国际肺癌研究协会（IASLC）提出了一种新的侵袭性肺腺癌（LUAD）组织学分级系统。然而，该分级系统在预测 LUAD 患者远处转移方面的功效仍有待探索。本研究旨在评估 IASLC 分级系统在预测可切除 LUAD 患者脑部和骨转移发生方面的潜力，从而识别术后远处转移高风险个体。我们回顾性分析了 174 例患者的临床数据和病理报告。 2008 年至 2015 年间在我们癌症中心接受手术切除的早期 LUAD 患者。对患者进行为期 5 年的监测，并确定他们的无骨转移和脑转移生存率。174 名患者中有 28 名在 5 年内发生远处转移，无转移患者的中位总生存期为 60 个月，无转移患者的中位总生存期为 38.3 个月。远处转移。所有样本的肿瘤分级均通过 IASLC 分级和基于主要模式的分级系统进行评估。受试者工作特征（ROC）曲线用于评估IASLC分级系统和肿瘤分期对远处转移的预测能力。与主要的基于模式的分级系统相比，IASLC分级系统与远处转移和淋巴管侵犯的发生率具有更好的相关性。 ROC 分析显示，IASLC 分级系统在预测远处转移方面优于肿瘤分期。我们的研究表明，IASLC 分级系统能够预测早期侵袭性 LUAD 患者远处转移的发生率。© 作者（或其作者）雇主）2024。禁止商业重复使用。请参阅权利和权限。英国医学杂志出版。

The International Association for the Study of Lung Cancer (IASLC) has proposed a new histological grading system for invasive lung adenocarcinoma (LUAD). However, the efficacy of this grading system in predicting distant metastases in patients with LUAD remains unexplored. This study aims to assess the potential of the IASLC grading system in predicting the occurrence of brain and bone metastases in patients with resectable LUAD, thereby identifying individuals at high risk of post-surgery distant metastasis.We retrospectively analysed clinical data and pathological reports of 174 patients with early-stage LUAD who underwent surgical resection between 2008 and 2015 at our cancer center. Patients were monitored for 5 years, and their bone and brain metastasis-free survival rates were determined.28 out of 174 patients developed distant metastases in 5 years with a median overall survival of 60 months for metastasis-free patients and 38.3 months for patients with distant metastasis. Tumour grading of all samples was evaluated by both IASLC grading and predominant pattern-based grading systems. Receiver operating characteristic (ROC) curves were used to evaluate the predictive capabilities of the IASLC grading system and tumour stage for distant metastasis. Compared with the predominant pattern-based grading system, the IASLC grading system showed a better correlation with the incidence of distant metastasis and lymphovascular invasion. ROC analyses revealed that the IASLC grading system outperformed tumour stage in predicting distant metastasis.Our study indicates that the IASLC grading system is capable of predicting the incidence of distant metastasis among patients with early-stage invasive LUAD.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.