Related factors of lymph node metastasis in lung adenocarcinoma patients with T1 stage_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YIN Chuntong ¹ , ZHANG Chunyan ¹ , LI Huawei ² , ZHANG Han ¹ , GUO Congying ¹ ,  ZHANG Linyou ¹

1. Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, P.R.China;
2. Department of Thoracic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, Henan, P.R.China;

Corresponding author：

ZHANG Linyou, Email: lyzhang6666@gmail.com

Keywords：

Ground glass nodules; lung adenocarcinoma; lymph node metastasis; consolidation tumor ratio

DOI：

10.7507/1007-4848.201710016

Video：

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Objective To investigate the relationship between clinical features and lymph node metastasis in lung adenocarcinoma patients with T1 stage. Methods We retrospectively analyzed the clinical data of 253 T1-stage lung adenocarcinoma patients (92 males and 161 females at an average age of 59.45±9.36 years), who received lobectomy and systemic lymph node dissection in the Second Affiliated Hospital of Harbin Medical University from October 2013 to February 2016. Results Lymph node metastasis was negative in 182 patients (71.9%) and positive in 71 (28.1%). Poor differentiation (OR=6.988, P=0.001), moderate differentiation (OR=3.589, P=0.008), micropapillary type (OR=24.000, P<0.001), solid type (OR=5.080, P=0.048), pleural invasion (OR=2.347, P=0.024), age≤53.5 years (OR=2.594, P=0.020) were independent risk factors for lymph node metastasis. In addition, in the tumor with diameter≥1.55 cm (OR=0.615, P=0.183), although the cut-off value of 1.55 cm had no significant difference, it still suggested that tumor diameter was an important risk factor of lymph node metastasis. Conclusion In lung adenocarcinoma with T1 stage, the large tumor diameter, the low degree of differentiation, the high ratio of consolidation, and the micropapillary or solid pathological subtypes are more prone to have lymph node metastasis.

Citation： YIN Chuntong, ZHANG Chunyan, LI Huawei, ZHANG Han, GUO Congying, ZHANG Linyou. Related factors of lymph node metastasis in lung adenocarcinoma patients with T1 stage. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(9): 755-761. doi: 10.7507/1007-4848.201710016 Copy

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11.	Liang W, He J, Shen Y, et al. Impact of examined lymph node count on precise staging and long-term survival of resected non-small-cell lung cancer: A population study of the US SEER Database and a Chinese multi-institutional registry. J Clin Oncol, 2017, 35(11): 1162-1170.
12.	Jiang L, Yin WQ, Peng GL, et al. Prognosis and status of lymph node involvement in patients with adenocarcinoma in situ and minimally invasive adenocarcinoma-a systematic literature review and pooled-data analysis. J Thorac Dis, 2015, 7(11): 2003-2009.
13.	朱斌, 柳仓生. 非小细胞肺癌的淋巴结转移相关因素及规律的探讨. 中国肿瘤临床, 2012, 29(15): 1115-1118.
14.	崔岳, 杨晓军, 谢天鹏, 等. 非小细胞肺癌肺内淋巴结转移规律的临床研究. 中国胸心血管外科临床杂志, 2016, 21(10): 982-987.
15.	谢远财, 李运, 刘彦国, 等. 直径≤3 cm 的周围型非小细胞肺癌纵隔淋巴结转移规律的初步研究. 中国微创外科杂志, 2010, 10(7): 577-580.
16.	Li H, Hu H, Wang R, et al. Lung adenocarcinoma: Are skip N2 metastases different from non-skip? J Thorac Cardiovasc Surg, 2015, 150(4): 790-795.

1. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology, 2008, 246(3): 697-722.
2. Patel VK, Naik SK, Naidich DP, et al. A practical algorithmic approach to the diagnosis and management of solitary pulmonary nodules: part 1: radiologic characteristics and imaging modalities. Chest, 2013, 143(3): 825-839.
3. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol, 2016, 11(1): 39-51.
4. El Masri J, Ren S, Zhang J. Getting familiar with the forthcoming eighth edition of TNM classification of lung cancer: from the T to N and M descriptors. Ann Transl Med, 2016, 4(4): 67.
5. Cohen JG, Goo JM, Yoo RE, et al. Software performance in segmenting ground-glass and solid components of subsolid nodules in pulmonary adenocarcinomas. Eur Radiol, 2016, 26(12): 4465-4474.
6. Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285.
7. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol, 2015, 10(9): 1243-1260.
8. Chen K, Chen H, Yang F, et al. Validation of the Eighth Edition of the TNM Staging System for Lung Cancer in 2043 surgically treated patients with non-small-cell lung cancer. Clin Lung Cancer, 2017, 18(6): e457-e466.
9. Osarogiagbon RU, Smeltzer MP, Faris N, et al. Comment on the proposals for the revision of the N descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(10): 1612-1614.
10. Tsutani Y, Miyata Y, Nakayama H, et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg, 2013, 146(2): 358-364.
11. Liang W, He J, Shen Y, et al. Impact of examined lymph node count on precise staging and long-term survival of resected non-small-cell lung cancer: A population study of the US SEER Database and a Chinese multi-institutional registry. J Clin Oncol, 2017, 35(11): 1162-1170.
12. Jiang L, Yin WQ, Peng GL, et al. Prognosis and status of lymph node involvement in patients with adenocarcinoma in situ and minimally invasive adenocarcinoma-a systematic literature review and pooled-data analysis. J Thorac Dis, 2015, 7(11): 2003-2009.
13. 朱斌, 柳仓生. 非小细胞肺癌的淋巴结转移相关因素及规律的探讨. 中国肿瘤临床, 2012, 29(15): 1115-1118.
14. 崔岳, 杨晓军, 谢天鹏, 等. 非小细胞肺癌肺内淋巴结转移规律的临床研究. 中国胸心血管外科临床杂志, 2016, 21(10): 982-987.
15. 谢远财, 李运, 刘彦国, 等. 直径≤3 cm 的周围型非小细胞肺癌纵隔淋巴结转移规律的初步研究. 中国微创外科杂志, 2010, 10(7): 577-580.
16. Li H, Hu H, Wang R, et al. Lung adenocarcinoma: Are skip N2 metastases different from non-skip? J Thorac Cardiovasc Surg, 2015, 150(4): 790-795.

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