Sawabata Noriyoshi, Funaki Soichiro, Shintani Yasushi, Okumura Meinosin
Japan Community Healthcare Organization, Hoshigaoka Medical Center, Hirakata, Japan Division of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
Division of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Interact Cardiovasc Thorac Surg. 2016 Feb;22(2):131-5. doi: 10.1093/icvts/ivv301. Epub 2015 Nov 3.
Lung excision to treat non-small-cell lung cancer (NSCLC) is associated with a worse prognosis when compared with a lobectomy. Cancer relapse may be caused by tumour cells remaining in the residual lobe, the possibility of dislodged cancer cells in the residual lobe is assessed using pulmonary vein blood (PVB) from the resected lung.
Twenty-eight patients with pathological stage I NSCLC who underwent lung excision followed by a lobectomy were evaluated according to the status of isolated tumour cells (ITCs) (origin of circulating tumour cells) in PVB from the resected lobe. Survival was also assessed according to the status of ITCs.
The rate of ITC presence was 60.7% and depended on margin distance/tumour size (M/T) with a threshold of 1.0-30.8% (4/13) in M/T greater than or equal to 1.0 and 86.7% (13/15) in M/T smaller than 1.0 (P = 0.001). PVB-ITC status was no ITCs (N) in 11 (39.3%), only singular cells (S) in 13 (50.0%) and clustered cells (C) in 4 (14.3%). In addition, the survival status of patients with clustered cells was exclusively wrong.
After pulmonary excision for lung cancer, tumour cells remain in the residual lobe and the morphology of which may indicate recurrence.
与肺叶切除术相比，肺切除术治疗非小细胞肺癌（NSCLC）的预后较差。癌症复发可能是由于肿瘤细胞残留在残余肺叶中，通过检测切除肺叶的肺静脉血（PVB）来评估残余肺叶中癌细胞脱落的可能性。
对28例接受肺切除术后行肺叶切除术的病理I期NSCLC患者，根据切除肺叶PVB中分离肿瘤细胞（ITCs）（循环肿瘤细胞来源）的状态进行评估。并根据ITCs状态评估生存率。
ITCs存在率为60.7%，取决于切缘距离/肿瘤大小（M/T），M/T大于或等于1.0时阈值为1.0 - 30.8%（4/13），M/T小于1.0时为86.7%（13/15）（P = 0.001）。PVB - ITCs状态为无ITCs（N）的有11例（39.3%），仅单个细胞（S）的有13例（50.0%），成簇细胞（C）的有4例（14.3%）。此外，成簇细胞患者的生存状态均不佳。
肺癌肺切除术后，肿瘤细胞残留在残余肺叶中，其形态可能预示复发。
