Characterization Of Lung Adenocarcinoma With A Cribriform Component Reveals Its Association With Spread Through Air Spaces And Poor Outcomes

Objective:To further investigate the relationship between the cribriform component and spread through air spaces(STAS),and to unravel the potential pathological mechanism of poor prognoses in patients with the cribriform component.Methods:We retrospectively reviewed the clinicopathological characteristics of 208 adenocarcinomas.A cribriform component was identified by hematoxylin and eosin staining.The identification of STAS referred to our previous study.The relationship between a cribriform component and STAS was determined by using a logistic regression model.The effects of the cribriform component and STAS on prognosis were analyzed using a Cox proportional hazards regression model.Results:Patients with a cribriform component had significantly inferior outcomes(P<0.001)and increased risk of both locoregional and distant recurrences(P<0.001)when compared with those with no cribriform component.Among 67 patients with a cribriform component presented,48(71.6%)cases had STAS.The logistic regression model identified that the cribriform component was an independent risk factor for presence of STAS(OR,2.21;P=0.044).Subgroup analysis showed that cribriform+/STAS+patients had significantly inferior outcomes when compared with cribriform+/STAS-patients(P<0.001).Moreover,the multivariate Cox regression analysis further confirmed that STAS was an independent risk factor for a worsening recurrence-free survival(RFS)(HR,3.17;P=0.001)and overall survival(OS)(HR,3.64,P<0.001)in patients with a cribriform component.Conclusions:Our results indicated that STAS was more frequently observed in adenocarcinoma with a cribriform component.Moreover,STAS could provide helpful prognostic information in patients with stage I-III adenocarcinoma with a cribriform component.