{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T23:02:34Z","timestamp":1782255754003,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T00:00:00Z","timestamp":1549584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To determine whether cancer\u2010associated fibroblasts (CAFs) are associated with microvessel density (MVD) and lymphatic vessel density (LVD) in lung adenocarcinoma (ADC) or are not prognostic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety\u2010three lung adenocarcinoma patients without adjuvant therapy between January 2010 and June 2011 were enrolled. CAFs, MVD, and LVD were identified by \u03b1\u2010smooth muscle actin (\u03b1\u2010SMA), CD34 and D2\u201040 staining via immunohistochemistry. Staining intensities were assessed and quantified. For statistics, Pearson's chi\u2010square test, logistic regression, Kaplan\u2010Meier, and log\u2010rank tests were applied. In addition, the Cox proportional hazards model was used for multifactor analysis to predict survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CAFs abundance in lung adenocarcinoma is associated with higher MVD and LVD. In addition, a correlation was demonstrated between MVD and LVD (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). CAFs, MVD, and LVD are significantly correlating with age, tumor size, differentiation grade, clinical stage, and lymph node metastasis (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), but not influenced by gender, tumor location, and smoking history. Three\u2010year overall survival in the CAFs\u2010poor group is 64.5%, which is significant higher than that in the CAFs\u2010rich cohort (41.9%). Further, we found that age, clinical stage, \u03b1\u2010SMA, CD34, D2\u201040 positivity, tumor size, differentiation grade, and lymph node metastasis significantly correlate with overall survival of patients with lung adenocarcinoma. However, sex, smoking history, and tumor location have no association with 3\u2010year survival. The clinical stage is an independent prognostic factor in overall survival (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The density of CAFs identified by \u03b1\u2010SMA staining is associated with progression and metastasis of lung adenocarcinoma and affects the patient's disease outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22832","type":"journal-article","created":{"date-parts":[[2019,2,9]],"date-time":"2019-02-09T07:47:08Z","timestamp":1549698428000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical significance of cancer\u2010associated fibroblasts and their correlation with microvessel and lymphatic vessel density in lung adenocarcinoma"],"prefix":"10.1002","volume":"33","author":[{"given":"Ling","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Oncology Qingdao Municipal Hospital  Qingdao 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