TY - JOUR
T1 - Radiologic Features of Resected Lung Adenocarcinoma With Epithelial–Mesenchymal Transition
AU - Matsubara, Taichi
AU - Tagawa, Tetsuzo
AU - Toyokawa, Gouji
AU - Kamitani, Takeshi
AU - Takada, Kazuki
AU - Oba, Taro
AU - Osoegawa, Atsushi
AU - Mori, Masaki
N1 - Funding Information:
The authors wish to thank Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript, and Mototsugu Shimokawa (Clinical Research Institute, National Hospital Organization, Kyushu Cancer Center) for his professional statistical comments during the revision stage of this manuscript.
Publisher Copyright:
© 2021 The Society of Thoracic Surgeons
PY - 2021/11
Y1 - 2021/11
N2 - Background: Epithelial–mesenchymal transition plays a crucial role in cancer progression and is a significant prognosticator for postoperative survival in patients with lung cancer. Predicting epithelial–mesenchymal transition preoperatively using computed tomography may help to determine the optimal surgical strategy. Methods: We performed an immunohistochemical analysis of E-cadherin and vimentin expressions using tumor specimens from resected primary lung adenocarcinoma and classified the results into 3 subgroups according to the expressions: epithelial, intermediate, and mesenchymal. The intermediate and mesenchymal groups were classified as the epithelial–mesenchymal transition conversion group. We analyzed the association between epithelial–mesenchymal transition and radiologic characteristics, especially computed tomographic features. Results: The epithelial–mesenchymal transition conversion group comprised 162 patients (49.1%). Computed tomography revealed that tumors with epithelial–mesenchymal transition conversion showed a high consolidation/tumor ratio compared with those without conversion. Univariate analysis demonstrated that tumors with epithelial–mesenchymal transition were significantly associated with bronchial and/or vascular convergence (P < .001) and notching (P = .028). When the cutoff value for the consolidation/tumor ratio was set by the receiver operating characteristic curve, independent predictive factors for epithelial–mesenchymal transition by multivariate analysis were high ratio (>0.7946; P < .001) and the presence of convergence (P = .05). Tumors with a high consolidation/tumor ratio and convergence had a 4-fold higher odds ratio for epithelial–mesenchymal transition, and patients had significantly poorer survival. Conclusions: Convergence and a high consolidation/tumor ratio were independently associated with epithelial–mesenchymal transition conversion. These preoperative radiologic results will help to predict epithelial–mesenchymal transition conversion in lung adenocarcinoma.
AB - Background: Epithelial–mesenchymal transition plays a crucial role in cancer progression and is a significant prognosticator for postoperative survival in patients with lung cancer. Predicting epithelial–mesenchymal transition preoperatively using computed tomography may help to determine the optimal surgical strategy. Methods: We performed an immunohistochemical analysis of E-cadherin and vimentin expressions using tumor specimens from resected primary lung adenocarcinoma and classified the results into 3 subgroups according to the expressions: epithelial, intermediate, and mesenchymal. The intermediate and mesenchymal groups were classified as the epithelial–mesenchymal transition conversion group. We analyzed the association between epithelial–mesenchymal transition and radiologic characteristics, especially computed tomographic features. Results: The epithelial–mesenchymal transition conversion group comprised 162 patients (49.1%). Computed tomography revealed that tumors with epithelial–mesenchymal transition conversion showed a high consolidation/tumor ratio compared with those without conversion. Univariate analysis demonstrated that tumors with epithelial–mesenchymal transition were significantly associated with bronchial and/or vascular convergence (P < .001) and notching (P = .028). When the cutoff value for the consolidation/tumor ratio was set by the receiver operating characteristic curve, independent predictive factors for epithelial–mesenchymal transition by multivariate analysis were high ratio (>0.7946; P < .001) and the presence of convergence (P = .05). Tumors with a high consolidation/tumor ratio and convergence had a 4-fold higher odds ratio for epithelial–mesenchymal transition, and patients had significantly poorer survival. Conclusions: Convergence and a high consolidation/tumor ratio were independently associated with epithelial–mesenchymal transition conversion. These preoperative radiologic results will help to predict epithelial–mesenchymal transition conversion in lung adenocarcinoma.
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U2 - 10.1016/j.athoracsur.2020.10.034
DO - 10.1016/j.athoracsur.2020.10.034
M3 - Article
C2 - 33248987
AN - SCOPUS:85109079200
VL - 112
SP - 1647
EP - 1655
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 5
ER -
