Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Zhang, Chengyan; Pang, Guanchao; Ma, Chengxi; Wu, Jingni; Wang, Pingli; Wang, Kai

doi:10.1155/2019/6263249

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Notably, some LUAD patients develop lymph node metastasis when the diameter of the primary tumor remains very small. Early lymph node metastasis significantly affects the long-term survival of patients ( Liu et al, 2019 ; Zhang et al, 2019a ), and our study verified that stage-T1 patients with lymph node metastasis have a shorter OS. ( Takada et al, 2020 ) demonstrated that early lymph node metastasis in breast cancer is related to tumor-infiltrating lymphocytes, whereas no relevant research has been published on early lymph node metastasis of lung cancer.…”

Section: Discussionsupporting

confidence: 73%

Macrophage-Related SPP1 as a Potential Biomarker for Early Lymph Node Metastasis in Lung Adenocarcinoma

Dong

Huang

et al. 2021

Front. Cell Dev. Biol.

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Lymph node metastasis is a major factor that affects prognosis in patients with lung adenocarcinoma (LUAD). In some cases, lymph node metastasis has already occurred when the primary tumors are still small (i.e., early T stages), however, relevant studies on early lymph node metastasis are limited, and effective biomarkers remain lacking. This study aimed to explore new molecular biomarker for early lymph node metastasis in LUAD using transcriptome sequencing and experimental validation. Here, we performed transcriptome sequencing on tissues from 16 matched patients with Stage-T1 LUAD (eight cases of lymph node metastasis and eight cases of non-metastasis), and verified the transcriptome profiles in TCGA, GSE68465, and GSE43580 cohorts. With the bioinformatics analysis, we identified a higher abundance of M0 macrophages in the metastatic group using the CIBERSORT algorithm and immunohistochemistry (IHC) analysis and the enrichment of the epithelial–mesenchymal transition (EMT) pathway was identified in patients with higher M0 infiltration levels. Subsequently, the EMT hallmark gene SPP1, encoding secreted phosphoprotein 1 (SPP1), was identified to be significantly correlated with macrophage infiltration and M2 polarization, and was determined to be a key risk indicator for early lymph node metastasis. Notably, SPP1 in the blood, as detected by enzyme-linked immunosorbent assay (ELISA) showed a superior predictive capability for early lymph node metastasis [area under the curve (AUC) = 0.74]. Furthermore, a long non-coding RNA (lncRNA, AC037441), negatively correlated with SPP1 and macrophage infiltration, had also been identified and validated to be involved in the regulation of early lymph node metastasis. In conclusion, we revealed the potential role of macrophages in lymph node metastasis and identified the macrophage-related gene SPP1 as a potential biomarker for early lymph node metastasis in LUAD.

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Section: Discussionsupporting

confidence: 73%

Macrophage-Related SPP1 as a Potential Biomarker for Early Lymph Node Metastasis in Lung Adenocarcinoma

Dong

Huang

et al. 2021

Front. Cell Dev. Biol.

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“…We focused on these markers as they are routinely tested in standard clinical practice within the preoperative assessment and therefore immediately available essentially in all centers performing lung resections for cancer. Other serum markers such as Carcino-Embryonic Antigen (CEA)-which has also been associated with occult nodal spread in early stage NSCLC [1,10,11]-are not typically measured before surgical treatment of early NSLCL in many centers. Recently published literature on this topic also corroborated the basic idea of our study.…”

Section: Discussionmentioning

confidence: 99%

Blood-Derived Systemic Inflammation Markers and Risk of Nodal Failure in Stage Ia Non-Small Cell Lung Cancer: A Multicentric Study

Tacconi

Mangiameli

Voulaz

et al. 2023

JCM

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Background: Unexpected spread to regional lymph nodes can be found in up to 10% of patients with early stage non-small cell lung cancer (NSCLC), thereby affecting both prognosis and treatment. Given the known relation between systemic inflammation and tumor progression, we sought to evaluate whether blood-derived systemic inflammation markers might help to the predict nodal outcome in patients with stage Ia NSCLC. Methods: Preoperative levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation score (SII, platelets × NLR) were collected from 368 patients who underwent curative lung resection for NSCLC. After categorization, inflammatory markers were subjected to logistic regression and time-event analysis in order to find associations with occult nodal spread and postoperative nodal recurrence. Results: No inflammation marker was associated with the risk of occult nodal spread. SII showed a marginal effect on early nodal recurrence at a quasi-significant level (p = 0.065). However, patients with T1c tumors and elevated PLR and/or SII had significantly shorter times to nodal recurrence compared to T1a/T1b patients (p = 0.001), while patients with T1c and normal PLR/SII did not (p = 0.128). Conclusions: blood-derived inflammation markers had no value in the preoperative prediction of nodal status. Nevertheless, our results might suggest a modulating effect of platelet-derived inflammation markers on nodal progression after the resection of tumors larger than 2 cm.

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“…The findings revealed that imaging invasiveness, lesion diameter, and depth were predictive factors for lymph node metastasis in T1 lung adenocarcinoma. Additionally, the micropapillary subtype, as determined by pathological analysis, was identified as a risk factor specifically for N2 skip lymph node metastasis 10–12 . Previous studies have examined the risk factors for lymph node metastasis in T1 lung cancer, often focusing on either N1 or N2 endpoints.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the micropapillary subtype, as determined by pathological analysis, was identified as a risk factor specifically for N2 skip lymph node metastasis. 10 , 11 , 12 Previous studies have examined the risk factors for lymph node metastasis in T1 lung cancer, often focusing on either N1 or N2 endpoints. However, in clinical practice, the risk factors for N1 and N2 metastasis can differ.…”

Section: Discussionmentioning

confidence: 99%

Lymph node metastasis and its risk factors in T1 lung adenocarcinoma

Zhang,

Mu,

Huang

et al. 2023

Thoracic Cancer

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BackgroundIn this study, the focus was primarily on examining the occurrence of lymph node metastasis in T1 lung adenocarcinoma, while also analyzing the relationship between clinical variables such as imaging characteristics, pathological classifications, and lymph node metastasis.MethodsWe retrospectively analyzed data from patients with T1 lung adenocarcinoma who underwent lobectomy and lymph node dissection between January 2016 and December 2019. Utilizing univariate and multivariate analyses, we assessed the associations between lymph node metastasis and various clinical factors, including imaging characteristics, lesion location and depth, and pathological subtypes.ResultsOf the 433 patients with T1 lung adenocarcinoma, 139 had lymph node metastasis. Moreover, the incidence of node 1 (N1) lymph node, sequential, and node 2 (N2) skip metastases were 12.2%, 12.7%, and 7.2%, respectively. Univariate analysis revealed that tumor diameter, depth ratio, sex, invasive imaging features, and pathological subtype were significantly associated with lymph node metastasis. Multivariate analysis revealed that the tumor depth ratio, tumor diameter, pleural indentation or traction sign, nonvascular penetration sign, solid component, nonadherence, and micropapillary pathological subtype were risk factors for lymph node metastasis. In the multivariate analysis, the micropapillary pathological subtype was an independent risk factor for N2 skip metastasis.ConclusionsIn patients with clinical stage T1 lung adenocarcinoma, the risk of lymph node metastasis is higher for tumors located deep within the lung tissue with solid components, invasive preoperative imaging features, and larger diameters. For N2 skip lymph node metastasis, the micropapillary pathological subtype represents a significant high‐risk factor.

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Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Cited by 6 publications

References 30 publications

Macrophage-Related SPP1 as a Potential Biomarker for Early Lymph Node Metastasis in Lung Adenocarcinoma

Macrophage-Related SPP1 as a Potential Biomarker for Early Lymph Node Metastasis in Lung Adenocarcinoma

Blood-Derived Systemic Inflammation Markers and Risk of Nodal Failure in Stage Ia Non-Small Cell Lung Cancer: A Multicentric Study

Lymph node metastasis and its risk factors in T1 lung adenocarcinoma

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