Research progress on lung adenocarcinoma with micropapillary component in stage IA

doi:10.19983/j.issn.2096-8493.20250164

Abstract

Abstract:

Lung adenocarcinoma is the most common subtype of non-small cell lung cancer. Compared to other subtypes, pulmonary adenocarcinoma with a micropapillary component (micropapillary pattern pulmonary adenocarcinoma, MPPAC), particularly the micropapillarypredominant form, exhibits relatively distinct pathological characteristics and a unique tumor immune microenvironment, along with highly invasive behavior. Thanks to increased health awareness and the widespread adoption of low-dose spiral CT, the detection rate of early-stage lung cancer has significantly improved. Against this backdrop, timely diagnosis of MPPAC is crucial for guiding surgical planning and developing personalized adjuvant treatment strategies. Due to its high malignant potential and aggressiveness, patients with lung adenocarcinoma featuring micropapillary structures often have a poorer prognosis. This article provides an overview of recent research progress regarding the histopathological characteristics, imaging features, underlying mechanisms of formation, genetic mutations, treatment approaches, and prognosis in stage IA lung adenocarcinoma with micropapillary components, aiming to offer a reference for clinical diagnosis and management.

Key words: Adenocarcinoma, papillary, Lung, Diagnosis, Therapeutics, Prognosis

CLC Number:

R734.2

Li Kaidi, Fan Qingda, Jiang Wensheng. Research progress on lung adenocarcinoma with micropapillary component in stage IA[J]. Journal of Tuberculosis and Lung Disease , 2026, 7(1): 106-111. doi: 10.19983/j.issn.2096-8493.20250164

References 38

[1]	Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin, 73(1): 17-48. doi:10.3322/caac.21763.
[2]	Silver SA, Askin FB. True papillary carcinoma of the lung: a distinct clinicopathologic entity. Am J Surg Pathol, 1997, 21(1): 43-51. doi:10.1097/00000478-199701000-00005. pmid: 8990140
[3]	Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285. doi:10.1097/JTO.0b013e318206a221. pmid: 21252716
[4]	Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol, 2015, 10(9): 1243-1260. doi:10.1097/JTO.0000000000000630. pmid: 26291008
[5]	张斌杰, 乐涵波, 颜波儿, 等. 伴微乳头结构肺腺癌的临床病理特征分析. 浙江医学, 42(14): 1500-1503. doi:10.12056/j.issn.1006-2785.2020.42.14.2019-1676.
[6]	Yao J, Zhu E, Li M, et al. Prognostic impact of micropapillary component in patients with node-negative subcentimeter lung adenocarcinoma: A Chinese cohort study. Thorac Cancer, 2020, 11(12): 3566-3575. doi:10.1111/1759-7714.13702. pmid: 33058505
[7]	Emoto K, Eguchi T, Tan KS, et al. Expansion of the Concept of Micropapillary Adenocarcinoma to Include a Newly Recognized Filigree Pattern as Well as the Classical Pattern Based on 1468 Stage Ⅰ Lung Adenocarcinomas. J Thorac Oncol, 2019, 14(11): 1948-1961. doi:10.1016/j.jtho.2019.07.008.
[8]	中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2022版). 中华肿瘤杂志, 2022, 44(6): 457-490. doi:10.3760/cma.j.cn112152-20220413-00255.
[9]	Chen Q, Lin K, Zhang B, et al. CT morphological features and histogram parameters to predict micropapillary or solid components in stage IA lung adenocarcinoma. Front Oncol, 2024, 14: 1448333. doi:10.3389/fonc.2024.1448333.
[10]	陈挺, 李盛. MSCT不同重建方式对于3cm以内肺磨玻璃结节的诊断价值. 医学影像学杂志, 2019, 29(7): 1123-1127.
[11]	Yoon DW, Kim CH, Hwang S, et al. Reappraising the clinical usability of consolidation-to-tumor ratio on CT in clinical stage IA lung cancer. Insights Imaging, 2022, 13(1): 103. doi:10.1186/s13244-022-01235-2.
[12]	Zhou L, Sun J, Long H, et al. Imaging phenotyping using ¹⁸F-FDG PET/CT radiomics to predict micropapillary and solid pattern in lung adenocarcinoma. Insights Imaging, 2024, 15(1): 5. doi:10.1186/s13244-023-01573-9.
[13]	Lee HY, Lee SW, Lee KS, et al. Role of CT and PET Imaging in Predicting Tumor Recurrence and Survival in Patients with Lung Adenocarcinoma: A Comparison with the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification of Lung Adenocarcinoma. J Thorac Oncol, 2015, 10(12): 1785-1794. doi:10.1097/JTO.0000000000000689. pmid: 26473646
[14]	Shao X, Niu R, Jiang Z, et al. Role of PET/CT in Management of Early Lung Adenocarcinoma. AJR Am J Roentgenol, 2020, 214(2): 437-445. doi:10.2214/AJR.19.21585.
[15]	梁云, 任蒙蒙, 黄德龙, 等. 人工智能量化参数鉴别Ⅰ期浸润性肺腺癌病理分级的临床价值. 中国胸心血管外科临床杂志, 2025, 32(5): 598-607. doi:10.7507/1007-4848.202408028.
[16]	Shi R, Bao X, Unger K, et al. Identification and validation of hypoxia-derived gene signatures to predict clinical outcomes and therapeutic responses in stage Ⅰ lung adenocarcinoma patients. Theranostics, 2021, 11(10): 5061-5076. doi:10.7150/thno.56202.
[17]	Umeda D, Harada A, Motooka D, et al. Hypoxia drives the formation of lung micropapillary adenocarcinoma-like structure through hypoxia-inducible factor-1α. Sci Rep, 2024, 14(1): 31642. doi:10.1038/s41598-024-80280-x.
[18]	Warth A, Penzel R, Lindenmaier H, et al. EGFR, KRAS, BRAF and ALK gene alterations in lung adenocarcinomas: patient outcome, interplay with morphology and immunophenotype. Eur Respir J, 2014, 43(3): 872-883. doi:10.1183/09031936.00018013. pmid: 23988776
[19]	Huo Y, Sun L, Yuan J, et al. Comprehensive analyses unveil novel genomic and immunological characteristics of micropapillary pattern in lung adenocarcinoma. Front Oncol, 2022, 12: 931209. doi:10.3389/fonc.2022.931209.
[20]	Qu Y, Feng X, Chen H, et al. Multi-omics analyses reveal distinct molecular characteristics and transformation mechanisms of stage Ⅰ-Ⅲ micropapillary lung adenocarcinoma. J Pathol, 2025, 266(2): 204-216. doi:10.1002/path.6416.
[21]	王也, 杨磊, 于芳, 等. 非小细胞肺癌罕见驱动基因突变特点及其与临床病理特征的相关性. 中日友好医院学报, 2020, 34(4): 209-213, 封2. doi:10.3969/j.issn.1001-0025.2020.04.005.
[22]	Yeh YC, Nitadori J, Kadota K, et al. Using frozen section to identify histological patterns in stage Ⅰ lung adenocarcinoma of ≤3 cm: accuracy and interobserver agreement. Histopathology, 2015, 66(7): 922-938. doi:10.1111/his.12468.
[23]	Zhao S, Xie H, Su H, et al. Identification of filigree pattern increases the diagnostic accuracy of micropapillary pattern on frozen section for lung adenocarcinoma. Histopathology, 2022, 81(1): 119-127. doi:10.1111/his.14672.
[24]	张宏伟, 赵光强, 陈小波. IA期肺腺癌手术方式的研究进展. 中国肿瘤临床, 2023, 50(11): 581-586. doi:10.12354/j.issn.1000-8179.2023.20230037.
[25]	Huang CS, Hsu PK, Chen CK, et al. Surgeons’ preference sublobar resection for stage Ⅰ NSCLC less than 3cm. Thorac Cancer, 2020, 11(4): 907-917. doi:10.1111/1759-7714.13336.
[26]	Fan X, Liang C, Ma X, et al. Clinical, Imaging, and Pathological-Molecular Characteristics Associated with Stage IA Invasive Lung Adenocarcinoma Recurrence After Sub-lobar Resection. Acad Radiol, 2025, 32(1): 450-459. doi:10.1016/j.acra.2024.07.003.
[27]	Xu L, Zhou H, Wang G, et al. The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤2cm. Front Oncol, 2022, 12: 954317. doi:10.3389/fonc.2022.954317.
[28]	Matsushima K, Sonoda D, Mitsui A, et al. Factors associated with lymph node metastasis upstage after resection for patients with micropapillary lung adenocarcinoma. Thorac Cancer, 2022, 13(1): 48-53. doi:10.1111/1759-7714.14220.
[29]	王忠照, 唐昊. 《中华医学会肺癌临床诊疗指南(2024版)》更新要点解读. 海军军医大学学报, 2025, 46(1): 17-23. doi:10.16781/j.CN31-2187/R.20240697.
[30]	Peng B, Li G, Guo Y. Prognostic significance of micropapillary and solid patterns in stage IA lung adenocarcinoma. Am J Transl Res, 2021, 13(9): 10562-10569. pmid: 34650727
[31]	Passiglia F, Bertaglia V, Reale ML, et al. Major breakthroughs in lung cancer adjuvant treatment: Looking beyond the horizon. Cancer Treat Rev, 2021, 101: 102308. doi:10.1016/j.ctrv.2021.102308.
[32]	Li Y, Zhao J, Zhao Y, et al. Survival benefit of adjuvant chemotherapy after resection of Stage Ⅰ lung adenocarcinoma containing micropapillary components. Cancer Med, 2024, 13(3): e7030. doi:10.1002/cam4.7030.
[33]	Moreira AL, Ocampo PSS, Xia Y, et al. A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee. J Thorac Oncol, 2020, 15(10): 1599-1610. doi:10.1016/j.jtho.2020.06.001. pmid: 32562873
[34]	Li R, Qiu J, Li Z, et al. Prognostic significance and survival benefits of postoperative adjuvant chemotherapy in patients with stage IA lung adenocarcinoma with non-predominant micropapillary components. World J Surg Oncol, 2024, 22(1): 32. doi:10.1186/s12957-024-03303-x. pmid: 38273367
[35]	Wang K, Xue M, Qiu J, et al. Genomics Analysis and Nomogram Risk Prediction of Occult Lymph Node Metastasis in Non-Predominant Micropapillary Component of Lung Adenocarcinoma Measuring ≤3 cm. Front Oncol, 2022, 12: 945997. doi:10.3389/fonc.2022.945997.
[36]	Potter AL, Costantino CL, Suliman RA, et al. Recurrence After Complete Resection for Non-Small Cell Lung Cancer in the National Lung Screening Trial. Ann Thorac Surg, 2023, 116(4): 684-692. doi:10.1016/j.athoracsur.2023.06.004.
[37]	Dong D, Zhang S, Jiang B, et al. Corrigendum: Correlation analysis of MRD positivity in patients with completely resected stage Ⅰ-ⅢA non-small cell lung cancer: a cohort study. Front Oncol, 2023, 13: 1275851. doi:10.3389/fonc.2023.1275851.
[38]	顾庆龙, 梁云, 刘曙亮. 微乳头型肺腺癌的研究进展. 癌症进展, 2024, 22(20): 2211-2214, 2219. doi:10.11877/j.issn.1672-1535.2024.22.20.02.