Risk Factors Of Lymph Node Metastasis In Lung Squamous Cell Carcinoma Of 3cm Or Less In Diameter

Part ?Risk Factors of Lymph Node Metastasis in Lung Squamous Cell Carcinoma of 3 cm or Less in DiameterObjective:Through literature review we can't find an efficient risk factor of lymph node metastasis in lung squamous cell carcinoma(SCC).This study aimed to investigate the risk factors of pathological lymph node status in patients with lung SCC of 3 cm or less in diameter,to provide some reference for the fellow surgeons in the decision of operative option.Methods:In total,we analysed 154 patients with lung SCC of 3 cm or less in diameter who underwent lobectomy or bilobectomy or pneumonectomy with systematic lymph node dissection.The relationship between lymph node status and clinical characteristics were examined.Results:Lymph node metastases were present in 48 patients(31.2%)of the study subjects.Multivariate analysis indicated that,age<60 years old(P = 0.004),tumor long axis>2 cm but<3 cm(P = 0.029),vascular invasion(P = 0.036),perineural invasion(P = 0.003),serum cytokeratin fragment 21-1(CYFRA21-1)level ?5 ng/ml(P = 0.012)were associated with lymph node metastasis,and their odd ratios(OR)were 3.472,2.523,3.201,4.134 and 4.678,respectively.In the group of the 39 SCCs without above associated factors,there were 4 exceptions with nodal involvement(4/39,10.3%).Conclusions:Systematic lymphadenectomy is recommended when one or more risk factors of lymph node metastasis are present.Even in the group of the 39 SCCs without above associated factors,lymph node dissection or sampling is still recommended.Part IIRisk Factors of Lymph Node Metastasis in Lung Peripheral Squamous Cell Carcinoma of 3 cm or Less in DiameterOBJECTIVE:This study aimed to investigate the predictors of pathological lymph node status in patients with lung peripheral squamous cell carcinoma of 3 cm or less in diameter,to select candidates for sublobar resection.METHODS:In total,we analysed 74 patients with lung peripheral squamous cell carcinoma of 3 cm or less in diameter who underwent lobectomy or pneumonectomy with systematic lymph node dissection.The relationship between lymph node status and clinical features,such as age,sex,tumor size,histopathological characteristics,and serum tumour markers were examined.RESULTS:Lymph node metastases were present in 17.6%of the study subjects,age,tumor size were identified as significant predictors of lymph node metastasis.The area under the ROC curve(AUC)of these two factors was 0.704(95%confidence interval(CI)= 0.523-0.886),and 0.657(95%CI = 0.504-0.810),respectively.CONCLUSIONS:In conclusion,among the patients with lung peripheral squamous cell carcinoma of 3 cm or less in diameter,age<60 years,tumor long arm>2 cm but<3 cm all significantly increased the rate of lymph node metastasis.Sublobar resection can be carefully chosen for peripheral clinical stage I lung SCCs with tumor long arm<2 cm,specially with age>60.