Onodera Ken, Sakurada Akira, Hoshi Fumihiko, Abe Jiro, Hasumi Tohru, Takahashi Satomi, Saito Yasuki, Okada Yoshinori
Department of Thoracic Surgery, Sendai Medical Center, Sendai, 983-8520, Japan.
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Seiryo-machi 4-1, Aoba-ku, Sendai, 980-8575, Japan.
Gen Thorac Cardiovasc Surg. 2020 Feb;68(2):164-169. doi: 10.1007/s11748-019-01170-y. Epub 2019 Jul 9.
The significance of clinicopathological features of pre- and post-resection pleural lavage cytology (PLC) for non-small cell lung carcinoma (NSCLC) currently remains unknown.
Between January 2010 and December 2012, pre- and post-resection PLC were performed for NSCLC in 565 patients at Tohoku University, Miyagi Cancer Center, or Sendai Medical Center. The relationship between the clinicopathological features and patient outcomes was analyzed.
Twenty-two patients (3.9%) had positive findings from pre- or post-resection PLC. Both PLC were correlated with pT and pl factors, while only post-resection PLC was correlated with pN factor (p < 0.005). The 5-year disease-free survival (DFS) rate of the positive pre-resection PLC was significantly poorer than that of negative (26.7% vs. 76.9%, p < 0.0001). In addition, the 5-year DFS of the positive post-resection PLC was also poorer than that of negative (14.3% vs. 76.0%, p < 0.0001). Multivariate analyses revealed that both PLC were not independent prognostic factors in our study.
A significant association of post-resection PLC with N factor is considered to be characteristics of post-resection PLC different from pre-resection PLC. A prognostic impact of post-resection PLC and its detailed difference from pre-resection PLC should be clarified by further investigations.
目前，非小细胞肺癌（NSCLC）切除术前和术后胸膜灌洗细胞学检查（PLC）的临床病理特征的意义尚不清楚。
2010年1月至2012年12月期间，在东北大学、宫城癌症中心或仙台医疗中心对565例NSCLC患者进行了切除术前和术后PLC检查。分析临床病理特征与患者预后之间的关系。
22例患者（3.9%）切除术前或术后PLC检查结果为阳性。两种PLC均与pT和pl因子相关，而仅切除术后PLC与pN因子相关（p < 0.005）。切除术前PLC阳性患者的5年无病生存率（DFS）显著低于阴性患者（26.7%对76.9%，p < 0.0001）。此外，切除术后PLC阳性患者的5年DFS也低于阴性患者（14.3%对76.0%，p < 0.0001）。多因素分析显示，在我们的研究中，两种PLC均不是独立的预后因素。
切除术后PLC与N因子的显著相关性被认为是切除术后PLC不同于切除术前PLC的特征。切除术后PLC的预后影响及其与切除术前PLC的详细差异应通过进一步研究加以阐明。
