Clinicopathological features and postoperative prognosis of invasive mucinous adenocarcinoma: a retrospective study

AbstractBackground: Mucinous adenocarcinoma is a rare lung adenocarcinoma subtype, and its biological behavior remains unclear.Methods: We reviewed data of patients with primary lung adenocarcinoma who underwent surgery between January 2016 and December 2017. Overall, 83 patients were included in the invasive mucinous adenocarcinoma (IMA) group, and 1300 were included in the non invasive mucinous adenocarcinoma (non-IMA) group. Clinical characteristics and prognoses of the two groups were compared.Results: In terms of sex, age, smoking history, carcinoembryonic antigen level, and cyfra21-1 level, there were no statistically significant differences between the IMA and non-IMA groups. Compared with non-IMA patients, the local recurrence rate of IMA was significantly higher (51.2% vs. 20.5%). There was no significant difference between two groups in 5-year disease-free survival. However, 5-year overall survival of the IMA group was significantly decreased. In the IMA group, the 5-year OS of pneumonia-type patients was lower than that of nodule-type patients, and pneumonia-type patients included stage II and III exclusively. The 5-year disease-free survival rates in IMA patients was 75.1%, 7.8%, and 14.3% at stages I, II, and III, respectively. The 5-year overall survival rates for IMA patients with stage I, II, and III were 92.4%, 49.7%, and 23.8%, respectively. In multivariate analysis, only the pathological stage was a significant prognostic factor for IMA.

摘要与背景：黏液腺癌是一种少见的肺腺癌亚型，其生物学行为目前仍不明确。
方法：回顾性分析2016年1月至2017年12月期间接受手术治疗的原发性肺腺癌患者的临床资料，最终纳入侵袭性黏液腺癌（invasive mucinous adenocarcinoma, IMA）组83例、非侵袭性黏液腺癌（non-invasive mucinous adenocarcinoma, non-IMA）组1300例，对比分析两组患者的临床特征与预后情况。
结果：在性别、年龄、吸烟史、癌胚抗原（carcinoembryonic antigen, CEA）水平及细胞角蛋白19片段（cyfra21-1）水平方面，IMA组与non-IMA组均无统计学显著性差异。与non-IMA组患者相比，IMA组的局部复发率显著更高（51.2% vs 20.5%）。两组患者的5年无病生存率无显著差异，但IMA组的5年总生存率显著降低。在IMA组中，肺炎型患者的5年总生存率低于结节型患者，且肺炎型患者仅涵盖Ⅱ期与Ⅲ期病例。IMA组Ⅰ、Ⅱ、Ⅲ期患者的5年无病生存率分别为75.1%、7.8%及14.3%；Ⅰ、Ⅱ、Ⅲ期IMA患者的5年总生存率分别为92.4%、49.7%及23.8%。多因素分析结果显示，仅病理分期为影响IMA患者预后的显著因素。