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Year : 2021  |  Volume : 11  |  Issue : 2  |  Page : 95-99

Biomarker potential of preoperative tumor size in determination of the lymphovascular invasion in squamous cell lung cancer and lung adenocarcinoma

1 Clinical Center University of Sarajevo, Clinic for Thoracic Surgery, Sarajevo, Bosnia and Herzegovina
2 Department of Internal Medicine, Division of Pulmonary Diseases, General Hospital “Prim. Dr. Abdulah Nakas,” Sarajevo, Bosnia and Herzegovina
3 Department of Human Physiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
4 Clinical Center University of Sarajevo, Urology Clinic, Sarajevo, Bosnia and Herzegovina
5 Department of Cardiology, General Hospital “Prim.Dr. Abdulah Nakas”; Department of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
6 Department of Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

Correspondence Address:
Edin Begic
Department of Cardiology, General Hospital “Prim.Dr. Abdulah Nakas”, Sarajevo 71000
Bosnia and Herzegovina
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijabmr.IJABMR_500_20

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Introduction: The invasion of blood and lymph vessels with tumor tissue represents a negative prognostic factor of the disease course in patients with non-small cell lung cancer. Aim: The aim of the study was to determine the marker value of a preoperatively determined size of pulmonary squamous cell carcinoma and adenocarcinoma and its impact on lymphovascular invasion (LVI) in resected lung tissue. Materials and Methods: The conducted observational cross-sectional study included 322 patients with a complete resection of confirmed squamous cell lung carcinoma and lung adenocarcinoma. Preoperative size and type of tumor were determined by a preoperative chest computed tomography scan and cytological/histological analysis of obtained samples, while LVI status was determined by pathohistological analysis of resected tumor lung tissue. Receiver operating characteristic (ROC) curve analysis was performed to assess whether tumor size could serve as a reliable marker for LVI. P < 0.05 was considered statically significant. Results: A statistically significant difference in the frequency of tumor size (P = 0.580) along with LVI (P = 0.656) was not established between the patients with squamous cell lung cancer and lung adenocarcinoma. A ratio between the size of lung adenocarcinoma and LVI status (P < 0.001) was determined as statistically significant, while such a difference was not established in squamous cell lung cancer (P = 0.052). The ROC analysis revealed that tumor size >39 mm in patients with lung adenocarcinoma has obtained a sensitivity of 70.8% and a specificity of 60.9% to differentiate patients with a LVI (areas under the curve [AUC] = 0.70; 95% CI 0.60‒0.79; P < 0.001). A tumor size >4.6 cm in patients with squamous cell lung cancer obtained a sensitivity of 56.5% and a specificity of 60.3% to differentiate patients with a LVI (AUC = 0.59; 95% CI 0.50‒0.67; P = 0.043). Conclusion: The preoperative size of lung adenocarcinoma could be an acceptable marker of LVI presence in resected lung tissue, while in the squamous cell lung cancer, a potential biomarker role of the preoperative size of the tumor was inadequate.

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