC/ATS/ERS classification in pN0 pulmonary adenocarcinomas: a study with radiological-pathological comparisons and survival analyses.
abstract: The aim of this study was: (1) to compare the new pathological findings as detected by the IASLC/ATS/ERS classification with the traditional radiological features in pulmonary pN0 adenocarcinomas, (2) to evaluate their prognostic significance on overall survival (OS). A total of 42 surgically resected pN0 pulmonary adenocarcinomas were analyzed. On CT scans, the following radiological data were recorded: sphericity, predominant margins, cavitation and bronchogram, attenuation and percentage of ground glass opacity (GGO). On pathological examination, tumors were categorized according to the IASLC/ATS/ERS classification; Sica score and grade, pathological stage, tumor major axis, pleural invasion, vascular and lymphatic invasion, peritumoral lymphoid infiltration, and cytological features were also determined. Clinical follow up was available in 37 cases (range 1-117 months). Radiologically, 31 solid and 11 semisolid tumors were found. Morphologically, 2 minimally invasive and 40 invasive adenocarcinomas were diagnosed. In radiological-pathological comparisons, (1) the acinar pattern was higher in tumors with solid attenuation and low GGO (p=0.018); (2) the lepidic pattern was more elevated in tumors with high GGO (p=0.012). In multivariate survival analyses with stage, predominant margins on CT scans (p=0.036) and Sica score (p=0.028) significantly affected OS. This study confirms the validity of the new classification of pulmonary adenocarcinomas in radiological-pathological comparisons and underlines the importance of both radiological and pathological findings in correctly identifying their prognostic features.
authors.affiliation: Pathology Unit, Central Hospital, Bolzano, Italy. Electronic address: andrea.ambrosinispaltro@asbz.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ambrosini-Spaltro
authors.affiliation: Radiology Unit, Central Hospital, Bolzano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruiu
authors.affiliation: Pneumology Unit, Central Hospital, Bolzano, Italy.
authors.forename: Christine
authors.initials: C
authors.lastname: Seebacher
authors.affiliation: Oncology Unit, Central Hospital, Bolzano, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Vattemi
authors.affiliation: Radiology Unit, Central Hospital, Bolzano, Italy.
authors.forename: Luigia
authors.initials: L
authors.lastname: Gentile
authors.affiliation: Thoracic Surgery Unit, Central Hospital, Bolzano, Italy.
authors.forename: Birgit
authors.initials: B
authors.lastname: Feil
authors.affiliation: Thoracic Surgery Unit, Central Hospital, Bolzano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zaraca
authors.affiliation: Pathology Unit, Central Hospital, Bolzano, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Carella
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000000981:diagnostic imaging* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
keywords: Adenocarcinoma; Lung; Pathology; Pattern; Radiology