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Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter
The prognostic markers of lung squamous cell carcinoma (LSCC) are less investigated. The aim of our study was to evaluate tumour budding (TB), minimal cell nest size, nuclear diameter (ND), and spread through air spaces (STAS) among patients with resected LSCC, semi-quantitatively. Furthermore, we a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542270/ https://www.ncbi.nlm.nih.gov/pubmed/37555982 http://dx.doi.org/10.1007/s00428-023-03612-8 |
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author | Zombori-Tóth, Noémi Hegedűs, Fanni Almási, Szintia Sejben, Anita Tiszlavicz, László Furák, József Cserni, Gábor Zombori, Tamás |
author_facet | Zombori-Tóth, Noémi Hegedűs, Fanni Almási, Szintia Sejben, Anita Tiszlavicz, László Furák, József Cserni, Gábor Zombori, Tamás |
author_sort | Zombori-Tóth, Noémi |
collection | PubMed |
description | The prognostic markers of lung squamous cell carcinoma (LSCC) are less investigated. The aim of our study was to evaluate tumour budding (TB), minimal cell nest size, nuclear diameter (ND), and spread through air spaces (STAS) among patients with resected LSCC, semi-quantitatively. Furthermore, we aimed to identify a grading system for the best prognostic stratification of LSCC. Patients who underwent surgical resection at the Department of Surgery, University of Szeged between 2010 and 2016 were included. Follow-up data were collected from medical charts. Morphological characteristics were recorded from histologic revision of slides. Kaplan-Meier analysis, log rank test and Cox proportional-hazards model, ROC curve analysis, and intraclass correlation were utilised. Altogether 220 patients were included. In univariate analysis, higher degree of TB, infiltrative tumour border, larger ND, the presence of single cell invasion (SCI) and STAS were associated with adverse prognosis. Based on our results, we proposed an easily applicable grading scheme focusing on TB, ND, and SCI. In multivariate analysis, the proposed grading system (p(OS )< 0.001, p(RFS )< 0.001) and STAS (p(OS )= 0.008, p(RFS )< 0.001) were independent prognosticators. Compared to the previously introduced grading systems, ROC curve analysis revealed that the proposed grade had the highest AUC values (AUC(OS): 0.83, AUC(RFS): 0.78). Each category of the proposed grading system has good (ICC: 0.79–0.88) reproducibility. We validated the prognostic impact of TB, SCI, ND, and STAS in LSCC. We recommend a reproducible grading system combining TB, SCI, and ND for proper prognostic stratification of LSCC patients. Further research is required for validation of this grading scheme. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00428-023-03612-8. |
format | Online Article Text |
id | pubmed-10542270 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105422702023-10-03 Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter Zombori-Tóth, Noémi Hegedűs, Fanni Almási, Szintia Sejben, Anita Tiszlavicz, László Furák, József Cserni, Gábor Zombori, Tamás Virchows Arch Original Article The prognostic markers of lung squamous cell carcinoma (LSCC) are less investigated. The aim of our study was to evaluate tumour budding (TB), minimal cell nest size, nuclear diameter (ND), and spread through air spaces (STAS) among patients with resected LSCC, semi-quantitatively. Furthermore, we aimed to identify a grading system for the best prognostic stratification of LSCC. Patients who underwent surgical resection at the Department of Surgery, University of Szeged between 2010 and 2016 were included. Follow-up data were collected from medical charts. Morphological characteristics were recorded from histologic revision of slides. Kaplan-Meier analysis, log rank test and Cox proportional-hazards model, ROC curve analysis, and intraclass correlation were utilised. Altogether 220 patients were included. In univariate analysis, higher degree of TB, infiltrative tumour border, larger ND, the presence of single cell invasion (SCI) and STAS were associated with adverse prognosis. Based on our results, we proposed an easily applicable grading scheme focusing on TB, ND, and SCI. In multivariate analysis, the proposed grading system (p(OS )< 0.001, p(RFS )< 0.001) and STAS (p(OS )= 0.008, p(RFS )< 0.001) were independent prognosticators. Compared to the previously introduced grading systems, ROC curve analysis revealed that the proposed grade had the highest AUC values (AUC(OS): 0.83, AUC(RFS): 0.78). Each category of the proposed grading system has good (ICC: 0.79–0.88) reproducibility. We validated the prognostic impact of TB, SCI, ND, and STAS in LSCC. We recommend a reproducible grading system combining TB, SCI, and ND for proper prognostic stratification of LSCC patients. Further research is required for validation of this grading scheme. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00428-023-03612-8. Springer Berlin Heidelberg 2023-08-09 2023 /pmc/articles/PMC10542270/ /pubmed/37555982 http://dx.doi.org/10.1007/s00428-023-03612-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Zombori-Tóth, Noémi Hegedűs, Fanni Almási, Szintia Sejben, Anita Tiszlavicz, László Furák, József Cserni, Gábor Zombori, Tamás Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title | Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title_full | Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title_fullStr | Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title_full_unstemmed | Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title_short | Proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
title_sort | proposal of a grading system for squamous cell carcinoma of the lung — the prognostic importance of tumour budding, single cell invasion, and nuclear diameter |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542270/ https://www.ncbi.nlm.nih.gov/pubmed/37555982 http://dx.doi.org/10.1007/s00428-023-03612-8 |
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