Radiologic Features of Resected Lung Adenocarcinoma With Epithelial–Mesenchymal Transition

Taichi Matsubara, Tetsuzo Tagawa, Gouji Toyokawa, Takeshi Kamitani, Kazuki Takada, Taro Oba, Atsushi Osoegawa, Masaki Mori

Research output: Contribution to journalArticlepeer-review


Background: Epithelial–mesenchymal transition plays a crucial role in cancer progression and is a significant prognosticator for postoperative survival in patients with lung cancer. Predicting epithelial–mesenchymal transition preoperatively using computed tomography may help to determine the optimal surgical strategy. Methods: We performed an immunohistochemical analysis of E-cadherin and vimentin expressions using tumor specimens from resected primary lung adenocarcinoma and classified the results into 3 subgroups according to the expressions: epithelial, intermediate, and mesenchymal. The intermediate and mesenchymal groups were classified as the epithelial–mesenchymal transition conversion group. We analyzed the association between epithelial–mesenchymal transition and radiologic characteristics, especially computed tomographic features. Results: The epithelial–mesenchymal transition conversion group comprised 162 patients (49.1%). Computed tomography revealed that tumors with epithelial–mesenchymal transition conversion showed a high consolidation/tumor ratio compared with those without conversion. Univariate analysis demonstrated that tumors with epithelial–mesenchymal transition were significantly associated with bronchial and/or vascular convergence (P < .001) and notching (P = .028). When the cutoff value for the consolidation/tumor ratio was set by the receiver operating characteristic curve, independent predictive factors for epithelial–mesenchymal transition by multivariate analysis were high ratio (>0.7946; P < .001) and the presence of convergence (P = .05). Tumors with a high consolidation/tumor ratio and convergence had a 4-fold higher odds ratio for epithelial–mesenchymal transition, and patients had significantly poorer survival. Conclusions: Convergence and a high consolidation/tumor ratio were independently associated with epithelial–mesenchymal transition conversion. These preoperative radiologic results will help to predict epithelial–mesenchymal transition conversion in lung adenocarcinoma.

Original languageEnglish
Pages (from-to)1647-1655
Number of pages9
JournalAnnals of Thoracic Surgery
Issue number5
Publication statusPublished - Nov 2021

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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