Sistema de Salut de Catalunya
Institut Català de la Salut
[Thunnissen E] Dept. of Pathology, Amsterdam UMC, VU University, Amsterdam, the Netherlands. [Blaauwgeers H] Dept. of Pathology, OLVG LAB BV, Amsterdam, the Netherlands. [Filipello F] Dept. of Pathology, San Raffaele Scientific Institute, Milan, Italy. [Lissenberg-Witte B] Dept. of Epidemiology and Data Science, Amsterdam UMC, VU University, Amsterdam, the Netherlands. [Minami Y] Dept. of Pathology, National Hospital Organization Ibarakihigashi National Hospital, Tokai, Japan. [Noguchi M] Dept. of Pathology, Naritatomisato Tokushukai Hospital, Chiba, Japan. [Sansano I] Servei d’Anatomia Patològica, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-03-17T12:47:09Z
2025-03-17T12:47:09Z
2024
2025-01
Pulmonary adenocarcinoma; Classification; Biomarkers
Adenocarcinoma pulmonar; Classificació; Biomarcadors
Adenocarcinoma pulmonar; Clasificación; Biomarcadores
Objectives Evaluating invasion in non-mucinous adenocarcinoma (NMA) of the lung is crucial for accurate pT-staging. This study compares the World Health Organization (WHO) with a recently modified NMA classification. Materials and Methods A retrospective case-control study was conducted on small NMA pT1N0M0 cases with a 5-year follow-up. Seventy cases were reviewed by 42 pulmonary pathologists first according to the WHO classification and after tutorial according to a modified classification. A third round was conducted based on feedback from 41 peers of previous rounds. Additionally, orthogonal biomarker analysis was performed. Results In the first two rounds, 42 pathologists from 13 countries assessed all 70 cases, while 36 pathologists evaluated 41 non-unanimous cases in the third round. Kappa values for invasiveness increased in rounds 1, 2, and 3 to 0.27, 0.45 and 0.62, respectively. In contrast to low variation in total tumor size measurements (6 %), a marked increase in invasive tumor size variation was observed (42 %), which was associated with high uncertainty. In the third round 10 cases were non-invasive, all without recurrence. The modified classification showed in the 3rd round marked reduction of the variation in pT staging compared to the current WHO classification. Proliferation rate, tumor mutational burden, and transcriptomic profiles supported the distinction between invasive cases and non-invasive cases of the modified classification. Conclusion The modified classification demonstrates essentially higher reproducibility compared to the current WHO classification in NMA. The modified classification proves valuable in identifying low-risk lesions that are entirely non-invasive, and is supported by biomarker analysis.
Article
Published version
English
Marcadors tumorals; Pulmons - Càncer; Adenocarcinoma; Classificació; DISEASES::Neoplasms::Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms::Adenocarcinoma of Lung; DISEASES::Neoplasms::Neoplastic Processes::Neoplasm Invasiveness; CHEMICALS AND DRUGS::Biological Factors::Biomarkers::Biomarkers, Tumor; PUBLIC HEALTH::Epidemiology and Biostatistics::Biostatistics::Health Classifications; ENFERMEDADES::neoplasias::neoplasias::neoplasias por localización::neoplasias torácicas::neoplasias del tracto respiratorio::neoplasias pulmonares::adenocarcinoma de pulmón; ENFERMEDADES::neoplasias::procesos neoplásicos::invasividad neoplásica; COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores::marcadores tumorales; SALUD PÚBLICA::epidemiología y bioestadística::bioestadística::clasificaciones en salud
Elsevier
Lung Cancer;199
https://doi.org/10.1016/j.lungcan.2024.108060
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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