Grbic Kemal, Mujakovic Aida, Lepara Orhan, Lepara Zahid, Begic Edin, Krupic Ferid
Clinical Center University of Sarajevo, Clinic for Thoracic Surgery, Sarajevo, Bosnia and Herzegovina.
Department of Internal Medicine, Division of Pulmonary Diseases, General Hospital "Prim. Dr. Abdulah Nakas," Sarajevo, Bosnia and Herzegovina.
Int J Appl Basic Med Res. 2021 Apr-Jun;11(2):95-99. doi: 10.4103/ijabmr.IJABMR_500_20. Epub 2021 Apr 8.
The invasion of blood and lymph vessels with tumor tissue represents a negative prognostic factor of the disease course in patients with non-small cell lung cancer.
The aim of the study was to determine the marker value of a preoperatively determined size of pulmonary squamous cell carcinoma and adenocarcinoma and its impact on lymphovascular invasion (LVI) in resected lung tissue.
The conducted observational cross-sectional study included 322 patients with a complete resection of confirmed squamous cell lung carcinoma and lung adenocarcinoma. Preoperative size and type of tumor were determined by a preoperative chest computed tomography scan and cytological/histological analysis of obtained samples, while LVI status was determined by pathohistological analysis of resected tumor lung tissue. Receiver operating characteristic (ROC) curve analysis was performed to assess whether tumor size could serve as a reliable marker for LVI. < 0.05 was considered statically significant.
A statistically significant difference in the frequency of tumor size ( = 0.580) along with LVI ( = 0.656) was not established between the patients with squamous cell lung cancer and lung adenocarcinoma. A ratio between the size of lung adenocarcinoma and LVI status ( < 0.001) was determined as statistically significant, while such a difference was not established in squamous cell lung cancer ( = 0.052). The ROC analysis revealed that tumor size >39 mm in patients with lung adenocarcinoma has obtained a sensitivity of 70.8% and a specificity of 60.9% to differentiate patients with a LVI (areas under the curve [AUC] = 0.70; 95% CI 0.60‒0.79; < 0.001). A tumor size >4.6 cm in patients with squamous cell lung cancer obtained a sensitivity of 56.5% and a specificity of 60.3% to differentiate patients with a LVI (AUC = 0.59; 95% CI 0.50‒0.67; = 0.043).
The preoperative size of lung adenocarcinoma could be an acceptable marker of LVI presence in resected lung tissue, while in the squamous cell lung cancer, a potential biomarker role of the preoperative size of the tumor was inadequate.
肿瘤组织侵袭血管和淋巴管是影响非小细胞肺癌患者病程的不良预后因素。
本研究旨在确定术前测定的肺鳞癌和腺癌大小的标志物价值及其对切除肺组织中淋巴管血管侵犯（LVI）的影响。
本观察性横断面研究纳入322例确诊为肺鳞癌和肺腺癌并已完全切除的患者。术前通过胸部计算机断层扫描及获取样本的细胞学/组织学分析确定肿瘤的大小和类型，而LVI状态则通过切除的肿瘤肺组织的病理组织学分析来确定。采用受试者操作特征（ROC）曲线分析来评估肿瘤大小是否可作为LVI的可靠标志物。P<0.05被认为具有统计学意义。
肺鳞癌和肺腺癌患者在肿瘤大小频率（P=0.580）以及LVI频率（P=0.656）方面未发现统计学显著差异。肺腺癌大小与LVI状态之间的比值（P<0.001）具有统计学意义，而在肺鳞癌中未发现此类差异（P=0.052）。ROC分析显示，肺腺癌患者肿瘤大小>39 mm时，区分有LVI患者的敏感性为70.8%，特异性为60.9%（曲线下面积[AUC]=0.70；95%CI 0.60‒0.79；P<0.001）。肺鳞癌患者肿瘤大小>4.6 cm时，区分有LVI患者的敏感性为56.5%，特异性为60.3%（AUC=0.59；95%CI 0.50‒0.67；P=0.043）。
肺腺癌的术前大小可能是切除肺组织中存在LVI的可接受标志物，而在肺鳞癌中，肿瘤术前大小的潜在生物标志物作用不足。
