title: Minor Components of Micropapillary and Solid Subtypes in Lung Adenocarcinoma are Predictors of Lymph Node Metastasis and Poor Prognosis.
abstract: Lung adenocarcinoma with micropapillary and solid predominant subtypes was reported to be associated with poor prognosis; however, whether minor components (non-predominant) of micropapillary and solid subtypes predict poor prognosis remains unknown. In this study, we investigated the predictive and prognostic value of lymph node metastasis of minor micropapillary and solid components.
  
  
  
  Specimens of resected tumors of 1244 patients were reclassified to determine the predominant subtype and minor components (>5 %, but not predominant). Of these specimens, 105 contained a micropapillary component and 210 contained a solid component. The correlation between each subtype and lymph node metastasis was analyzed, and survival analyses were used to determine the association between each subtype and patient survival.
  
  
  
  Adenocarcinomas harboring micropapillary and/or solid components held higher rates of metastatic lymph node stations (25.2 % vs. 15.6 %, p = 0.002; and 24.0 % vs. 14.9 %, p < 0.001, respectively) and lymph nodes (17.3 % vs. 10.1 %, p = 0.004; and 15.5 % vs. 9.7 %, p = 0.001, respectively). Patients with micropapillary and solid components in their tumors showed a shorter median recurrence-free survival (15.8 vs. 62.8 months, p < 0.001; and 20.8 months vs. not reached, p < 0.001) and overall survival (47.0 months vs. not reached, p < 0.001; and 69.0 months vs. not reached, p < 0.001).
  
  
  
  Minor components of micropapillary and/or solid subtypes of lung adenocarcinoma are correlated with lymph node metastasis and poor prognosis. Thus, it is beneficial to focus not only on predominant subtypes but also minor components to predict prognoses and make therapeutic strategies more comprehensively.
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Yue
authors: Y
authors: Zhao
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Rui
authors: R
authors: Wang
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.|Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors: Xuxia
authors: X
authors: Shen
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Yunjian
authors: Y
authors: Pan
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Chao
authors: C
authors: Cheng
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.|Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors: Yuan
authors: Y
authors: Li
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.|Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors: Lei
authors: L
authors: Shen
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Yang
authors: Y
authors: Zhang
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Hang
authors: H
authors: Li
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Difan
authors: D
authors: Zheng
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Ting
authors: T
authors: Ye
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: Shanbo
authors: S
authors: Zheng
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. Sun_yihua76@hotmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. Sun_yihua76@hotmail.com.
authors: Yihua
authors: Y
authors: Sun
authors: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. hqchen1@yahoo.com.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. hqchen1@yahoo.com.|Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. hqchen1@yahoo.com.|Institutes of Biomedical Sciences, Fudan University, Shanghai, China. hqchen1@yahoo.com.
authors: Haiquan
authors: H
authors: Chen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D002291:Carcinoma, Papillary / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate