scholarly journals Optimal margins for early stage peripheral lung adenocarcinoma resection

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pan Yin ◽  
Bingqing Yue ◽  
Ji Zhang ◽  
Dong Liu ◽  
Dongyu Bai ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Lung Tissue ◽  
Early Stage ◽  
Negative Margin ◽  
Sublobar Resection ◽  
Group V ◽  
Significant Safety ◽  
Group Iii ◽  
Peripheral Lung ◽  
Tumor Edge

Abstract Background A pathologically confirmed negative margin is required when performing sublobar resection in patients with early stage peripheral lung adenocarcinoma. However, the optimal margin distance to ensure complete tumor resection while preserving healthy lung tissue remains unknown. We aimed to establish a reliable distance range for negative margins. Methods A total of 52 intraoperative para-cancer tissue specimens from patients with peripheral lung adenocarcinoma with pathological tumors ≤2 cm in size were examined. Depending on the distance from the tumor edge (D), the para-cancer tissues were divided into the following five groups: D < 0.5 cm (group I); 0.5 cm ≤ D < 1.0 cm (group II); 1.0 cm ≤ D < 1.5 cm (group III); 1.5 cm ≤ D < 2.0 cm (group IV); and D ≥ 2.0 cm (group V). During pathological examination of the specimens under a microscope, the presence of atypical adenomatous hyperplasia or more severe lesions was considered unsafe, whereas the presence of normal lung tissue or benign hyperplasia was considered safe. Results Group V, in which the margin was the farthest from the tumor edge, was the safest. There were significant safety differences in between groups I and V (χ2 = 26.217, P < 0.001). Significant safety differences also existed between groups II and V (χ2 = 9.420, P < 0.005). There were no significant safety differences between group III or IV and group V (P = 0.207; P = 0.610). Conclusions We suggest that when performing sublobar resection in patients with early stage peripheral lung adenocarcinoma with pathological tumor sizes ≤2 cm, the resection margin distance should be ≥1 cm to ensure a negative margin.

scholarly journals Risk factors for lymph node metastasis and surgical methods in patients with early-stage peripheral lung adenocarcinoma presenting as ground glass opacity

2020 ◽  
Author(s):  
yongming wang ◽  
lijun jing ◽  
gongchao wang
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Ground Glass Opacity ◽  
Tumor Diameter ◽  
Node Metastasis ◽  
Peripheral Lung ◽  
Stage Ia

Abstract Background: It is difficult to predict lymph node metastasis in patients with early lung cancer. Pure ground glass opacity (GGO) on computed tomography indicates an early-stage adenocarcinoma that can be removed by limited resection or lobectomy without the need for mediastinal lymph node dissection or sampling, and lung adenocarcinoma with GGO therefore has a good prognosis. We examined the incidence and risk factors of lymph node metastasis in patients with clinical stage IA lung adenocarcinoma. Methods: We retrospectively analyzed clinical data for 327 patients with stage IA peripheral lung cancer treated in our hospital from March 2014 to December 2018. The patients were divided into four groups according to computed tomography signs. Lobectomy and systematic lymph node dissection were performed in all patients. Correlations between lymph node metastasis and clinical pathological factors were analyzed by logistic regression.Results: Among the 327 patients, 26 (7.95%) had lymph node metastasis. No patients with pure GGO or GGO-dominant types had lymph node metastasis. Logistic regression identified tumor diameter, solid content, plasma carcinoembryonic antigen (CEA) level, pathological type, lymphovascular invasion, and pleural invasion as factors related to the presence of lymph node metastasis. Conclusions: Tumor diameter, solid component ratio, plasma CEA level, pathological type, vascular tumor thrombus, and pleural invasion are possible independent risk factors for lymph node metastasis in patients with stage IA lung adenocarcinoma. In contrast, lymph node metastasis is rare in patients with pure GGO or GGO-dominant lung adenocarcinoma.

scholarly journals Consideration of the Optimal Surgical Procedure Based on the Risk of Recurrence in Clinical Stage 0 or IA Lung Adenocarcinoma

2021 ◽  
Author(s):  
Tomoyoshi Takenaka ◽  
Tetsuzo Tagawa ◽  
Naoki Hartake ◽  
Fumihiko Kinoshita ◽  
Yuki Ono ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Solid Tumors ◽  
Surgical Procedures ◽  
Early Stage ◽  
Tnm Classification ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Sublobar Resection ◽  
8Th Edition ◽  
Ct Features

Abstract Background Although sublobar resection is widely performed for early-stage non-small cell lung cancer, what kind of patients should be actively indicated for sublobar resection has not yet been established according to 8th edition of tumor node metastasis classification (TNM). We evaluated the computed tomography (CT) features and optimal surgical procedures of clinical stage 0 or IA adenocarcinoma from the perspective of recurrence. Methods We retrospectively investigated 508 lung adenocarcinoma diagnosed as c-stage 0 or IA in the 8th edition of TNM classification. A survival analysis was performed according to the clinical T descriptor, CT features and surgical procedures. Results The tumors were classified as follows: 74 with pure ground glass opacity (GGO), 237 part-solid tumors and 197 solid tumors. The types of surgical procedures were lobectomy (n = 328), segmentectomy (n = 73) and wedge resection (n = 107). Clinical T descriptors were cTis in 74 patients, cT1mi in 68 patients, cT1a in 94 patients, cT1b in 181 patients and cT1c in 91 patients. Recurrence was observed 46 cases (9%), including 3 (3.1%) with cT1a, 23 (12.7%) with cT1b and 20 (22.0%) with cT1c. No recurrence was observed in cTis or cT1mi cases. Solid tumors with cT1b recurred more often than part-solid tumors among cT1b cases (6.8% vs. 16.8%) (p = 0.046). There were no marked differences in the recurrence rate between part-solid and solid tumors in the cT1a and cT1c groups. The patients who received sublobar resection developed recurrence more often than the patients who received lobectomy among cT1b cases (10.1% vs. 21.4%) and cT1c cases (18.0% vs. 46.2%) (p = 0.053 and p = 0.023). Conclusions Pure GGO and cT1mi cases should be actively considered for sublobar resection, while cT1b (especially solid cT1b cases) and cT1c cases should be considered for lobectomy to prevent recurrence.

scholarly journals Radiographic Characteristics of Early Stage of Non-mucus Producing Peripheral Lung Adenocarcinoma. With Special Reference to the Stromal Elastotic Framework of the Tumor.

Haigan ◽  
2001 ◽  
Vol 41 (4) ◽  
pp. 305-312
Author(s):  
Takashi Eto ◽  
Harumi Suzuki ◽  
Shinichiro Ohota ◽  
Nobuaki Nakajima ◽  
Atsuro Honda
Keyword(s):  
Lung Adenocarcinoma ◽  
Special Reference ◽  
Early Stage ◽  
Peripheral Lung

scholarly journals Study on the changes of ADRP+ cell population in the process of pulmonary fibrosis

2020 ◽  
Author(s):  
Wei Tan ◽  
Yaru Wang ◽  
Yuhua Chen ◽  
Cheng Chen
Keyword(s):  
Pulmonary Fibrosis ◽  
Lung Tissue ◽  
Early Stage ◽  
Research Direction ◽  
Alveolar Epithelial Cells ◽  
Alveolar Epithelial ◽  
Aggregation Site ◽  
Peripheral Lung ◽  
New Research ◽  
M1 Type

Abstract Background ADRP is a marker of lung lipofibroblasts. Lipofibroblasts play an important role in assist type 2 alveolar epithelial cells function in peripheral lung tissue. Pulmonary fibrosis is characterized by continuous irreversible destruction of peripheral lung tissue. The expression of ADRP and the role of ADRP+ cells in pulmonary fibrosis are of interest to us. Methods Quantitative PCR as well as immunohistochemical multiplex staining were used to analyze the expression of ADRP during lung development, bleomycin-induced pulmonary fibrosis, and identify the type and function of ADRP+ cells during pulmonary fibrosis lesions. Results ADRP+ cells were found to decrease gradually from birth to adulthood. During pulmonary fibrosis, the expression of ADRP increased gradually, while another marker of lipofibroblast, the expression of PDGFRα decreased. There was a co-localization relationship between macrophage marker CD68 and ADRP. Both M1-type and M2-type macrophages can express ADRP in the early stage of pulmonary fibrosis. While in the subsequent pulmonary fibrosis process, M1-type ADRP+ macrophages gradually decrease, while the ADRP+ cells were mainly M2-type macrophages. ADRP+ M2-type macrophages can release S100A4 and distribute around the lesion area of pulmonary fibrosis. Pulmonary fibrosis gradually developed as M2-polarized macrophages replaced M1 to become the main population of pulmonary ADRP+ macrophages Conclusion In the process of pulmonary fibrosis, a large number of ADRP+ cells are macrophages, including M1 and M2 types successively. The aggregation site of ADRP+ M2-type macrophages indicates that fibrosis damage is about to or has already occurred. This study may provide a new research direction for the treatment of pulmonary fibrosis.

scholarly journals Risk factors for lymph node metastasis and surgical methods in patients with early-stage peripheral lung adenocarcinoma presenting as ground glass opacity

2020 ◽  
Author(s):  
yongming wang ◽  
lijun jing ◽  
gongchao wang
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Ground Glass Opacity ◽  
Tumor Diameter ◽  
Node Metastasis ◽  
Peripheral Lung ◽  
Stage Ia

Abstract Background It is difficult to predict lymph node metastasis in patients with early lung cancer. Pure ground glass opacity (GGO) on computed tomography indicates an early-stage adenocarcinoma that can be removed by limited resection or lobectomy without the need for mediastinal lymph node dissection or sampling, and lung adenocarcinoma with GGO therefore has a good prognosis. We examined the incidence and risk factors of lymph node metastasis in patients with clinical stage IA lung adenocarcinoma. Methods We retrospectively analyzed clinical data for 327 patients with stage IA peripheral lung cancer treated in our hospital from March 2014 to December 2018. The patients were divided into four groups according to computed tomography signs. Lobectomy and systematic lymph node dissection or sampling were performed in all patients. Correlations between lymph node metastasis and clinical pathological factors were analyzed by logistic regression. Results Among the 327 patients, 26 (7.95%) had lymph node metastasis. No patients with pure GGO or GGO-dominant types had lymph node metastasis. Logistic regression identified tumor diameter, solid content, plasma carcinoembryonic antigen (CEA) level, pathological type, lymphovascular invasion, and pleural invasion as factors related to the presence of lymph node metastasis. Conclusions Tumor diameter, solid component ratio, plasma CEA level, pathological type, vascular tumor thrombus, and pleural invasion are possible independent risk factors for lymph node metastasis in patients with stage IA lung adenocarcinoma. In contrast, lymph node metastasis is rare in patients with pure GGO or GGO-dominant lung adenocarcinoma.

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