Department of General Thoracic Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Department of Pathology, Faculty of Medicine, Shimane University, Shimane, Japan.
Interact Cardiovasc Thorac Surg. 2022 Jun 1;34(6):1081-1088. doi: 10.1093/icvts/ivac005.
High-grade tumours are observed even in Stage I lung adenocarcinomas. Tumour spread through air spaces (STAS) is a risk factor for recurrence after resection. However, there is no ideal predictive biomarker for STAS in high-grade Stage I lung adenocarcinoma. This study assessed the prognostic impact of the preoperative peripheral monocyte count in lung adenocarcinoma.
We retrospectively analysed the data of 444 patients with resected Stage I lung adenocarcinoma during 2006-2016. Univariable and multivariable Cox proportional analyses of recurrence-free probability (RFP) and overall survival (OS) were used to analyze preoperative complete peripheral blood cell count data. Since monocyte count was associated with poor prognosis, the relationship between preoperative peripheral monocyte count and clinicopathological factors, including STAS, was assessed. In addition, immunohistochemical CD68 staining was performed to evaluate tumour-associated macrophages (TAMs).
A higher preoperative peripheral monocyte count was a predictor of lower RFP (P = 0.004) and lower OS (P < 0.001). In multivariable analysis, a higher peripheral monocyte count was an independent prognostic factor for RFP and OS (hazard ratio: 1.88, 95% confidence interval: 1.07-3.31, P = 0.029; hazard ratio: 2.13, 95% confidence interval: 1.22-3.75, P = 0.008, respectively). A higher peripheral monocyte count was associated with a higher frequency of STAS (P = 0.017) and higher number of CD68+ TAMs (P = 0.013).
A higher preoperative peripheral monocyte count was an independent marker for a poor prognosis in Stage I lung adenocarcinoma and was associated with a higher frequency of STAS.
在 I 期肺腺癌中也观察到高级别肿瘤。肿瘤通过气腔播散（STAS）是切除后复发的危险因素。然而，对于高级别 I 期肺腺癌的 STAS，目前尚无理想的预测生物标志物。本研究评估了术前外周血单核细胞计数对肺腺癌的预后影响。
我们回顾性分析了 2006 年至 2016 年间接受切除的 444 例 I 期肺腺癌患者的数据。采用单变量和多变量 Cox 比例风险分析复发无进展概率（RFP）和总生存（OS），分析术前全血白细胞计数数据。由于单核细胞计数与预后不良相关，因此评估了术前外周血单核细胞计数与包括 STAS 在内的临床病理因素之间的关系。此外，还进行了免疫组化 CD68 染色以评估肿瘤相关巨噬细胞（TAMs）。
较高的术前外周血单核细胞计数是 RFP 降低（P=0.004）和 OS 降低（P<0.001）的预测指标。在多变量分析中，较高的外周血单核细胞计数是 RFP 和 OS 的独立预后因素（风险比：1.88，95%置信区间：1.07-3.31，P=0.029；风险比：2.13，95%置信区间：1.22-3.75，P=0.008）。较高的外周血单核细胞计数与更高的 STAS 频率（P=0.017）和更高的 CD68+TAMs 数量（P=0.013）相关。
较高的术前外周血单核细胞计数是 I 期肺腺癌预后不良的独立标志物，与更高的 STAS 频率相关。
