Prognostic value of the international association for the study of lung cancer grading system and its association with the tumor microenvironment in stage I EGFR-muted lung adenocarcinoma

Shoko Kubota ¹, Tetsuro Taki ², Tomohiro Miyoshi ³

⁰Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan.

European Journal of Cancer (Oxford, England : 1990) +

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June 27, 2024

View abstract on PubMed

Summary

The International Association for the Study of Lung Cancer (IASLC) grading system predicts outcomes for EGFR-mutated lung adenocarcinoma. Grade 3 tumors show a more aggressive tumor microenvironment (TME), correlating with poorer patient survival.

Area Of Science

Oncology
Pathology
Cancer Research

Background

The International Association for the Study of Lung Cancer (IASLC) grading system is utilized to predict outcomes in early-stage lung adenocarcinoma.
Understanding the prognostic implications of this grading system, particularly in EGFR-mutated cases, is crucial for personalized treatment strategies.

Purpose Of The Study

To investigate the prognostic value of the IASLC grading system in Stage I EGFR-mutated lung adenocarcinoma.
To explore the association between IASLC tumor grades and the tumor microenvironment (TME) composition.

Main Methods

Compared clinicopathological characteristics of 296 EGFR-mutated lung adenocarcinomas based on IASLC grade.
Analyzed E-cadherin expression, tumor-infiltrating lymphocytes (TILs), tumor-associated macrophages (TAMs), and cancer-associated fibroblasts (CAFs) using digital pathology.

Main Results

Grade 3 IASLC classification was associated with significantly shorter recurrence-free survival (RFS) compared to grades 1 and 2.
Invasive size, lymphatic permeation, and Grade 3 were independent poor prognostic factors for RFS.
Grade 3 tumors exhibited higher numbers of CD204+ TAMs and PDPN+ CAFs, indicating a more pro-tumorigenic TME.

Conclusions

The IASLC grading system effectively correlates with outcomes in EGFR-mutated lung adenocarcinoma.
Grade 3 tumors possess a TME composition that promotes tumor progression, explaining their unfavorable prognosis.

Keywords:

Cancer-associated fibroblast IASLC grading system Lung adenocarcinoma with EGFR mutation Prognosis Tumor-associated macrophages