Gotoh Hajimu, Kanomata Naoki, Yoshimura Masahiro, Ohno Yoshiharu, Moriya Takuya, Ohbayashi Chiho
Surgical Pathology Division, Kobe University Hospital, Kobe, Japan.
Med Mol Morphol. 2009 Sep;42(3):162-6. doi: 10.1007/s00795-009-0455-x. Epub 2009 Sep 26.
Nodal staging is a crucial factor in choosing the treatment option for non-small cell lung cancer (NSCLC). However, so far as we know, a computer-based histomorphometric analysis of lymph nodes in NSCLC has never been developed. We studied 299 surgically resected lymph nodes from 108 patients with NSCLC. Microscopic digital images were analyzed with Scion Image software. Seventy lymph nodes had at least one metastatic focus. The metastasis occupancy area per node ranged from 0.01 to 209.58 mm(2) (mean, 29.58 +/- 5.87 mm(2)). The metastasis occupancy ratio ranged from 0.01% to 100% (mean, 48.70% +/- 42.10%). The short-axis diameter of malignant lymph nodes was significantly longer than that of benign lymph nodes (P = 0.0002). The average metastasis occupancy area in the regional lymph nodes of NSCLC is quite small. Various inflammatory conditions can result in a false-positive diagnosis when these techniques are used. Studies that combine analysis of primary tumor size and serum carcinoembryonic antigen (CEA) levels with imaging methods should be considered. Finally, the use of mediastinoscopy or video-assisted thoracoscopic surgery is encouraged in determining the exact nodal status in NSCLC.
淋巴结分期是选择非小细胞肺癌（NSCLC）治疗方案的关键因素。然而，据我们所知，尚未开展基于计算机的NSCLC淋巴结组织形态计量学分析。我们研究了108例NSCLC患者手术切除的299个淋巴结。用Scion Image软件分析微观数字图像。70个淋巴结至少有一个转移灶。每个淋巴结的转移灶面积范围为0.01至209.58 mm²（平均29.58±5.87 mm²）。转移灶占有率范围为0.01%至100%（平均48.70%±42.10%）。恶性淋巴结的短轴直径明显长于良性淋巴结（P = 0.0002）。NSCLC区域淋巴结的平均转移灶面积相当小。使用这些技术时，各种炎症情况可能导致假阳性诊断。应考虑将原发肿瘤大小和血清癌胚抗原（CEA）水平分析与成像方法相结合的研究。最后，在确定NSCLC的确切淋巴结状态时，鼓励使用纵隔镜检查或电视辅助胸腔镜手术。
