{"title":"Clinicopathological Significance of Spread Through Air Spaces in Lung Cancer.","authors":"Emi Ibuki, Chihiro Yoshida, Kyuichi Kadota","doi":"10.1111/pin.70037","DOIUrl":null,"url":null,"abstract":"<p><p>Although it has been known for over 40 years that lung cancer can progress by spreading through alveolar spaces, the WHO formally published the term \"spread through air spaces\" (STAS) only 10 years ago, in 2015. Numerous studies have proven that STAS is a poor prognostic factor in all histological types of lung cancer and affects surgical procedure selection and stage classification. While it is clear that STAS should be reported in the routine diagnosis of lung cancer, diagnosis can sometimes be challenging, and pathologists need to be aware of the diagnostic and exclusion criteria. Clinicians also need to recognize the importance of STAS and cooperate in improving diagnosis using frozen sections, which has become a topic of discussion in recent years. In this review, we summarize the current status of research on STAS from various perspectives, including clinical, morphological, genetic, molecular, and tumor immune microenvironmental properties, and discuss future prospects.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathology International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/pin.70037","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Although it has been known for over 40 years that lung cancer can progress by spreading through alveolar spaces, the WHO formally published the term "spread through air spaces" (STAS) only 10 years ago, in 2015. Numerous studies have proven that STAS is a poor prognostic factor in all histological types of lung cancer and affects surgical procedure selection and stage classification. While it is clear that STAS should be reported in the routine diagnosis of lung cancer, diagnosis can sometimes be challenging, and pathologists need to be aware of the diagnostic and exclusion criteria. Clinicians also need to recognize the importance of STAS and cooperate in improving diagnosis using frozen sections, which has become a topic of discussion in recent years. In this review, we summarize the current status of research on STAS from various perspectives, including clinical, morphological, genetic, molecular, and tumor immune microenvironmental properties, and discuss future prospects.
期刊介绍：
Pathology International is the official English journal of the Japanese Society of Pathology, publishing articles of excellence in human and experimental pathology. The Journal focuses on the morphological study of the disease process and/or mechanisms. For human pathology, morphological investigation receives priority but manuscripts describing the result of any ancillary methods (cellular, chemical, immunological and molecular biological) that complement the morphology are accepted. Manuscript on experimental pathology that approach pathologenesis or mechanisms of disease processes are expected to report on the data obtained from models using cellular, biochemical, molecular biological, animal, immunological or other methods in conjunction with morphology. Manuscripts that report data on laboratory medicine (clinical pathology) without significant morphological contribution are not accepted.
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