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Background <p>Lung adenocarcinoma is classified into subtypes based on pathological features; however, the clinical and biological characteristics of each subtype, including driver mutations and programmed death-ligand 1 (PD-L1) expression, remain unclear. We aimed to clarify these characteristics.</p> Methods <p>We retrospectively analyzed 1412 cases of stage I–III lung adenocarcinoma that underwent complete resection between 2004 and 2023. Clinical and biological characteristics were compared by predominant subtypes.</p> Results <p>Among the 1412 cases, the predominant subtypes were papillary (n = 686, 48.6%), lepidic (n = 317, 22.5%), acinar (n = 234, 16.6%), solid (n = 166, 11.8%), and micropapillary (n = 9, 0.6%). The lepidic subtype was more common in females (58.0% vs. 43.5%; <i>p</i> &lt; 0.001), had a lower smoking rate (47.3% vs. 60.9%; <i>p</i> &lt; 0.001), smaller invasive size (8&#xa0;mm vs. 18&#xa0;mm; <i>p</i> &lt; 0.001), higher frequency of epidermal growth factor receptor (EGFR) mutation (63.4% vs. 45.2%; <i>p</i> &lt; 0.001), and lower PD-L1 expression (15.5% vs. 45.2%; <i>p</i> &lt; 0.001). The solid subtype was more prevalent in males (76.5% vs. 50.2%) and smokers (83.1% vs. 54.5%), with a larger invasive size (20.1&#xa0;mm vs. 15.0&#xa0;mm), fewer EGFR mutations (12.6% vs. 54.2%; <i>p</i> &lt; 0.001), and higher PD-L1 expression (66.6% vs. 35.2%; <i>p</i> &lt; 0.001). The 5-year Recurrence-free survival rates for the lepidic, acinar, papillary, and solid subtypes were 88.2, 72.9, 65.1, and 58.2%, respectively (<i>p</i> &lt; 0.001).</p> Conclusion <p>Lung adenocarcinoma subtypes present distinct clinical and pathological profiles, which may affect treatment strategies and prognostic evaluation.</p>

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Assessment of clinical and biological characteristics by pathological subtypes of lung adenocarcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月19日

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  • Kohei Abe,
  • Jun Suzuki,
  • Hikaru Watanabe,
  • Satoshi Takamori,
  • Tetsuro Uchida,
  • Satoshi Shiono

摘要

Background

Lung adenocarcinoma is classified into subtypes based on pathological features; however, the clinical and biological characteristics of each subtype, including driver mutations and programmed death-ligand 1 (PD-L1) expression, remain unclear. We aimed to clarify these characteristics.

Methods

We retrospectively analyzed 1412 cases of stage I–III lung adenocarcinoma that underwent complete resection between 2004 and 2023. Clinical and biological characteristics were compared by predominant subtypes.

Results

Among the 1412 cases, the predominant subtypes were papillary (n = 686, 48.6%), lepidic (n = 317, 22.5%), acinar (n = 234, 16.6%), solid (n = 166, 11.8%), and micropapillary (n = 9, 0.6%). The lepidic subtype was more common in females (58.0% vs. 43.5%; p < 0.001), had a lower smoking rate (47.3% vs. 60.9%; p < 0.001), smaller invasive size (8 mm vs. 18 mm; p < 0.001), higher frequency of epidermal growth factor receptor (EGFR) mutation (63.4% vs. 45.2%; p < 0.001), and lower PD-L1 expression (15.5% vs. 45.2%; p < 0.001). The solid subtype was more prevalent in males (76.5% vs. 50.2%) and smokers (83.1% vs. 54.5%), with a larger invasive size (20.1 mm vs. 15.0 mm), fewer EGFR mutations (12.6% vs. 54.2%; p < 0.001), and higher PD-L1 expression (66.6% vs. 35.2%; p < 0.001). The 5-year Recurrence-free survival rates for the lepidic, acinar, papillary, and solid subtypes were 88.2, 72.9, 65.1, and 58.2%, respectively (p < 0.001).

Conclusion

Lung adenocarcinoma subtypes present distinct clinical and pathological profiles, which may affect treatment strategies and prognostic evaluation.