Abstract：
Lung cancer is the most frequent cause of cancer-related death worldwide. The patient’s outcome depends on tumor size, lymph node involvement and metastatic spread at the time of diagnosis. The prognostic value of lymph and blood vessel invasion, however, is still insufficiently investigated. We retrospectively examined the invasion of lymph vessels and blood vessels separately as two possible prognostic factors in 160 patients who underwent a video-assisted thoracoscopic lobectomy for non-small-cell lung cancer at our institution between 2014 and 2019. Lymph vessel invasion was significantly associated with the UICC stage, lymph node involvement, tumor dedifferentiation, blood vessel invasion and recurrence. Blood vessel invasion tended to be negative prognostic, but missed the level of significance (p = 0.108). Lymph vessel invasion, on the other hand, proved to be a prognostic factor for both histological subtypes, adenocarcinoma (p < 0.001) as well as squamous cell carcinoma (p = 0.018). After multivariate analysis apart from the UICC stage, only lymph vessel invasion remained independently prognostic (p = 0.018). Remarkably, we found analogue survival curve progressions of patients with stage I, with lymph vessel invasion, compared to stage II non-small-cell lung cancer. After further validation in prospective studies, lymph vessel invasion might be considered as an upstaging factor in resectable lung cancer. Especially in the early-stage of the disease, it might represent an additional risk factor to consider adjuvant therapy after surgical resection.
摘要：
肺癌是全球癌症相关死亡的最常见原因。患者的预后取决于肿瘤的大小,诊断时淋巴结受累和转移扩散。淋巴和血管浸润的预后价值，然而,仍然没有得到充分的调查。我们回顾性研究了2014年至2019年在我们机构接受电视胸腔镜肺叶切除术治疗非小细胞肺癌的160例患者中，淋巴管和血管的浸润分别作为两个可能的预后因素。淋巴管侵入与UICC分期显著相关，淋巴结受累,肿瘤去分化,血管侵犯和复发。血管浸润倾向于阴性预后，但错过了显著性水平(p=0.108)。淋巴管侵入,另一方面,被证明是两种组织学亚型的预后因素，腺癌（p<0.001）以及鳞状细胞癌（p=0.018）。在除了UICC阶段之外的多变量分析之后，只有淋巴管浸润保持独立预后(p=0.018).值得注意的是,我们发现I期患者的模拟生存曲线进展，淋巴管浸润，与II期非小细胞肺癌相比。经过前瞻性研究的进一步验证，淋巴管浸润可能被认为是可切除肺癌的升级因素。特别是在疾病的早期，手术切除后考虑辅助治疗可能是另一个危险因素.
