期刊
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
卷 45, 期 11, 页码 1509-1515出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PAS.0000000000001788
关键词
metastasis; invasion; lung adenocarcinoma; lung squamous cell carcinoma; micropapillary
资金
- National Institutes of Health [T32CA009501, P30 CA008748, R01 CA236615-01, R01 CA235667, R01 CA217169, R01 CA240472]
- U.S. Department of Defense [BC132124, LC160212, CA170630, CA180889]
- Comedy versus Cancer Foundation
- Dalle Pezze Foundation
- Derfner Foundation
- Geoffrey Beene Foundation
- Memorial Sloan Kettering Technology Development Fund
- Miner Fund for Mesothelioma Research
- Commonwealth Foundation for Cancer Research
- Experimental Therapeutics Center of Memorial Sloan Kettering Cancer Center
- Mr. William H. Goodwin and Alice Goodwin
The study suggests that the phenomenon of tumor spread through air spaces (STAS) is an in vivo process rather than an artifact of tissue processing in patients undergoing limited resection (LR) for non-small cell lung carcinoma (NSCLC). It indicates that occult STAS tumor cells can be present in the remaining lung tissue after LR, potentially contributing to locoregional recurrence. This observation supports the concept that STAS plays a role in locoregional recurrence following LR.
Tumor spread through air spaces (STAS) is associated with locoregional recurrence in patients undergoing limited resection (LR) for non-small cell lung carcinoma (NSCLC). We hypothesized that the observation of STAS in both the initial LR specimen and the additional resection specimen from the same patient, processed using different knives, would provide evidence that STAS is an in vivo phenomenon contributing to locoregional recurrence. We retrospectively identified patients with NSCLC (9 adenocarcinoma, 1 squamous cell carcinoma) who underwent LR, had STAS in the LR specimen, and underwent additional resection (lobectomy or LR). The LR and additional resection specimens from each patient were processed at different times using different tissue-processing knives. All specimens were analyzed for STAS. All 10 patients underwent LR with negative margins (R0). All additional resection specimens had STAS: 8 patients had STAS clusters in their completion lobectomy specimens, and 2 had STAS in their additional LR specimens. In 2 patients, STAS was found in the completion lobectomy specimen only after extensive sampling (>10 sections) from the staple line adjacent to the initial LR. The presence of STAS in both the LR and the additional resection specimen processed using different knives supports the concept that STAS is an in vivo phenomenon, rather than an artifact from tissue processing. This observation indicates that occult STAS tumor cells can be present in the lung tissue of the remaining unresected lobe after LR and supports the concept that STAS is a contributing factor for locoregional recurrence following LR.
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