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1、ORIGINALARTICLEClinicalRelevanceofDifferentPapillaryGrowthPatternsofPulmonaryAdenocarcinomaArneWarth,MD,*ThomasMuley,PhD,wAlexanderHarms,MD,*HansHoffmann,MD,PhD,zHendrikDienemann,MD,PhD,zPeterSchirmacher,MD,PhD,*andWilkoWeichert,MD,PhD*yroundbreakingdiscove
2、riesinthefieldofnovelclas-Abstract:Growthpatternsofpulmonaryadenocarcinoma(ADC)Gsificationandtreatmentstrategiesinpulmonaryad-havehighprognosticimpactandareacceptedasanovelclassi-enocarcinoma(ADC)overthelastdecadehaveficationsystemforthisentity.However,specifi
3、callyforthepap-fundamentallychangedourviewontheprognosisandillarypattern,divergentdatawithrespecttoprevalence,clinicaltreatmentoflungcancerpatients.Onecrucialstepaheadassociations,andprognosticimpacthavebeenreported.Bywastheintroductionofanovelmultidiscipl
4、inaryADCevaluating674resectedpulmonaryADCscontaining308casesclassificationpublishedbytheInternationalAssociationwithapapillarycomponentand101papillarypredominantcases,fortheStudyofLungCancer(IASLC),theAmericanwedocumenteddifferencesinthemorphologiccompositio
5、nofThoracicSociety(ATS),andtheEuropeanRespiratorypapillarygrowthpatternsanddelineated3differenttypes.TheSociety(ERS)in2011,1whichwasalsoadoptedforthedifferenttypeswerecorrelatedwithpathologicandclinicaldatanovelWorldHealthOrganizationclassification.2Thisinclu
6、dingsurvival.Type3papillarycaseswithanyorpredom-classificationisbasedonasemiquantitativeassessmentofinantpapillarygrowthwereassociatedwithextensivespreadspecifichistomorphologicgrowthpatternsofinvasivethroughalveolarspaces,highproliferation,higherstage,lowAD
7、Cin5%incrementswithcategorizationofeachcaseratesofEGFRmutations,andsmoking,whereastype1papillaryaseitherlepidic,acinar,papillary,micropapillary,orsolidtumorsshowedtheoppositeassociations.Thesubclassificationofpredominant.Theprognosticvalueandthereproduci-pa
8、pillarygrowthrevealedtype-specificassociationsforoverallbilityofthisclassificationhavebeenvalidatedinmultipleanddisease-freesurvival(disease-freesurvivaltype1:67.1mo,independentstudies.3–10Subsequently,research
