Respiratio 2019; 9 (1-2): 77-81
POUZDANOST PROCJENE PRISUSUSTVA LIMFOVASKULARNE
INVAZIJE KOD PLUĆNOG ADENOKARCINOMA NA OSNOVU
PREOPERATIVNE VELIČINE TUMORA
RELIABILITY OF LYMPHOVASCULAR INVASION ASSESSMENTS IN PULMONARY
ADENOCARCINOMA BASED ON THE PREOPERATIVE TUMOR SIZE
Kemal Grbić, Mirko Stanetić, Slavko Grbić
Original research
Naučni članak
Sažetak:
U trenutno važećoj klasifikaciji tumora pluća uveden je pojam “invazivnog adenokarcinoma”
prema stepenu agresivnosti istog. Prisustvo limfovaskularne invazije u tumoru je jedan od takvih
atributa i parametar je očekivano lošeg toka bolesti.
Cilja rada je procjeniti prisustvo limfovaskularne
invazije kod plućnog adenokarcinoma na osnovu preoperativne veličine tumora.
Materijal i metode: U
istraživanje je uključen 261 pacijent operativno tertiran zbog dokazanog adenokarcinoma pluća. U
istraživanje su uključeni samo pacijenti sa decidnom preoperativnomveličinom tumora (cT=mm.) i
limfovaskularnim statusom (LVI) u plućnom resektatu.
Rezultati: Prisutnost LVI, spolna distribucija,
distribucija veličine tumora detreminirana CT-om, te starosna dob između muških i ženskih ispitanika u
ispitivanom uzorku bila je statistički signifikantna (p<0,05). Veličina tumora se pokazala kao značajan
marker pojave LVI u resektatu sa senzitivnošću od 90,9%, specifičnosti 93,5%; PPV = 97,8%; NPV =
76,3%. Cut off vrijednost veličine tumora je iznosila 4,5 cm, a AUK=0,945 (IP 0,905-0,985; p<0.001)
Logističkom regresijom je utvrđeno da je preoperativna veličina tumora nezavisni pozitivni prediktor
pojave limfovaskularne invazije kod adenokarcinoma pluća (OR=7,302; IP=4,303-12,392).
Zaključak:
Preoperativne veličina tumora je statistički značajan marker pojave limfovaskulaarne invazije kod
plućnog adenokarcinoma.
Ključne riječi: adenokarcinom pluća, veličina tumora, limfovaskularna invazija
Literatura
1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CACancer J Clin. 2018;68(6):394-424. [CrossRef] |
|
|
|
2. American Cancer Society, Cancer Facts & Figures 2018. http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf. Pristupljeno: mart 2019. |
|
|
|
3. Robert Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. Krebs in Deutschland 2013/2014;10. Ausgabe,Berlin 2015. |
|
|
|
4. https://eliph.klinikum.uniheidelberg.de/texte_s/651/bronchialkarzinom.Pristupljeno:mart 2017. |
|
|
|
5. Travis WD. Reporting lung cancer pathologal specimens. Impact of the anticipated 7th Edition TNM Classification based on recommendation of the IASLC Staging Committee. Histopathology. 2009; 54(1): 3-11. [CrossRef] |
|
|
|
6. Helmut H. Popper. Progression and metastasis of lung cancer. Cancer Metastais Rev. 2016; 35: 75-79. [CrossRef] |
|
|
|
7. Matias Riihimaki, Hauke Thomsen, Kristina Sundquist, Jan Sundquist, Kari Hemminiki. Clinicall landscape of cancer metastases. Cancer Med. 2018; 7(11): 5534-5542. [CrossRef] |
|
|
|
8. Tamura T., Kurishima K., Nakazawa K., Kagohashi K., Ishikawa H., Satoh H. Specific organ metastases and survival in metastatic non-cmall-cell lung cancer. Molecular and Clinical Oncology. 2015; 3: 217-221. [CrossRef] |
|
|
|
9. William D. Travis, MD, Elisabeth Brambilla, MD, Masayuki Noguchi, MD, Andrew G, Nicholson, MD, Kim R. Geisinger, MD, Yasushi Yatabe, et al. International Association for the Study of Lung Cancer, J Thorac Oncol. 2011; 6(2): 244-285. |
|
|
|
10. Mollberg NM, Bennette C et al. Lymphovascular invasion as a prognostic indicator in stage I nonsmall cell lung cancer: a systemic review and metaanalysis. Ann Thorac Surg. 2014; 97(3): 965-971. [CrossRef] |
|
|
|
11. Sung SY, Kwak YK, Lee SW, Jo IY, Park JK, Kim KS, Lee KY, Kim YS. Lymphovascular Invasion Increases the Risk of Nodal and Distant Recurrence in Node-Negative Stage I-IIA Non-Small-Cell Lung Cancer. Oncology 2018; 30:1-7. [CrossRef] |
|
|
|
12. Okiror L, Harling L, Toufektzian L, King J, Routledge T, Harrison-Phipps K. Prognostic factors including lymphovascular invasion on survival for resected non-small cell lung cancer, J Thorac Cardiovasc Surg. 2018; 156(2): 785-793. [CrossRef] |
|
|
|
13. W. D.Travis, MD, E. Brambilla, MD, A. G. Nicholson, MD et al. The 2015 World Healt OrganizationClassification of Lung Tumors Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J. Thorac Oncol. 2015; 10: 1243-1260. |
|
|
|
14. Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. The IASLC Lung Cancer Staging Project: Proposals for the Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2015; 10(7): 990-1003. [CrossRef] |
|
|
|
15. Wang S, Zhang B, Qian J, Qiao R, Xu J, Zhang L, Zhao Y et al. Proposal on incorporating lymphovascular invasion as a T-descriptor for stage Ilung cancer. Lung Cancer 2018; 2018: 245-252. [CrossRef] |
|
|
|
16. Park C, In Lee IJ, Jang SH, Lee JW. Factors affecting tumor recurrence after curative surgery for NSCLC: impacts of lymphovascular invasion on early tumor recurrence. J Thorac Dis. 2014; 6(10); 1420-1428. |
Corresponding author:
Kemal Grbić
Clinic for Thoracic Surgery, Clinical Center University of Sarajevo
Bolnička 25. 71000 Sarajevo, Bosnia and Herzegovina
Tel. 061 790 994, 033 297 238
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.