1. Micropapillary pattern (MPP) in pT1 lung adenocarcinomas is associated with frequent nodal metastasis and worse survival.
2. Small cluster invasion (SCI), defined as single or small clusters of carcinoma cells invading stroma within fibrotic foci, is significantly more frequent in MPP-positive cases and is significantly associated with lymphatic involvement and nodal metastasis.
3. Carcinoma cells undergoing SCI demonstrate the same characteristic MUC-1 expression on the outer surface of cell clusters as those undergoing MPP, suggesting that SCI could link MPP to nodal metastasis in pT1 lung adenocarcinomas.
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