CHEST
Original ResearchLung CancerTumor Budding Correlates With the Protumor Immune Microenvironment and Is an Independent Prognostic Factor for Recurrence of Stage I Lung Adenocarcinoma
Section snippets
Patient Clinicopathologic Characteristics
The median age of the 1,038 patients was 69 years (range, 23-96 years). Most patients were women (n = 646), and most had stage IA disease (n = 731). Regarding surgical procedures, 796 patients had undergone lobectomy, and 242 had undergone limited resection (segmentectomy [n = 76] and wedge resection [n = 166]). Only 14 patients (1%) received adjuvant chemotherapy.
During the study period, 14% of patients (n = 144) experienced recurrence (locoregional [n = 44] and distant [n = 100]) and 15% (n =
Discussion
We have demonstrated that, in patients with stage I lung adenocarcinoma, tumor budding was an independent prognostic factor that can be used to further stratify risk of recurrence in patients with stage IA, stage IB, acinar-predominant, papillary-predominant, and solid-predominant tumors. Furthermore, it positively correlated with protumor immune cell infiltration, including regulatory T cells and tumor-associated macrophages.
In an attempt to identify prognostic factors for intermediate-grade
Conclusions
In conclusion, we have demonstrated that tumor budding was an independent, unfavorable prognostic factor for disease recurrence in patients with resected stage I lung adenocarcinoma. Moreover, tumor budding positively correlated with protumor immune markers—stromal FoxP3+ lymphocyte infiltration, stromal FoxP3/CD3 lymphocyte index, and tumoral IL-7R expression—and tumor-associated macrophage infiltration. These observations may warrant investigations into interactions between FoxP3+ regulatory
Acknowledgments
Author contributions: W. D. T. and P. S. A. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. K. K., W. D. T., and P. S. A. contributed to study design, data acquisition, analysis, and interpretation; Y.-C. Y., J. V.-V., L. C., and D. R. J. contributed to data acquisition, analysis, and interpretation; E. N. D. and C. S. S. contributed to data analysis and interpretation; and K. K., Y.-C. Y., J. V.-V., L.
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2021, Computerized Medical Imaging and GraphicsCitation Excerpt :Previous studies are always probing about the relationship with clinical outcomes and radiomic features in the primary tumor (Coroller et al., 2015; Craigie et al., 2017; Wu et al., 2016). However, Pathological studies have shown that lung tumors can propagate through lymphatic vasculature and blood, and also lead to worse clinical performance (Kadota et al., 2015a, b; Matsumura et al., 2012; Uruga et al., 2017). In the clinical command of the disease, recognizing the histological classification by stages is required for a correct strategy for the patients.
originally published Online First April 2, 2015.
Preliminary data from this study were presented at the World Conference on Lung Cancer, October 27-31, 2013, Sydney, NSW, Australia.
FUNDING/SUPPORT: This work was supported by grants from the National Institutes of Health [R21 CA164568-01A1, R21 CA164585-01A1, R01 CA136705-06, U54 CA137788, P50 CA086438-13, and P30 CA008748], the US Department of Defense [PR101053 and LC110202], Mr William H. Goodwin and Mrs Alice Goodwin, the Commonwealth Foundation for Cancer Research, and the Experimental Therapeutics Center of Memorial Sloan Kettering Cancer Center.