Prognostic and clinicopathologic divergence in pulmonary mucinous adenocarcinoma versus nonmucinous adenocarcinoma with a mucin-laden feature.
5 affiliations
- 1Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China.
- 2Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
- 3Clinical Research Unit, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
- 4Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
- 5Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China.
Abstract
Background
The discrepancies in clinicopathologic characteristics and prognosis between invasive mucinous adenocarcinoma (IMA) and nonmucinous lung adenocarcinoma with a mucin-laden feature (MNLA) remain unclear.Methods
Data were collected retospectively for 978 consecutive patients with IMA/MNLA who underwent surgical resection between October 2017 and December 2019. Survival outcomes were estimated using the Kaplan-Meier method and compared using the log-rank test. The adjusted hazard ratio (aHR) with 95% confidence interval (CI) of the prognosticator was calculated using a multivariable Cox proportional hazards model.Results
Pure IMA was associated with a higher prevalence of KRAS mutation (51.5%), while MNLA was associated with higher prevalences of EGFR mutation (40.4%) and EML4-ALK rearrangement (19.1%). Regarding prognosis, compared to patients with pure IMA, patients with MNLA or mixed IMA had worse disease-free survival (MNLA: aHR, 2.620, 95% CI, 1.690-4.061; mixed IMA: aHR, 3.458, 95% CI, 1.704-7.016) and overall survival (MNLA: aHR, 2.229, 95% CI, 1.185-4.193; mixed IMA: aHR, 1.723, 95% CI, 0.632-4.698). Among patients who experienced recurrence, those with pure IMA had a higher incidence of intrathoracic-only recurrence compared to those with MNLA (80.8% vs 39.6%), demonstrating that extrathoracic-only recurrence was more prevalent in MNLA (35.1% vs 7.3%). The recurrence pattern of mixed IMA was different from that of pure IMA (pure IMA vs mixed IMA: intrathoracic-only, 80.8% vs 50.0%; both intrathoracic and extrathoracic, 11.5% vs 40.0%).Conclusions
Although MNLA, pure IMA, and mixed IMA have consistent mucin-laden features, they appear to exhibit differences in prognosis, clinicopathologic characteristics, and molecular profiles.
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BibTeX
@article{yang2026prognostic,
title = {{Prognostic and clinicopathologic divergence in pulmonary mucinous adenocarcinoma versus nonmucinous adenocarcinoma with a mucin-laden feature.}},
author = {Fujun Yang and Ke Sun and Zhaoxun Li and Aijun You and Zhen Yang and Yimu Wu and Mengxing Li and Yu Liu and Dongliang Bian and Junhong Guo and Gening Jiang},
journal = {JTCVS open},
year = {2026},
month = jul,
doi = {10.1016/j.xjon.2026.101964},
url = {https://europepmc.org/article/MED/42948083},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prognostic and clinicopathologic divergence in pulmonary mucinous adenocarcinoma versus nonmucinous adenocarcinoma with a mucin-laden feature.
AU - Fujun Yang
AU - Ke Sun
AU - Zhaoxun Li
AU - Aijun You
AU - Zhen Yang
AU - Yimu Wu
AU - Mengxing Li
AU - Yu Liu
AU - Dongliang Bian
AU - Junhong Guo
AU - Gening Jiang
PY - 2026
DA - 2026/07/14
JO - JTCVS open
DO - 10.1016/j.xjon.2026.101964
UR - https://europepmc.org/article/MED/42948083
AB - Background The discrepancies in clinicopathologic characteristics and prognosis between invasive mucinous adenocarcinoma (IMA) and nonmucinous lung adenocarcinoma with a mucin-laden feature (MNLA) remain unclear.Methods Data were collected retospectively for 978 consecutive patients with IMA/MNLA who underwent surgical resection between October 2017 and December 2019. Survival outcomes were estimated using the Kaplan-Meier method and compared using the log-rank test. The adjusted hazard ratio (aHR) with 95% confidence interval (CI) of the prognosticator was calculated using a multivariable Cox proportional hazards model.Results Pure IMA was associated with a higher prevalence of KRAS mutation (51.5%), while MNLA was associated with higher prevalences of EGFR mutation (40.4%) and EML4-ALK rearrangement (19.1%). Regarding prognosis, compared to patients with pure IMA, patients with MNLA or mixed IMA had worse disease-free survival (MNLA: aHR, 2.620, 95% CI, 1.690-4.061; mixed IMA: aHR, 3.458, 95% CI, 1.704-7.016) and overall survival (MNLA: aHR, 2.229, 95% CI, 1.185-4.193; mixed IMA: aHR, 1.723, 95% CI, 0.632-4.698). Among patients who experienced recurrence, those with pure IMA had a higher incidence of intrathoracic-only recurrence compared to those with MNLA (80.8% vs 39.6%), demonstrating that extrathoracic-only recurrence was more prevalent in MNLA (35.1% vs 7.3%). The recurrence pattern of mixed IMA was different from that of pure IMA (pure IMA vs mixed IMA: intrathoracic-only, 80.8% vs 50.0%; both intrathoracic and extrathoracic, 11.5% vs 40.0%).Conclusions Although MNLA, pure IMA, and mixed IMA have consistent mucin-laden features, they appear to exhibit differences in prognosis, clinicopathologic characteristics, and molecular profiles.
SN - 2666-2736
ER -