MTA1 Promotes Spread Through Air Space And Predicts Prognosis In Lung Adenocarcinoma

Objective:The aim of this study was to characterize the relationship between metastasis-associated protein 1(MTA1)and spread through air spaces(STAS),particularly on the joint prognostic value of MTA1 and STAS in resected lung adenocarcinomas.Methods:We retrospectively reviewed 208 operated patients with stage I–III lung adenocarcinoma from January 2009 to December 2014.H&E staining was used to identify STAS,and immunohistochemistry was used to quantify the expression levels of MTA1.A logistic regression model was applied to confirm the predictive factors of MTA1 and STAS.Survival analysis was performed to evaluate the synergistic and separated effects of MTA1 and STAS on prognosis.Results:(1)Patients with either STAS or high MTA1 expression had significantly worse overall survival(OS)and recurrence-free survival(RFS)than those without STAS or low MTA1 expression(p<0.001).(2)MTA1 was confirmed as an independent predictor of increased frequency of STAS(p<0.01).(3)Among 107 patients with STAS present in adenocarcinomas,57(53.3%)had high MTA1 levels.STAS-positive patients with high MTA1 levels had significantly worst survival compared with patients in other groups(p<0.001),while high MTA1/STAS-negative patients shared similar RFS with those high MTA1/STAS-positive.(4)Meanwhile,high MTA1 levels in STAS-positive patients correlated with a higher risk of postoperative metastasis(p<0.001).Conclusion:STAS was more frequently observed in adenocarcinomas with high MTA1 expression levels.MTA1 resulted in a higher risk of recurrence and worse survival among patients with STAS and could provide helpful prognostic information in STAS-positive patients with stage I–III lung adenocarcinoma.Thus,postoperative immunohistochemical detection of MTA1 in STAS-positive patients should be routinely recommended.