Rocco Trisolini, Valeria Cetoretta, Giovanni Sotgiu, Alessandra Cancellieri, Mariangela Puci, Marta Viscuso, Vanina Livi, Massimiliano Cani, Giovanni Scambia, Federico Cappuzzo, Emilio Bria, Silvia Novello
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引用次数: 0
Abstract
Background: The prevalence of supraclavicular lymph nodes metastases (SNM) in advanced lung cancer has not been systematically evaluated, nor has then been a comparison of demographic, clinical, or molecular characteristics between patients with and without SNM.
Methods: In this prospective cohort study, the presence of SNM was evaluated using imaging studies (CT, PET, neck ultrasonography) in patients with suspected advanced lung cancer referred for biopsy aimed at diagnosis and molecular profiling. Ultrasound-guided biopsy confirmed or excluded metastatic involvement when suspicious supraclavicular nodes were identified. We assessed the prevalence of SNM and compared the demographic, clinicopathologic and molecular characteristics of patients with and without SNM.
Results: Among the 348 patients with advanced lung cancer, 94 (27%) had SMN. SMN was more common in small cell lung cancer (24/48, 50%) and adenocarcinoma (61/248, 24.6%) than in squamous cell carcinoma (4/35, 11.4%). Compared to patients without SMN, those with SMN were more likely to have small-cell lung cancer, N2/3 disease (97.9 vs. 83.9%, P < .0001), liver metastases (29.8% vs. 16.1% P = .006), and metastases to less common sites (33.7% vs. 14.1%, P < .0001). The prevalence of genomic alterations and PD-L1 expression did not differ between biopsy samples obtained from SNM and those from the primary tumor or other metastatic sites.
Conclusion: SNM is common in patients with advanced small-cell lung cancer and adenocarcinoma. Ultrasound-guided biopsy of SNM is a simple and relatively inexpensive method for obtaining adequate tissue samples for diagnosis and comprehensive molecular profiling.
背景：晚期肺癌锁骨上淋巴结转移（SNM）的患病率尚未得到系统评估，也没有对有无SNM患者的人口学、临床或分子特征进行比较。方法：在这项前瞻性队列研究中，通过影像学检查（CT、PET、颈部超声检查）对疑似晚期肺癌患者进行活检以诊断和分子谱分析，评估SNM的存在。超声引导活检证实或排除转移灶当可疑的锁骨上淋巴结被发现。我们评估了SNM的患病率，并比较了SNM患者和非SNM患者的人口学、临床病理和分子特征。结果：348例晚期肺癌患者中，94例（27%）有SMN。SMN在小细胞肺癌（24/48,50%）和腺癌（61/248,24.6%）中较鳞状细胞癌（4/35,11.4%）更为常见。与没有SMN的患者相比，有SMN的患者更容易发生小细胞肺癌、N2/3疾病（97.9 vs. 83.9%, P < 0.0001）、肝转移（29.8% vs. 16.1% P = 0.006）和不常见部位转移（33.7% vs. 14.1%, P < 0.0001）。从SNM和原发肿瘤或其他转移部位获得的活检样本中获得的基因组改变和PD-L1表达的患病率没有差异。结论：SNM在晚期小细胞肺癌和腺癌患者中较为常见。超声引导下的SNM活检是一种简单且相对便宜的方法，可以获得足够的组织样本进行诊断和全面的分子谱分析。
期刊介绍：
Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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