{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:40:38Z","timestamp":1790311238056,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Tumor spread through air spaces (STAS), a significant prognostic indicator, has been described recently as a pattern of invasion in pulmonary carcinomas. However, questions remain regarding preoperative identification of STAS and whether it represents an in vivo phenomenon versus an ex vivo artifact.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed 67 paired preoperative bronchoalveolar lavage (BAL) or bronchial washing (BW) cytology specimens with the subsequent lung adenocarcinoma surgical resection specimen to determine whether preoperative cytology could predict STAS. Other clinical, radiologic, and pathologic features of the resected lesions were also correlated with preoperative bronchial cytology results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Positive bronchial cytology was observed in 28 cases (41.8%), 24 of which had STAS (85.7%); however, negative BAL\/BW cytology was observed in 39 cases (58.2%), 29 of which had STAS (74.4%) (x<jats:sup>2<\/jats:sup>\u00a0=\u00a01.27, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.26, not significant). High\u2010STAS burden was observed in 44 cases (83.0%), 21 (47.7%) with negative BAL\/BW and 23 (52.3%) with positive BAL\/BW. Low\u2010STAS burden was observed in 9 cases (17.0%), 8 (88.9%) with negative BAL\/BW and only 1 (11.1%) with positive BAL\/BW (x<jats:sup>2<\/jats:sup>\u00a0=\u00a05.11, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.024, significant). For tumors with STAS, a statistically significant difference was identified in the maximal STAS distance from the main tumor edge between BAL\/BW\u2010positive and BAL\/BW\u2010negative groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.007). Of the remaining clinicopathologic and radiologic features, only visceral pleural invasion was significantly associated with BAL\/BW positivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Presurgical bronchial cytology alone cannot adequately predict tumor STAS; however, it may provide useful information regarding the extent and overall burden of STAS on the subsequent resection specimen.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22243","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T16:33:35Z","timestamp":1580747615000},"page":"278-286","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Preoperative bronchial cytology for the assessment of tumor spread through air spaces in lung adenocarcinoma resection specimens"],"prefix":"10.1002","volume":"128","author":[{"given":"Mayra A.","family":"Medina","sequence":"first","affiliation":[{"name":"Department of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"Onken","sequence":"additional","affiliation":[{"name":"Department of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"de Margerie\u2010Mellon","sequence":"additional","affiliation":[{"name":"Department of Radiology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt H.","family":"Heidinger","sequence":"additional","affiliation":[{"name":"Department of Radiology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yigu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander A.","family":"Bankier","sequence":"additional","affiliation":[{"name":"Department of Radiology Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7234-5652","authenticated-orcid":false,"given":"Paul A.","family":"VanderLaan","sequence":"additional","affiliation":[{"name":"Department of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston 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Three\u2010dimensional immunofluorescence analysis of dynamic vessel co\u2010option of spread through air spaces (STAS) in lung cancer","author":"Yagi Y","year":"2018","journal-title":"J Thorac Oncol"}],"container-title":["Cancer 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