PMID- 37555982
OWN - NLM
STAT- MEDLINE
DCOM- 20231002
LR  - 20231004
IS  - 1432-2307 (Electronic)
IS  - 0945-6317 (Print)
IS  - 0945-6317 (Linking)
VI  - 483
IP  - 3
DP  - 2023 Sep
TI  - Proposal of a grading system for squamous cell carcinoma of the lung - the 
      prognostic importance of tumour budding, single cell invasion, and nuclear 
      diameter.
PG  - 393-404
LID - 10.1007/s00428-023-03612-8 [doi]
AB  - The prognostic markers of lung squamous cell carcinoma (LSCC) are less 
      investigated. The aim of our study was to evaluate tumour budding (TB), minimal 
      cell nest size, nuclear diameter (ND), and spread through air spaces (STAS) among 
      patients with resected LSCC, semi-quantitatively. Furthermore, we aimed to 
      identify a grading system for the best prognostic stratification of LSCC. 
      Patients who underwent surgical resection at the Department of Surgery, 
      University of Szeged between 2010 and 2016 were included. Follow-up data were 
      collected from medical charts. Morphological characteristics were recorded from 
      histologic revision of slides. Kaplan-Meier analysis, log rank test and Cox 
      proportional-hazards model, ROC curve analysis, and intraclass correlation were 
      utilised. Altogether 220 patients were included. In univariate analysis, higher 
      degree of TB, infiltrative tumour border, larger ND, the presence of single cell 
      invasion (SCI) and STAS were associated with adverse prognosis. Based on our 
      results, we proposed an easily applicable grading scheme focusing on TB, ND, and 
      SCI. In multivariate analysis, the proposed grading system (p(OS )< 0.001, 
      p(RFS )< 0.001) and STAS (p(OS )= 0.008, p(RFS )< 0.001) were independent 
      prognosticators. Compared to the previously introduced grading systems, ROC curve 
      analysis revealed that the proposed grade had the highest AUC values (AUC(OS): 
      0.83, AUC(RFS): 0.78). Each category of the proposed grading system has good 
      (ICC: 0.79-0.88) reproducibility. We validated the prognostic impact of TB, SCI, 
      ND, and STAS in LSCC. We recommend a reproducible grading system combining TB, 
      SCI, and ND for proper prognostic stratification of LSCC patients. Further 
      research is required for validation of this grading scheme.
CI  - (c) 2023. The Author(s).
FAU - Zombori-Toth, Noemi
AU  - Zombori-Toth N
AD  - Csongrad-Csanad County Hospital of Chest Diseases, Deszk, Hungary.
FAU - Hegedus, Fanni
AU  - Hegedus F
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary.
FAU - Almasi, Szintia
AU  - Almasi S
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary.
FAU - Sejben, Anita
AU  - Sejben A
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary.
FAU - Tiszlavicz, Laszlo
AU  - Tiszlavicz L
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary.
FAU - Furak, Jozsef
AU  - Furak J
AD  - Department of Surgery, Albert Szent-Gyorgyi Medical Centre, University of Szeged, 
      Szeged, Hungary.
FAU - Cserni, Gabor
AU  - Cserni G
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary.
AD  - Department of Pathology, Bacs-Kiskun County Teaching Hospital, Kecskemet, 
      Hungary.
FAU - Zombori, Tamas
AU  - Zombori T
AUID- ORCID: 0000-0002-0654-563X
AD  - Department of Pathology, Albert Szent-Gyorgyi Medical Centre, University of 
      Szeged, Szeged, Hungary. zombori.tamas@med.u-szeged.hu.
LA  - eng
GR  - 6212/Szent-Gyorgyi Albert Orvostudomanyi Kar, Szegedi Tudomanyegyetem/
PT  - Journal Article
DEP - 20230809
PL  - Germany
TA  - Virchows Arch
JT  - Virchows Archiv : an international journal of pathology
JID - 9423843
SB  - IM
MH  - Humans
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Neoplasm Grading
MH  - *Carcinoma, Squamous Cell/pathology
MH  - *Lung Neoplasms/pathology
MH  - *Carcinoma, Non-Small-Cell Lung/pathology
MH  - Lung/pathology
MH  - Retrospective Studies
MH  - Neoplasm Invasiveness/pathology
MH  - Neoplasm Staging
PMC - PMC10542270
OTO - NOTNLM
OT  - Grade
OT  - Lung squamous cell carcinoma
OT  - Nuclear diameter
OT  - Single-cell invasion
OT  - Spread through air spaces
OT  - Tumour budding
COIS- The authors declare no competing interests.
EDAT- 2023/08/09 12:55
MHDA- 2023/10/02 06:42
PMCR- 2023/08/09
CRDT- 2023/08/09 11:15
PHST- 2023/04/10 00:00 [received]
PHST- 2023/07/24 00:00 [accepted]
PHST- 2023/06/16 00:00 [revised]
PHST- 2023/10/02 06:42 [medline]
PHST- 2023/08/09 12:55 [pubmed]
PHST- 2023/08/09 11:15 [entrez]
PHST- 2023/08/09 00:00 [pmc-release]
AID - 10.1007/s00428-023-03612-8 [pii]
AID - 3612 [pii]
AID - 10.1007/s00428-023-03612-8 [doi]
PST - ppublish
SO  - Virchows Arch. 2023 Sep;483(3):393-404. doi: 10.1007/s00428-023-03612-8. Epub 
      2023 Aug 9.