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Int J Clin Exp Pathol 2010;3(4):348-366
Original Article
Proposal of an altered histological sub-typing system for lung adenocarcinoma –
significant prognostic values for stage I disease
Koji Okudela, Tetsukan Woo, Hideaki Mitsui, Takuya Yazawa, Hiroaki Shimoyamada, Michihiko Tajiri, Nobuo Ogawa, Munetaka Masuda, Hitoshi
Kitamura
Department of Pathology and Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Division of General Thoracic
Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama, Japan
Received March 19, 2009; accepted March 21, 2010; available online March 25, 2010
Abstract: We have established a concise sub-typing system suitable for predicting the postoperative outcome in cases of stage I lung
adenocarcinoma (ADC), using morphometric profiling. The association between postoperative disease recurrence and a variety of
morphological features including histological architecture, cell type, cytoplasmic color/internal structure, nuclear shape/size, chromatin pattern,
and nucleoli count/remarkableness, was analyzed. Histological architecture had the most prognostic value and could be subdivided into low-
grade (bronchioloalveolar, papillary and tubular: “tubular” in this paper is defined as a tubular or glandular structure lined with single-layered
neoplastic cells) and high-grade (acinar and solid: “acinar” is defined as a tubular or glandular structure lined with poly-layered neoplastic cells
or as a fused glandular structure such as the cribriform pattern) components. The sub-groups separated based on a cut-off value, 71.5% of the
high-grade component comprised by a tumor, which was calculated according to a relative operating characteristic curve, exhibited a significant
difference in disease recurrence [estimated 5-year disease-free survival rate, 95.3% in the low-grade group versus 66.7% in the high-grade
group, hazard ratio 7.35, Log-rank test p = 0.002]. The sub-grouping system is concise and suitable for practical use. It will improve the
histological classification of ADC. (IJCEP1003007).
Key words: Lung adenocarcinoma, stage I, morphometric profiling, altered sub-typing system, prognostic value
Full text PDF
Address all correspondence to:
Hitoshi KITAMURA, MD
Department of Pathology
Yokohama City University Graduate School of Medicine
3-9, Fukuura, Kanazawa-ku, 236-0004
Yokohama, Japan,
Tel: +81-45-787-2583, Fax: +81-45-789-0588,
E-mail: pathola@med.yokohama-cu.ac.jp
Original Article
Proposal of an altered histological sub-typing system for lung adenocarcinoma –
significant prognostic values for stage I disease
Koji Okudela, Tetsukan Woo, Hideaki Mitsui, Takuya Yazawa, Hiroaki Shimoyamada, Michihiko Tajiri, Nobuo Ogawa, Munetaka Masuda, Hitoshi
Kitamura
Department of Pathology and Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Division of General Thoracic
Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama, Japan
Received March 19, 2009; accepted March 21, 2010; available online March 25, 2010
Abstract: We have established a concise sub-typing system suitable for predicting the postoperative outcome in cases of stage I lung
adenocarcinoma (ADC), using morphometric profiling. The association between postoperative disease recurrence and a variety of
morphological features including histological architecture, cell type, cytoplasmic color/internal structure, nuclear shape/size, chromatin pattern,
and nucleoli count/remarkableness, was analyzed. Histological architecture had the most prognostic value and could be subdivided into low-
grade (bronchioloalveolar, papillary and tubular: “tubular” in this paper is defined as a tubular or glandular structure lined with single-layered
neoplastic cells) and high-grade (acinar and solid: “acinar” is defined as a tubular or glandular structure lined with poly-layered neoplastic cells
or as a fused glandular structure such as the cribriform pattern) components. The sub-groups separated based on a cut-off value, 71.5% of the
high-grade component comprised by a tumor, which was calculated according to a relative operating characteristic curve, exhibited a significant
difference in disease recurrence [estimated 5-year disease-free survival rate, 95.3% in the low-grade group versus 66.7% in the high-grade
group, hazard ratio 7.35, Log-rank test p = 0.002]. The sub-grouping system is concise and suitable for practical use. It will improve the
histological classification of ADC. (IJCEP1003007).
Key words: Lung adenocarcinoma, stage I, morphometric profiling, altered sub-typing system, prognostic value
Full text PDF
Address all correspondence to:
Hitoshi KITAMURA, MD
Department of Pathology
Yokohama City University Graduate School of Medicine
3-9, Fukuura, Kanazawa-ku, 236-0004
Yokohama, Japan,
Tel: +81-45-787-2583, Fax: +81-45-789-0588,
E-mail: pathola@med.yokohama-cu.ac.jp
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