{"title":"Histologic patterns of metastatic lymph nodes and recurrence patterns in resected pN1-2 lung adenocarcinoma.","authors":"Masayoshi Watanabe, Tetsuro Taki, Shunta Tsuchida, Kotaro Nomura, Masataka Kawai, Masashi Wakabayashi, Yoichi Ohtaki, Tomohiro Miyoshi, Kenta Tane, Yuki Matsumura, Keiju Aokage, Yukiko Sasahara, Michiko Nagamine, Shingo Sakashita, Naoya Sakamoto, Keisuke Asakura, Masahiro Tsuboi, Genichiro Ishii","doi":"10.1016/j.humpath.2026.106232","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Histologic grading of the primary tumor (PT) is an established prognostic factor in lung adenocarcinoma; however, the clinical relevance of histologic patterns in metastatic lymph nodes (MLNs) remains unclear. This study investigated whether MLN histology is associated with recurrence patterns after complete resection.</p><p><strong>Methods: </strong>We retrospectively analyzed 120 patients with pN1-2 lung adenocarcinoma who underwent complete resection at a single institution. Predominant histologic patterns of PTs and MLNs were categorized as low grade (lepidic), intermediate grade (papillary or acinar), or high grade (solid or micropapillary). Survival outcomes and recurrence patterns (locoregional vs distant) were compared across MLN histologic groups.</p><p><strong>Results: </strong>Predominant histologic patterns were frequently discordant between PTs and MLNs (McNemar test, P = 0.01; κ = 0.25). High-grade PTs were associated with significantly shorter recurrence-free survival (RFS) than intermediate-grade tumors (P = 0.02), whereas MLN histology was not associated with RFS (P = 0.70). PT histology was not significantly related to recurrence site. In contrast, intermediate-grade MLNs showed a significantly higher incidence of locoregional recurrence than high-grade MLNs (P = 0.04), which was confirmed by cumulative incidence analysis (P = 0.02). Distant recurrence rates were comparable between the two groups (P = 0.39).</p><p><strong>Conclusions: </strong>While histologic grading of the primary tumor reflects overall tumor aggressiveness and prognosis, the histologic architecture of metastatic lymph nodes may be associated with recurrence patterns rather than survival outcomes. These findings suggest that MLN morphology may provide complementary pathological information regarding patterns of locoregional recurrence after surgical resection.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106232"},"PeriodicalIF":3.0000,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.humpath.2026.106232","RegionNum":2,"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
Aims: Histologic grading of the primary tumor (PT) is an established prognostic factor in lung adenocarcinoma; however, the clinical relevance of histologic patterns in metastatic lymph nodes (MLNs) remains unclear. This study investigated whether MLN histology is associated with recurrence patterns after complete resection.
Methods: We retrospectively analyzed 120 patients with pN1-2 lung adenocarcinoma who underwent complete resection at a single institution. Predominant histologic patterns of PTs and MLNs were categorized as low grade (lepidic), intermediate grade (papillary or acinar), or high grade (solid or micropapillary). Survival outcomes and recurrence patterns (locoregional vs distant) were compared across MLN histologic groups.
Results: Predominant histologic patterns were frequently discordant between PTs and MLNs (McNemar test, P = 0.01; κ = 0.25). High-grade PTs were associated with significantly shorter recurrence-free survival (RFS) than intermediate-grade tumors (P = 0.02), whereas MLN histology was not associated with RFS (P = 0.70). PT histology was not significantly related to recurrence site. In contrast, intermediate-grade MLNs showed a significantly higher incidence of locoregional recurrence than high-grade MLNs (P = 0.04), which was confirmed by cumulative incidence analysis (P = 0.02). Distant recurrence rates were comparable between the two groups (P = 0.39).
Conclusions: While histologic grading of the primary tumor reflects overall tumor aggressiveness and prognosis, the histologic architecture of metastatic lymph nodes may be associated with recurrence patterns rather than survival outcomes. These findings suggest that MLN morphology may provide complementary pathological information regarding patterns of locoregional recurrence after surgical resection.
期刊介绍：
Human Pathology is designed to bring information of clinicopathologic significance to human disease to the laboratory and clinical physician. It presents information drawn from morphologic and clinical laboratory studies with direct relevance to the understanding of human diseases. Papers published concern morphologic and clinicopathologic observations, reviews of diseases, analyses of problems in pathology, significant collections of case material and advances in concepts or techniques of value in the analysis and diagnosis of disease. Theoretical and experimental pathology and molecular biology pertinent to human disease are included. This critical journal is well illustrated with exceptional reproductions of photomicrographs and microscopic anatomy.
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