对于完全切除 (R0) IB 期非小细胞肺癌 (NCLSC) 患者，辅助治疗的益处仍存在争议。在本研究中，我们旨在探讨 IB 期 NSCLC 患者的潜在预后因素。本研究包括 215 名 R0 IB 期肺腺癌 (LUAD) 患者（肿瘤大小：3-4 cm）。使用一组 9 个驱动基因对 126 名患者的手术样本进行 DNA 测序。通过14基因定量聚合酶链反应测定评估分子风险分层。在215名患者中，67.9%的肿瘤以微乳头/实体（MIP/SOL）为主。 126 名患者中有 75 名 (59.5%) 检测到表皮生长因子受体 (EGFR) 突变。与其他组织学模式相比，MIP/SOL 肿瘤的 EGFR 突变较少见（50.6% vs. 79.5%，P=0.003）。 99 例患者成功进行分子风险分层，其中高危、中危和低危分别占 37.4%、26.3% 和 36.4%。 MIP/SOL 模式与较短的无病生存期 (DFS) 相关[风险比 (HR) =2.16，95% 置信区间：1.28-3.67； P=0.01]。分子高危患者的DFS短于低危患者（HR=2.93，P=0.01）和中危患者（HR=2.35，P=0.06）。分子风险分层的预后价值在 MIP/SOL 子集中也很显着（中位 DFS 高风险：45 个月，低风险和中风险：未达到；P=0.03）。我们的研究表明，MIP/SOL 模式和分子高危类别是 IB 期 NSCLC 患者的不良预后因素。我们的结果表明，结合组织学分类和分子风险分层可能有助于识别预后不良的患者子集。2024 AME 出版公司。版权所有。

The benefit of adjuvant therapy remains controversial in completely resected (R0) stage IB non-small cell lung cancer (NCLSC) patients. In this study, we aimed to explore potential prognostic factors in stage IB NSCLC patients.This study included 215 patients with R0 stage IB lung adenocarcinoma (LUAD) (tumor size: 3-4 cm). DNA sequencing was performed with surgical samples of 126 patients using a panel of 9 driver genes. The molecular risk stratification was assessed by a 14-gene quantitative polymerase chain reaction assay.Among the 215 patients, 67.9% had micropapillary/solid (MIP/SOL)-predominant tumors. Epidermal growth factor receptor (EGFR) mutations were detected in 75 of 126 patients (59.5%). MIP/SOL tumors harbored less common EGFR mutations than the other histologic patterns (50.6% vs. 79.5%, P=0.003). Molecular risk stratification was successfully assessed in 99 patients, of whom 37.4%, 26.3%, and 36.4% were high, intermediate, and low risk, respectively. The MIP/SOL pattern was associated with shorter disease-free survival (DFS) [hazard ratio (HR) =2.16, 95% confidence interval: 1.28-3.67; P=0.01]. The molecular high-risk patients had shorter DFS than the low- (HR =2.93, P=0.01) and intermediate-risk patients (HR =2.35, P=0.06). The prognostic value of molecular risk stratification was also significant in the MIP/SOL subset (median DFS high-risk: 45 months, low and intermediate risk: not reached; P=0.03).Our study showed that both the MIP/SOL pattern and molecular high-risk category were adverse prognostic factors in stage IB NSCLC patients. Our results suggest that combining histologic classification and molecular risk stratification may help to identify the subset of patients with poor prognosis.2024 AME Publishing Company. All rights reserved.