Medscape (registration required) reports a study presented at the joint American Association for Cancer Research-International Association for the Study of Lung Cancer (AACR-IASLC) in which Sardari Nia et al from University of Antwerp, Belgium in which researchers from the University of Antwerp, Belgium identify tumor growth patterns in lung cancer that are independent predictors of disease-free survival, disease-specific survival, and overall survival.
They report having previously identified three growth patterns--destructive, alveolar, and papillary. These patterns do not describe histological subtypes (despite the confusing terminology). The "papillary" type ("normal lung tissue is preserved in the presence of a new microenvironment") seems to be non-invasive bronchioloalveolar type adenocarcinoma. "In the destructive pattern, the tumor is creates its own microenvironment for further growth In the alveolar pattern, the tumor uses the microenvironment of the lung to grow."
This is a confusing description but it would be interesting to see pictures of exactly what these patterns are that the authors describe.
This is a retrospective study of 432 patients with stage IA to IIIB NSCLC who underwent complete resection and follow-up was about 50 months. In this group, they report that 71.1% of the tumors showed a destructive pattern, 13.9% a papillary pattern, and 15% an alveolar pattern. They find that the alveolar pattern was an independent predictor of poorer disease-free survival, disease-specific survival, and overall survival.
This sounds like an intriguing study and I wonder how their findings relate to recent research on epithelial-mesenchymal transformation (EMT) as well as using "comprehensive histologic assessment" to assess subtyping for adenocarcinoma. If anyone sees where these findings are published, please leave a comment.
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