Clinical and pathological features of lung cancer with metastasis_West China Medical Journal

Authors：

JIN Jing , LI Lei ,  LI Weimin

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Weimin, Email: weimi003@yahoo.com

Keywords：

Lung cancer; Metastasis; Site of metastasis; Clinical and pathological characteristics

DOI：

10.7507/1002-0179.201710034

Video：

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Objective To analyze the clinical and pathological features of lung cancer with metastasis, explore the regularity and characteristics of the location of metastasis, and provide reference for future clinical treatment. Methods A total of 658 patients with lung cancer treated in West China Hospital of Sichuan University from January 2008 to December 2014 were enrolled in this study. The effect of different clinical and pathological characteristics on different locations of metastasis was analyzed by χ² test and logistic regression. Results Adenocarcinoma was the main pathological type (342 cases, 52.0%), and bone (150 cases, 22.8%) and pleura (118 cases, 18.0%) were the most common distant metastasis. Compared with patients with no corresponding metastasis, patients with age <60 years took bigger proportions in patients with bone, brain and mediastina metastasis ( P<0.05). Furthermore, logistic regression analysis showed that the younger patients were more likely to have brain metastasis (P=0.024). Besides, the elder patients were more common in those with liver metastasis (P<0.001). The proportion of males was higher in the patients with lymph node metastasis than those without lymph node metastasis (P=0.010); however, the proportion of females was higher in patients with bone or pleural metastasis than those without bone or pleural metastasis (P<0.05). There was no significant difference in gender among patients with brain, lung, liver, adrenal and mediastinal metastases (P>0.05). Conclusions Bone and pleura are the most common sites of metastasis of lung cancer. The age structure of brain metastasis tends to be younger.

Citation： JIN Jing, LI Lei, LI Weimin. Clinical and pathological features of lung cancer with metastasis. West China Medical Journal, 2018, 33(1): 41-46. doi: 10.7507/1002-0179.201710034 Copy

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27.	Yeh YC, Kadota K, Nitadori JI, et al. International association for the study of lung cancer/American thoracic society/European respiratory society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma. Eur J Cardiothorac Surg, 2016, 49(1): e9-e15.
28.	Kudo Y, Saji H, Shimada Y, et al. Do tumours located in the left lower lobe have worse outcomes in lymph node-positive non-small cell lung cancer than tumours in other lobes?. Eur J Cardiothorac Surg, 2012, 42(3): 414-419.
29.	赵春柳. 肺癌骨骼肌转移 1 例报道及文献复习. 临床肺科杂志, 2014(6): 1155-1157.
30.	王强, 王启文, 曲明江. 原发性肺癌伴皮下转移 6 例. 实用肿瘤学杂志, 2003, 17(2): 134.
31.	于涛, 李建业, 蒋俭, 等. 肺癌眼脉络膜转移的临床分析. 实用肿瘤杂志, 2012, 27(2): 145-148.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
3. Chen W, Zheng R, Zuo T, et al. National cancer incidence and mortality in China, 2012. Chin J Cancer Res, 2016, 28(1): 1-11.
4. Edge SB, Compton CC. The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6): 1471-1474.
5. Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol, 2013, 31(8): 992-1001.
6. He YT, Li DJ, Song GH, et al. Lung cancer burden has increased during the last 40 years in Hebei Province, China. Thoracic Cancer, 2016, 7(3): 323-332.
7. Wood SL, Pernemalm M, Crosbie PA, et al. The role of the tumor-microenvironment in lung cancer-metastasis and its relationship to potential therapeutic targets. Cancer Treat Rev, 2014, 40(4): 558-566.
8. Jiang W, Pang X, Xi J, et al. Clinical outcome of subcentimeter non-small cell lung cancer after surgical resection: single institution experience of 105 patients. J Surg Oncol, 2014, 110(3): 233-238.
9. Rossi A, Chiodini P, Sun JM, et al. Six versus fewer planned cycles of first-line platinum-based chemotherapy for non-small-cell lung cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol, 2014, 15(11): 1254-1262.
10. Katoh M, Din NU, Ukoumunne OC, et al. Age and gender variations in cancer diagnostic intervals in 15 cancers: analysis of data from the UK clinical practice research datalink. PLoS One, 2015, 10(5): e0127717.
11. Maeda R, Yoshida J, Hishida T, et al. Late recurrence of non-small cell lung cancer more than 5 years after complete resection incidence and clinical implications in patient follow-up. Chest, 2010, 138(1): 145-150.
12. Serke M, Stanzel F, Westhoff M. Gender-specific difference in lung cancer. Pneumologie, 2013, 67(5): 270-279.
13. Kuchuk M, Kuchuk I, Hutton B, et al. The incidence and clinical impact of bone metastases in non-small cell lung cancer Lung Cancer, 2013, 31(15, S): 197-202.
14. Neri S, Yoshida J, Ishii G, et al. Prognostic impact of microscopic vessel invasion and visceral pleural invasion in non-small cell lung cancer a retrospective analysis of 2657 patients. Ann Surg, 2014, 260(2): 383-388.
15. 王居正, 孙盈, 邢昊, 等. 非小细胞肺癌患者胸膜转移瘤中 NOK 的表达及其与生存期的相关性. 现代生物医学进展, 2016, 16(14): 2663-2666.
16. Guo H, Xing Y, Liu R, et al. -216G/T (rs712829), a functional variant of the EGFR promoter, is associated with the pleural metastasis of lung adenocarcinoma. Oncol Lett, 2013, 6(3): 693-698.
17. Kim S, Kim TM, Kim DW, et al. Heterogeneity of genetic changes associated with acquired crizotinib resistance in ALK-Rearranged lung cancer. J Thorac Oncol, 2013, 8(4): 415-422.
18. Hsiao SH, Chung CL, Chou YT, et al. Identification of subgroup patients with stage ⅢB/Ⅲ non-small cell lung cancer at higher risk for brain metastases. Lung Cancer, 2013, 82(2): 319-323.
19. Glass R, Hukku SR, Gershenhorn B, et al. Metastasis of lung adenosquamous carcinoma to meningioma: case report with literature review. Int J Clin Exp Pathol, 2013, 6(11): 2625-2630.
20. Langley RR, Fidler IJ. The seed and soil hypothesis revisited--the role of tumor-stroma interactions in metastasis to different organs. Int J Cancer, 2011, 128(11): 2527-2535.
21. Obenauf AC, Massague J. Surviving at a distance: organ specific metastasis. Trends Cancer, 2015, 1(1): 76-91.
22. Deeken JF, Loscher W. The blood-brain barrier and cancer: transporters, treatment, and Trojan horses. Clin Cancer Res, 2007, 13(6): 1663-1674.
23. Goncalves PH, Peterson SL, Vigneau FD, et al. Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data. Cancer, 2016, 122(12): 1921-1927.
24. Fenske DC, Price GL, Hess LM, et al. Systematic review of brain metastases in patients with non-small-cell lung cancer in the United States, European union, and Japan. Clin Lung Cancer, 2017, 18(6): 607-614.
25. Nadpara PA, Madhavan SS, Tworek CA, et al. Guideline-concordant lung cancer care and associated health outcomes among elderly patients in the United States. J Geriatr Oncol, 2015, 6(2): 101-110.
26. Peters S, Bexelius C, Munk V, et al. The impact of brain metastasis on quality of life, resource utilization and survival in patients with non-small-cell lung cancer. Cancer Treat Rev, 2016, 45: 139-162.
27. Yeh YC, Kadota K, Nitadori JI, et al. International association for the study of lung cancer/American thoracic society/European respiratory society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma. Eur J Cardiothorac Surg, 2016, 49(1): e9-e15.
28. Kudo Y, Saji H, Shimada Y, et al. Do tumours located in the left lower lobe have worse outcomes in lymph node-positive non-small cell lung cancer than tumours in other lobes?. Eur J Cardiothorac Surg, 2012, 42(3): 414-419.
29. 赵春柳. 肺癌骨骼肌转移 1 例报道及文献复习. 临床肺科杂志, 2014(6): 1155-1157.
30. 王强, 王启文, 曲明江. 原发性肺癌伴皮下转移 6 例. 实用肿瘤学杂志, 2003, 17(2): 134.
31. 于涛, 李建业, 蒋俭, 等. 肺癌眼脉络膜转移的临床分析. 实用肿瘤杂志, 2012, 27(2): 145-148.

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Clinical and pathological features of lung cancer with metastasis

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