肿瘤分泌是一个重要的预后指标，与各种来源的早期肿瘤的侵袭性行为有关。本研究的目的是评估肿瘤分泌在病理分期I期肺腺癌中的临床病理学意义。本研究纳入了2010年12月至2016年1月期间在我们医院接受根治性切除手术的107例病理分期I期肺腺癌患者。我们通过检查切除标本上常规苏木精与伊红染色（H&E）切片中的肿瘤分泌来进行评估。根据肿瘤分泌的程度，将肿瘤分为低级（分级为0-1）和高级（分级为2-3）两组。我们评估了肿瘤分泌与总生存期（OS）、无疾病存活期（DFS）和临床病理学参数之间的关系。高级分泌肿瘤组与低级分泌肿瘤组的5年DFS率之间存在显著差异（p=0.002），分别为70%和90%。高级分泌肿瘤阳性患者与低级分泌肿瘤阳性患者相比，在相同病理分期（p<0.001；HR=2.93 [1.51-5.68]）和临床分期（p=0.002）中的累积生存率较低。高级分泌肿瘤与空气间质扩散（STAS）（p<0.001）、淋巴管侵犯（LVI）（p<0.001）、肿瘤坏死（p<0.001）、高SUVmax值（SUVmax>3.0）（p<0.001）和肿瘤大小>20mm（p=0.024）呈正相关。高级分泌肿瘤是OS（p<0.006）和DFS（p<0.001）的显著预后因素，经单因素Cox回归危险模型分析证实。然而，在多变量分析中并未显示出显著性（p>0.05）。高级分泌肿瘤是一种独立的预后指标，与不良临床病理特征和较差的生存率相关。我们提议将高级分泌肿瘤作为一种新的预后指标，并有助于预测病理分期I期肺腺癌的临床进展。Copyright © 2023 Elsevier Inc. All rights reserved.

Tumor budding is a significant prognostic parameter that has been related to aggressive behavior in early-stage tumors of various origins. The aim of this study was to evaluate the clinicopathological significance of tumor budding in pathologic stage (pStage) I lung adenocarcinomas.This study comprised 107 patients who underwent curative resection for pStage I lung adenocarcinomas at our hospital between December 2010 and January 2016. We examined tumor budding on routine hematoxylin and eosin (H&E) slides from resected specimens. Tumors were categorized into two groups based on the degree of tumor budding: low grade (grade 0-1) and high grade (grade 2-3). We evaluated the relationship between tumor budding and overall survival (OS), disease-free survival (DFS) and clinicopathological parameters.There is a significant difference (p = 0.002) between the 5-year DFS rates of the high-grade and the low-grade tumor budding group, which were 70 % and 90 %, respectively. High-grade tumor budding positive patients from the same pathological stage (p < 0.001; HR = 2.93 [1.51-5.68]) and clinical stage (p = 0.002) had poorer cumulative survival rates than low grade tumor budding positive patients. High grade tumor budding was positively associated with spread through air spaces (STAS) (p < 0 0.001), lymphovascular invasion (LVI) (p < 0.001), tumor necrosis (p < 0.001), high SUVmax value (SUVmax>3.0) (p < 0.001), and tumor size >20 mm (p = 0.024). High-grade tumor budding was significant prognostic factor of OS (p < 0.006) and DFS (p < 0.001) on univariate Cox regression hazard model analysis. However, it did not show significance in the multivariate analysis (p > 0.05).High-grade tumor budding is an independent prognostic factor and associated with adverse clinicopathological features and poor survival rates. We proposed that high-grade tumor budding should be recognized as a new prognostic parameter and will be beneficial in predicting the clinical course in pStage I lung adenocarcinomas.Copyright © 2023 Elsevier Inc. All rights reserved.