{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:11:24Z","timestamp":1772799084448,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Medical Technology Program of Suzhou National Hi-Tech District","award":["2019Q015"],"award-info":[{"award-number":["2019Q015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>This study aimed to investigate the potential of complex glandular patterns (CGP) in lymph node micrometastasis (LNMM) and to determine the clinical beneficiaries in stage I lung adenocarcinoma (LUAD) with CGP. Meanwhile, the feasibility of detecting CGP on frozen section was also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We retrospectively analysed the clinicopathological characteristics of 848 pathologic-stage I LUADs. A logistic regression model and a Cox proportional-hazards model were conducted to define the risk factors for LNMM and survival respectively. Furthermore, 5 pathologists reviewed frozen sections of 100 LUADs independently.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The logistic regression model indicated that CGP [odds ratio 3.89, 95% confidence interval (CI) 2.46\u20136.15; P\u2009&amp;lt;\u20090.001] was an independent predictor of the presence of LNMM. Subgroup analysis revealed that CGP-present\/LNMM-positive LUAD had the highest risk of both loco-regional and distant recurrence. Moreover, adequate lymphadenectomy [recurrence-free survival: hazard ratio (HR) 0.61, 95% CI 0.40\u20130.95; P\u2009=\u20090.028; overall survival: HR 0.64, 95% CI 0.41\u20130.99; P\u2009=\u20090.043] and adjuvant chemotherapy (recurrence-free survival: HR 0.30, 95% CI 0.18\u20130.52; P\u2009&amp;lt;\u20090.001; overall survival: HR 0.33, 95% CI 0.19\u20130.57; P\u2009&amp;lt;\u20090.001) brought survival benefits to CGP-present patients, especially to CGP-present\/LNMM-positive subgroup. Across the 5 pathologists, sensitivity ranged from 59 to 68% and specificity ranged from 79 to 83%, with moderate diagnostic agreement and high interobserver agreement for detecting CGP on frozen section.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>LNMM was more frequently observed in stage I LUAD with CGP. Adequate lymphadenectomy and adjuvant chemotherapy were associated with improved survival in CGP-present patients, especially in CGP-present\/LNMM-positive subgroup. Additionally, it is feasible to identify CGP on frozen section intraoperatively.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezad073","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T13:34:58Z","timestamp":1677245698000},"source":"Crossref","is-referenced-by-count":5,"title":["Clinical profiles and intraoperative identification of complex glands in stage I lung adenocarcinoma"],"prefix":"10.1093","volume":"63","author":[{"given":"Qifeng","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University , Suzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donglai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanshan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Affiliated Hospital of Soochow University , Suzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University , Suzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liangyan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Affiliated Hospital of Soochow University , Suzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanzhou","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University , Suzhou, 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