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BioMed Research International
Volume 2014, Article ID 645681, 6 pages
Research Article

Prognostic Implication of Predominant Histologic Subtypes of Lymph Node Metastases in Surgically Resected Lung Adenocarcinoma

1Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama 589-8511, Japan
2Division of Molecular Pathology, Department of Pathology, Hyogo College of Medicine, 1-3-6 Minatojima, Chuo-ku, Kobe 650-8530, Japan

Received 19 June 2014; Accepted 27 September 2014; Published 12 October 2014

Academic Editor: Andrea Zanini

Copyright © 2014 Kenichi Suda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) proposed a new classification for lung adenocarcinoma (AD) based on predominant histologic subtypes, such as lepidic, papillary, acinar, solid, and micropapillary; this system reportedly reflects well outcomes of patients with surgically resected lung AD. However, the prognostic implication of predominant histologic subtypes in lymph nodes metastases is unclear so far. In this study, we compared predominant subtypes between primary lung tumors and lymph node metastatic lesions in 24 patients with surgically treated lung adenocarcinoma with lymph node metastases. Additionally, we analyzed prognostic implications of these predominant histologic subtypes. We observed several discordance patterns between predominant subtypes in primary lung tumors and lymph node metastases. Concordance rates were 22%, 64%, and 100%, respectively, in papillary-, acinar-, and solid-predominant primary lung tumors. We observed that the predominant subtype in the primary lung tumor (HR 12.7, ), but not that in lymph node metastases (HR 0.18, ), determines outcomes in patients with surgically resected lung AD with lymph node metastases.