N1 characteristics and influencing factors in non-small cell lung cancer of T2 stage_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Shanshan ¹ ,  XU Ning ² , GAO Yan ² , KONG Qinglong ² , CHANG Xu ² , LI Jun ²

1. Graduated School of Dalian Medical University, Dalian, 116033, P.R.China;
2. Department of Thoracic Surgery of Dalian Central Hospital, Dalian Medical University, Dalian, 116033, P.R.China;

Corresponding author：

XU Ning, Email: pierrexu@163.com

Keywords：

Tumor in T2 stage; intrapulmonary lymph nodes; transfer rate; risk factor; non-small cell lung cancer

DOI：

10.7507/1007-4848.201705009

Video：

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Objective To investigate the characteristics and influencing factors of N1 in T2 stage of the 8th TNM stage of The International Association for the Study of Lung Cancer (IASLC) (3 cm <tumor size≤5 cm) non-small cell lung cancer (NSCLC), to provide the basis for dissecting intrapulmonary lymph node more accurately during the operation.Methods We collected the clinical information of patients who underwent the pulmonary malignant tumor surgery in Dalian Central Hospital between October 2011 and November 2016. Through the inclusion and exclusion criteria, a total of 68 patients were obtained, including 48 males and 20 females, aged 48–81 (63.1±7.6) years. According to the pathological results, we invesigated the characteristics and influencing factors of N1 in T2 stage non-small cell lung cancer.Results The results showed that the highest positive rate of lymph node was 14.8% in the 12th group, 14.3% in the 13th group, and 13.9% in the 6th group, respectively. In the single factor analysis, it showed that male, T2b stage, poorly differentiated degree were the risk factors for intrapulmonary lymph node metastasis in T2 stage (P<0.05). But the intrapulmonary lymph nodes metastasis was no significant correlation with above factors according to the multivariate analysis.Conclusion It is necessary to extract the intrapulmonary lymph node of T2 stage NSCLC at utmost, especially for the No.12 and No.13 high-risk areas. T2b stage with odd ratio (OR) at 3.038 and poorly differentiated degree (OR=1.945) may be the risk factors for the intrapulmonary lymph nodes metastasis of NSCLC in T2 stage. But they are not determining factors.

Citation： LI Shanshan, XU Ning, GAO Yan, KONG Qinglong, CHANG Xu, LI Jun. N1 characteristics and influencing factors in non-small cell lung cancer of T2 stage. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(4): 293-298. doi: 10.7507/1007-4848.201705009 Copy

1.	Watanabe S, Asamura H. Lymph node dissection for lung cancer: significance, strategy, and technique. J Thorac Oncol, 2009, 4(5): 652-657.
2.	Amer K. Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg, 2012, 24(1): 74-78.
3.	Darling GE, Allen MS, Decker PA, et al. Number of lymph nodes harvested from a mediastinal lymphadenectomy: Results of the randomized, prospective ACOSOG Z0030 Trial. J Chest, 2010, 139(5): 1124-1129.
4.	吴彬, 徐志飞, 赵学维, 等. 肺癌淋巴结转移规律的临床分析. 中国肺癌杂志, 2004, 7(4): 361-363.
5.	王鑫, 支修益. 国际肺癌研究协会(IASLC)第八版肺癌 TNM 分期解读. 中华胸部外科电子杂志, 2016, 3(2): 70-76.
6.	蒋鸣, 李厚怀, 徐新宇, 等. 肺癌患者淋巴结转移规律及其相关因素分析. 肿瘤学杂志, 2016, 22(8): 639-642.
7.	Osarogiagbon RU, Eke R, Sareen S, et al. The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens. Ann Diagn Pathol, 2014, 18(4): 220-226.
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9.	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, 23(10): 982-987.
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11.	Ilic N, Petricevic A, Arar D, et al. Skip mediastinal nodal metastases in the IIIa/N2 non-small cell lung cancer. J Thorac Oncol, 2007, 2(11): 1018-1021.
12.	Kim AW. Lymph node drainage patterns and micrometastasis in lung cancer. Semin Thorac Cardiovasc Surg, 2009, 21(4): 298-308.
13.	Muraoka M, Akamine S, Oka T, et al. Sentinel node sampling limits lymphadenectomy in stage I non-small cell lung cancer. Eur J Cardiothorac Surg, 2007, 32(2): 356-361.
14.	林钢, 王准, 孙晓江, 等. 可手术非小细胞肺癌淋巴结转移特点及其临床意义. 中国肿瘤临床, 2015, 42(18): 921-925.
15.	马军亮, 刘伦旭, 蒲强, 等. 肺鳞癌和肺腺癌胸内淋巴结转移相关因素分析. 中国肿瘤临床, 2009, 36(20): 1156-1159.
16.	潘铁成, 郑智, 李军, 等. 肺鳞癌、腺癌肿瘤大小与淋巴结转移关系的临床研究. 中国肺癌杂志, 2006, 9(3): 267-269.
17.	Cerfolio RJ, Bryant AS. Distribution and likelihood of lymph node metastasis based on the lobar location of nonsmall-cell lung cancer. Ann Thorac Surg, 2006, 81(6): 1969-1973.
18.	Ketchedjian A, Daly BD, Fernando HC, et al. Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J Thorac Cardiovasc Surg, 2006, 132(3): 544-548.
19.	Henschke CI, Yankelevitz DF, Miettinen OS, et al. Computed tomographic screening for lung cancer: the relationship of disease stage to tumor size. Arch Intern Med, 2006, 166(3): 321-325.
20.	Fuwa N, Mitsudomi T, Daimon T, et al. Factors involved in lymph node metastasis in clinical stage I non-small cell lung cancer--from studies of 604 surgical cases. Lung Cancer, 2007, 57(3): 311-316.
21.	黄国金, 郑世营, 杨如松, 等. 非小细胞肺癌纵隔淋巴结转移特点临床探讨. 临床肺科杂志, 2009, 14(12): 1631-1632.
22.	Vincent RG, Chu TM, Lane WW. The value of carcinoembryonic antigen in patients with carcinoma of the lung. Cancer, 1979, 44(2): 685-691.
23.	宋平平, 刘希斌, 张为迪, 等. 非小细胞肺癌淋巴结转移相关因素的研究. 临床肿瘤学杂志, 2008, 13(12): 1085-1088.
24.	Nomiya T, Nemoto K, Miyachi H, et al. Significance of plasminogen-activation system in the formation of macroscopic types and invasion in esophageal carcinoma. Anticancer Res, 2002, 22(5): 2913-2916.

1. Watanabe S, Asamura H. Lymph node dissection for lung cancer: significance, strategy, and technique. J Thorac Oncol, 2009, 4(5): 652-657.
2. Amer K. Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg, 2012, 24(1): 74-78.
3. Darling GE, Allen MS, Decker PA, et al. Number of lymph nodes harvested from a mediastinal lymphadenectomy: Results of the randomized, prospective ACOSOG Z0030 Trial. J Chest, 2010, 139(5): 1124-1129.
4. 吴彬, 徐志飞, 赵学维, 等. 肺癌淋巴结转移规律的临床分析. 中国肺癌杂志, 2004, 7(4): 361-363.
5. 王鑫, 支修益. 国际肺癌研究协会(IASLC)第八版肺癌 TNM 分期解读. 中华胸部外科电子杂志, 2016, 3(2): 70-76.
6. 蒋鸣, 李厚怀, 徐新宇, 等. 肺癌患者淋巴结转移规律及其相关因素分析. 肿瘤学杂志, 2016, 22(8): 639-642.
7. Osarogiagbon RU, Eke R, Sareen S, et al. The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens. Ann Diagn Pathol, 2014, 18(4): 220-226.
8. Wu N, Lv C, Yan S, et al. Systemic mediastinal lymph node dissection of right lung cancer: surgical quality control and analysis of mediastinal lymph node metastatic patterns. Interact Cardiovasc Thorac Surg, 2008, 7(2): 240-243.
9. 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, 23(10): 982-987.
10. Alberg AJ, Ford JG, Samet JM, et al. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest, 2007, 132(3 Suppl): 29S-55S.
11. Ilic N, Petricevic A, Arar D, et al. Skip mediastinal nodal metastases in the IIIa/N2 non-small cell lung cancer. J Thorac Oncol, 2007, 2(11): 1018-1021.
12. Kim AW. Lymph node drainage patterns and micrometastasis in lung cancer. Semin Thorac Cardiovasc Surg, 2009, 21(4): 298-308.
13. Muraoka M, Akamine S, Oka T, et al. Sentinel node sampling limits lymphadenectomy in stage I non-small cell lung cancer. Eur J Cardiothorac Surg, 2007, 32(2): 356-361.
14. 林钢, 王准, 孙晓江, 等. 可手术非小细胞肺癌淋巴结转移特点及其临床意义. 中国肿瘤临床, 2015, 42(18): 921-925.
15. 马军亮, 刘伦旭, 蒲强, 等. 肺鳞癌和肺腺癌胸内淋巴结转移相关因素分析. 中国肿瘤临床, 2009, 36(20): 1156-1159.
16. 潘铁成, 郑智, 李军, 等. 肺鳞癌、腺癌肿瘤大小与淋巴结转移关系的临床研究. 中国肺癌杂志, 2006, 9(3): 267-269.
17. Cerfolio RJ, Bryant AS. Distribution and likelihood of lymph node metastasis based on the lobar location of nonsmall-cell lung cancer. Ann Thorac Surg, 2006, 81(6): 1969-1973.
18. Ketchedjian A, Daly BD, Fernando HC, et al. Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J Thorac Cardiovasc Surg, 2006, 132(3): 544-548.
19. Henschke CI, Yankelevitz DF, Miettinen OS, et al. Computed tomographic screening for lung cancer: the relationship of disease stage to tumor size. Arch Intern Med, 2006, 166(3): 321-325.
20. Fuwa N, Mitsudomi T, Daimon T, et al. Factors involved in lymph node metastasis in clinical stage I non-small cell lung cancer--from studies of 604 surgical cases. Lung Cancer, 2007, 57(3): 311-316.
21. 黄国金, 郑世营, 杨如松, 等. 非小细胞肺癌纵隔淋巴结转移特点临床探讨. 临床肺科杂志, 2009, 14(12): 1631-1632.
22. Vincent RG, Chu TM, Lane WW. The value of carcinoembryonic antigen in patients with carcinoma of the lung. Cancer, 1979, 44(2): 685-691.
23. 宋平平, 刘希斌, 张为迪, 等. 非小细胞肺癌淋巴结转移相关因素的研究. 临床肿瘤学杂志, 2008, 13(12): 1085-1088.
24. Nomiya T, Nemoto K, Miyachi H, et al. Significance of plasminogen-activation system in the formation of macroscopic types and invasion in esophageal carcinoma. Anticancer Res, 2002, 22(5): 2913-2916.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

N1 characteristics and influencing factors in non-small cell lung cancer of T2 stage

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