Correlation of tumor spread through air spaces and clinicopathological characteristics in surgically resected lung adenocarcinomas

Objectives: Tumor spread through air spaces (STAS) has recently been reported as a novel invasive pattern in lung adenocarcinoma, but the correlation between other clinicopathological and genetic profiles has not been well studied. The aim of this study was to investigate these correlations in patients with surgically resected lung adenocarcinoma. Materials and methods: Five hundred consecutive patients with lung adenocarcinoma who underwent curative lung tumor resection and with available STAS profile were reviewed retrospectively from January to December 2016. The correlations of STAS presence and clinicopathological and genetic characteristics were analyzed. Results: One hundred thirty-four patients (26.8%) had positive STAS. The pathological stage of these patients was adenocarcinoma in situ, IA, IB, II, and III in 25 (5%), 343 (68.6%), 63 (12.6%), 29 (5.8%), and 40 (8%), respectively. Multivariate analysis showed that the presence of STAS was significantly correlated to higher T (p = 0.001) and N (p = 0.032) stages, moderate/poor differentiation (p = 0.001), and the presence of lymphovascular invasion (p = 0.001). Although positive epidermal growth factor receptor mutation and non-lepidic histologic subtypes were correlated with the presence of STAS in the univariate analysis, they were not significantly correlated with the presence of STAS in the multivariate analysis (p = 0.676 and 0.286, respectively). Conclusions: STAS was significantly correlated with several invasive clinicopathological characteristics in surgically resected lung adenocarcinoma. Based on our results and current evidence, the presence of STAS may be considered as a staging profile in future staging system.