Frontiers in Oncology (Nov 2021)

Premalignant Changes in the Bronchial Epithelium Are Prognostic Factors of Distant Metastasis in Non-Small Cell Lung Cancer Patients

  • Olga V. Pankova,
  • Liubov A. Tashireva,
  • Evgeny O. Rodionov,
  • Sergey V. Miller,
  • Sergey A. Tuzikov,
  • Dmitry S. Pismenny,
  • Tatiana S. Gerashchenko,
  • Marina V. Zavyalova,
  • Marina V. Zavyalova,
  • Sergey V. Vtorushin,
  • Sergey V. Vtorushin,
  • Evgeny V. Denisov,
  • Evgeny V. Denisov,
  • Vladimir M. Perelmuter

DOI
https://doi.org/10.3389/fonc.2021.771802
Journal volume & issue
Vol. 11

Abstract

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BackgroundThe study assessed the possibility of dividing patients into groups based on the assessment of morphological changes in the epithelium of small-caliber bronchi located near the primary tumor in order to predict high and low risks of distant metastasis of non-small cell lung cancer.MethodsIn 171 patients with non-small cell lung cancer (T1-4N0-3M0) in small-caliber bronchi taken at a distance of 3–5 cm from the tumor, various variants of morphological changes in the bronchial epithelium (basal cell hyperplasia (BCH), squamous cell metaplasia (SM), and dysplasia (D)) were assessed. Long-term results of treatment, namely, distant metastasis, were assessed after 2 and 5 years.ResultsDuring the follow-up period, distant metastases were found in 35.1% (60/171) of patients. Most often, they were observed in patients of the high-risk group: BCH+SM−D− (51.6%, 40/95) and BCH−SM+D+ (54.4%, 6/11). Less often, distant metastases were observed in low-risk group patients: BCH+SM+D− (6.7%, 3/45) and BCH−SM−D− (10.0%, 2/20). Tumor size, grade, and stage were significant predictors of metastasis only in the high-risk group. The 5-year metastasis-free survival was better in the low-risk group of distant metastases.ConclusionsIsolated BCH or dysplasia in small bronchi distant from foci of tumor is associated with a high-risk distant metastasis and less 5-year metastasis-free survival.

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