Can the Risk of the N Diseases Development be Related to the Degree of Differentiation of Tumor Cells and the Presence of Peritumoral Lymphocytic Infiltration in the Non-Small Cell Lung Cancer

Introduction: Lung cancer is a significant health problem with more than 170,000 new cases diagnosed annually in the United States. The most important factor in the survival of a patient with non-small cell lung cancer is the condition of the mediastinal lymph nodes. The influence of a number of factors on the occurrence of N1 and N2 metastases was investigated, the most common being lung cancer, tumor size and the degree of differentiation of malignancy.

Patients and Methods: The study included a sample of 331 patients, of all ages, both genders, with complete resection of proven lung cancer. Surgery was performed under separated general anesthesia, with prior zonal exploration of mediastinal lymphonodes and / or thoracoscopic exploration of the pleural cavum. The peritumoral compartment in which lymphocytic infiltration was sought was defined as the area around the intratumoral compartment that includes the edge of the tumor and a width of 1 mm beyond it4.

Results: In our sample the most common type of lung cancer was adenocarcinoma, with PTLI being more than 69% of cases. The calculated relative risk of nodal metastases with the presence of PTLI is 35.5. Therefore, there is a 35.5 times higher risk of developing N disease when there is PTLI rather than when there is none.

Discussion: PTLI was present in 86 (37.55%) patients with N0 descriptor, 128 (55.89%) patients with N1 descriptor and 15 (6.55%) patients with N2 descriptor. In retrospective presentation of surgical treatment of primary lung cancer by Bačić and authors, a sample of 146 resectates, NO disease was detected in 64.6% of cases, N1 in 21.0% and N2 in 14.4% of resectors7.

Findings: In the treated sample, the most common type of lung cancer was adenocarcinoma, with PTLI present in more than 69% of cases. It has been shown that there is a 35.5-fold higher risk of developing N disease when there is PTLI than when there is no PTLI.

Keywords: lung cancer, surgery, metastases, complications, lymph nodes, prognosis.