title: Invasion Types Are Associated With Poor Prognosis in Lung Squamous Carcinoma Patients.
abstract: Although the prognostic significance of the histologic patterns in lung adenocarcinoma is being identified, no significant prognostic indicators in lung squamous carcinoma are accepted as a standard universally. The aim of this study was to evaluate the histologic characteristics incorporating the defined invasion types and distinguish the features that can reflect prognosis.We reviewed all slices of 132 patients with lung squamous carcinoma. The cases were classified according to the World Health Organization (WHO) classification and were evaluated for tumor budding, single cell invasion, large cell invasion, cytologic atypia degree, mitotic count, number of buds, tumor nest size, fibrosis, and necrosis.In univariate analysis, overall survival was associated significantly with age (P = 0.023), lymph nodes metastasis (P < 0.001), distant organ metastasis (P < 0.001), pleural invasion (P < 0.001), tumor budding (P = 0.003), single cell invasion (P = 0.001), mitotic count (P < 0.001), and the cytologic atypia degree (P = 0.009). However, the subtypes of 2004 WHO classification showed no association with outcome (P = 0.209). In multivariate analysis, the independent significant prognostic indicators of lung squamous carcinoma were tumor budding (hazard ratio [HR] = 0.466, P = 0.005), single cell invasion (HR = 0.447, P = 0.003), mitotic count (HR = 0.502, P = 0.048) and cytologic atypia degree (HR = 0.479, P = 0.024).Lung squamous carcinomas with the invasion types were associated with a poor prognosis.
authors.affiliation: From the Institute of Oncology (YZ, CQ, TZ, PH, XQ, QL, JD), Shandong Provincial Hospital Affiliated to Shandong University, Shandong University; Department of Thoracic Surgery (JD), Shandong Provincial Hospital Affiliated to Shandong University, Shandong University; and Department of Oncology (HS), Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hongchang
authors.initials: H
authors.lastname: Shen
authors.forename: Chen
authors.initials: C
authors.lastname: Qiu
authors.forename: Tiehong
authors.initials: T
authors.lastname: Zhang
authors.forename: Pingping
authors.initials: P
authors.lastname: Hu
authors.forename: Xiao
authors.initials: X
authors.lastname: Qu
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.forename: Jiajun
authors.initials: J
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis