Features of tumor spread through the air spaces in patients with non-small cell lung carcinoma

Abstract

Introduction. To date, the molecular mechanisms underlying the development of STAS remain poorly understood. The development of STAS – a marker of an unfavorable outcome of lung cancer – is likely to be associated with markers of a high risk of hematogenous metastasis and recurrence, i.e., changes in the bronchial epithelium.The paper aimed to study the features of STAS in patients with different morphological changes in the bronchial epithelium. Materials and methods. We studied surgical material from 90 patients with non-small cell lung cancer who received combined treatment in the thoracoabdominal department of the Research Institute of Oncology of the Tomsk National Research Medical Center between 2009 and 2017. Case histories and outpatient cards of patients were analyzed. We determined the prevalence of the disease according to the international classification using the TNM staging system (2017). We used the standard method to post the material and manufacture histological preparations. The 2015 WHO classification was used to determine the histological type of cancer. The study included only cases with non-small cell lung carcinoma, namely squamous cell carcinoma (n=50) or adenocarcinoma (n=40). In the lymph nodes, we assessed the presence of metastatic lesions and counted the number of lymph nodes with metastases. In the bronchial mucosa located 3–4 cm from the border of the tumor, we assessed the presence of changes in the bronchial epithelium. The information about the presence, timing, and location of hematogenous metastases and relapses was taken into account. We used descriptive statistics; the results were discussed with the statistically significant difference at p<0.05. Results. We identified a number of patterns that could complement the understanding of SPAS pathogenesis, a form of tumor progression relevant for lung cancer. Conclusion. We propose to consider the detection of STAS as an unfavorable prognostic sign associated with the risk of locoregional metastasis. Keywords: STAS, non-small cell lung cancer, regenerative hyperplasia of the bronchial epithelium, metaplasia of the bronchial epithelium, metastasis