Association of cytologic micropapillary clusters in cytology samples with lymphatic spread in clinical stage I lung adenocarcinomas
Association of cytologic micropapillary clusters in cytology samples with lymphatic spread in clinical stage I lung adenocarcinomas
复制标题
DOI：
10.1016/j.lungcan.2008.09.017
复制
发表时间：
2009-06-01
期刊：
影响因子：
5.3
通讯作者：
Miyata, Satoshi
中科院分区：
文献类型：
--
作者：
Satoh, Yukitoshi;Hoshi, Rira;Miyata, Satoshi
目的：细胞学微乳头状细胞簇（MPCs）是一种圆形、三维、内聚的肺癌细胞簇，具有假乳头状结构。最近，我们证明早期肺腺癌的MPCs可以被认为是评估预后的有用辅助工具。我们在此证明，术前细胞学检查发现MPCs阳性的I期肺腺癌有淋巴扩散的高风险。方法：回顾2004 ~ 2006年209例临床I期肺腺癌手术切除患者的临床病理特点、清扫淋巴结转移情况、血管浸润及术前细胞学标本中MPCs的表现。结果：38例（18%）患者MPC阳性；临床IA期21例，IB期17例，与术后IA期有显著相关性，病理检查有113例淋巴结转移频繁、静脉浸润（P < 0.05）。特别是，50%的临床I期MPCs患者在术后表现出疾病进展。结论：MPCs可能是临床I期肺腺癌侵袭性行为的表现，如淋巴结转移的频繁。因此，术前对MPCs的细胞学检测应提醒外科医生注意淋巴结转移的可能性。(C) 2008年由爱思唯尔爱尔兰有限公司出版
Objective: Cytologic micropapillary clusters (MPCs) are round, three-dimensional and cohesive clusters of lung cancer cells with a pseudopapillary configuration. Recently, we demonstrated that MPCs from early stage lung adenocarcinomas can be considered as useful aids to assessing prognosis. We here demonstrate that stage I lung adenocarcinomas found to be positive for MPCs in preoperative cytologic approaches are high risk for lymphatic spread.Methods: The clinicopathologic characteristics, metastatic status of dissected lymph nodes, vascular infiltration and presence of MPCs in preoperative cytologic specimens in 209 patients with clinical stage I lung adenocarcinomas undergoing complete surgical resection during 2004-2006 were reviewed.Results: Thirty-eight patients (18%) had positive MPC findings; 21 patients with clinical stage IA and 17 with stage IB. Significant associations with postoperative stages IA and 113, frequent lymph node metastasis and venous infiltration on pathologic examination were observed (P < 0.05). In particular, 50% of clinical stage I patients with MPCs demonstrated advance in the postoperative stage of disease.Conclusions: MPCs may be a manifestation of aggressive behavior, as evidenced by frequent lymph node metastasis, of clinical stage I lung adenocarcinomas. Preoperative cytologic detection of MPCs, therefore, should alert the surgeon to the probability of lymph node metastases. (C) 2008 Published by Elsevier Ireland Ltd.