Atrapamiento alveolar y diseminación interalveolar en carcinoma pulmonar no microcítico : correlación con la expresión de antígeno de grupo A, proteínas de choque térmico, estadificación y supervivencia

Abstract

[ABSTRACT] Lung carcinoma is the second most common cancer worldwide, following prostatic carcinoma in incidence but it remains the highest in mortality. The five year survival varies depending on the geographical areas but it ranges between 6 and 14% for males and between 7 and 18% for females, in such way that the total deaths due to pulmonary carcinoma are higher than those caused by colonic, mammary and prostatic carcinomas together, in spite of the advances in diagnosis and therapeutics. Even among patients with localized disease who are treated with surgical resection, 73% and 58% of them, respectively in stage IA and IB, live longer than 5 years. Further studies in order to discriminate which cases purported either a favorable or dismal clinical course are pivotal to know the patients who will need additional treatment and to look for new and more specific therapies. Nowadays, in the molecular age, a so classic and conventional procedure as staging constitutes the most important isolated factor to determine the survival, predict the prognosis, select the therapies and stratify the patients. Histological features of the nonsmall cell lung carcinoma (NSCLC) as prognostic factors have been variously studied with diverse and not uniform results. So the histologic type of the tumor, grade of differentiation, growth pattern at the periphery of the tumor, necrosis, presence of scar and desmoplasia inside the neoplasm, vascular invasion either lymphatic, venous or even arterial; mitotic count have been studied with diverse and sometimes contradictory results depending on the different series. Among the most constant microscopic features with prognostic implications are: vascular invasion, desmoplasia and some histologic patterns or variations as micropapillar areas in adenocarcinoma (AC), carcinomas with rhabdoid differentiation as unfavorable factors or bronchioloalveolar carcinoma (BC) or extensive areas with this bronchioloalveolar pattern as favorable ones...