title: Histological subtypes of solitary pulmonary nodules of adenocarcinoma and their clinical relevance.
abstract: OBJECTIVE
  To explore the histological subtypes of solitary pulmonary nodules (SPNs) of invasive adenocarcinoma and their clinical relevance.
  
  
  METHODS
  A total of 188 patients with pathologically confirmed invasive adenocarcinoma in our hospital from January 2007 to December 2011 were enrolled in this study. In accordance with the new classification of lung adenocarcinoma, all the histological sections were reviewed and classified, and the clinical data were collected and analyzed.
  
  
  RESULTS
  Of these 188 patients who had been initially diagnosed as SPNs of adenocarcinoma, there were 6 cases of lepidic predominant adenocarcinoma (LPA), 71 cases of acinar predominant adenocarcinoma (APA), 74 cases of papillary predominant adenocarcinoma (PPA), 15 cases of micorpapillary predominant adenocarcinoma (MPA), and 22 cases of solid predominant adenocarcinoma (SPA) with mucin production. The incidence of lymph node metastasis was 80.0% and 81.8% in MPA and SPA, respectively, which was significantly higher than those in LPA, APA, and PPA (all P<0.01). The incidence of LPA was 83.3% (5/6) in women, which was significantly higher than that in men (P=0.037).
  
  
  CONCLUSIONS
  According to the new classification, MPA and SPA have high incidence of lymph node metastasis. LPA is more likely to occur in women. Sub-typing of the lung adenocarcinoma based on the newest international classification criteria is helpful to identify the clinical features of this disease.
authors.affiliation: Department of Pathology, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Hui-Di
authors.initials: HD
authors.lastname: Hu
authors.affiliation: Department of Pathology, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Ming-Yue
authors.initials: MY
authors.lastname: Wan
authors.affiliation: Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China; ; Nanjing Clinical Center of Respiratory Diseases, Nanjing 210029, China.
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Xu
authors.affiliation: Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China; ; Nanjing Clinical Center of Respiratory Diseases, Nanjing 210029, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhan
authors.affiliation: Department of Pathology, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Jue
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Pathology, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Qian-Qian
authors.initials: QQ
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Yuan-Qing
authors.initials: YQ
authors.lastname: Zhang
keywords: Adenocarcinoma solitary pulmonary nodule (SPNs); clinical manifestations; histological subtype