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Vol. 38. Issue 2.
Pages 80-86 (March - April 2019)
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Vol. 38. Issue 2.
Pages 80-86 (March - April 2019)
Original Article
Tumor characteristics of lung cancer in predicting axillary lymph node metastases
Características tumorales del cáncer de pulmón para predecir metástasis en los ganglios axilares
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Funda Üstüna,
Corresponding author
fundaustun@trakya.edu.tr

Corresponding author.
, Burcu Tokucb, Ebru Tastekinc, Gülay Durmuş Altuna
a Trakya University, Faculty of Medicine, Department of Nuclear Medicine, Edirne, Turkey
b Trakya University, Faculty of Medicine, Department of Public Health, Edirne, Turkey
c Trakya University, Faculty of Medicine, Department of Pathology, Edirne, Turkey
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Tables (3)
Table 1. Clinical and pathological features of 157 patients with and without axillary lymph node metastasis (ALM and control group).
Table 2. Localization of axillary lymph node metastases according to primary lung cancer site.
Table 3. Logistic regression analysis of clinical and pathologic factors with ALM.
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Abstract
Aim

In lung cancer, axillary lymph node metastases (ALM) are rare, and according to the 8th grading system, it is classified as M1b disease. The aim of this study is to evaluate (i) the presence of ALM, and (ii) the effect of the primary tumors characteristics on the development of ALM.

Methods

We performed a descriptive cross-sectional study, with retrospective revision, to identify ALM.

Results

There were 157 patients included in this analysis: ALM (63 patients) and control group (94 patients). The presence of extrathoracic lymph node, contralateral pulmonary parenchymal and distant metastasis and all SUVmax values were significantly higher in the study group versus the control group (p<0.05). The SUVmax value of the primary tumor was not a predictor of ALM. According to the primary histopathologic diagnosis, small cell lung cancer was found to cause ALM development 3.4 times as much as squamous cancer (SQC) (OR: 3.40 (95% CI 1.3–10.20), p=0.029) and adenocarcinoma group was found to cause ALM development 4 times as much as SQC (OR: 4.02 (95% CI 1.73–9.34), p=0.001). The likelihood of developing ALM was significantly higher in tumor located in the central and upper lobe versus the lower lobe.

Conclusion

The finding of ALM on PET/CT images, the necessity of histopathologic confirmation is determined according to the results of primary tumor localization, primary tumor histopathology, M stage on PET/CT imaging, localization of ALM according to primary tumor, and N stage on PET/CT imaging.

Keywords:
Axillary lymph node metastasis
18F-FDG
Lung cancer
PET/CT
Resumen
Objetivo

En el cáncer de pulmón, las metástasis en los ganglios axilares (ALM) son infrecuentes y, con arreglo a la 8ª edición sistema de estadificación, se clasifican como enfermedad metastásica M1b. El objetivo de este estudio es evaluar (i) la presencia de ALM, y (ii) el efecto de las características de los tumores primarios en el desarrollo de ALM.

Métodos

Realizamos un estudio transversal descriptivo, con revisión retrospectiva, para identificar las ALM.

Resultados

Incluimos en este análisis a 157 pacientes: ALM (63 pacientes) y grupo control (94 pacientes). La presencia de ganglios extratorácicos, metástasis contralaterales pulmonares parenquimatosas y distantes, y todos los valores SUVmax fueron significativamente más elevados en el grupo de estudio, en comparación con el grupo control (p<0,05). El valor SUVmax del tumor primario no fue un factor predictivo de ALM. Con arreglo al diagnóstico histopatológico primario, detectamos que el cáncer de pulmón de células pequeñas causaba el desarrollo de ALM en una proporción 3,4 mayor que el cáncer de células escamosas (CCE) (OR: 3,4 (95% IC 1,3–10,2), p=0,029), y que el grupo de adenocarcinoma causaba el desarrollo de ALM en proporción 4 veces superior que el CCE (OR: 4,02 (95% IC 1,73–9,34), p=0,001). La probabilidad de desarrollar ALM fue considerablemente superior en los tumores localizados en el lóbulo superior que en el lóbulo inferior.

Conclusión

Tras el hallazgo de ALM en las imágenes PET/TC, la necesidad de confirmación histopatológica viene determinada con arreglo a los resultados de la localización del tumor primario, la histopatología de éste, el estadio M en PET/TC, la localización de ALM con arreglo al tumor primario, y el estadio N en PET/TC.

Palabras clave:
Metástasis en los ganglios axilares
18F-FDG
Cáncer de pulmón
PET/TC

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