title: Correlation between lymph node micrometastasis and histologic classification of small lung adenocarcinomas, in considering the indication of limited surgery.
abstract: The validity of limited surgery for lung carcinomas have not been clearly established. Several reports suggest that not only tumor size but also the histological findings may be of importance in this role. By conducting immunohistochemical examinations of lymph node micrometastases from small lung adenocarcinomas, we considered the suitability of limited surgery for especially localized bronchioloalveolar carcinoma (LBAC) without active fibroblastic proliferation (Noguchi's histologic classification types A and B). In this study, we enrolled 54 patients with lung adenocarcinoma smaller than 2 cm in diameter. Lymph node involvement was demonstrated in 11 (20.4%) patients. Lymph node micrometastasis was present in 11 (25.6%) of the 43 patients at pN0 disease. However, 13 patients with LBAC without active fibroblastic proliferation (types A and B) had neither lymph node involvement nor micrometastasis. Our results indicate that limited pulmonary resection may be acceptable procedure for LBAC without active fibroblastic proliferation.
authors.affiliation: Division of General Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-Higashi, Kanazawa-ku, Yokohama 236-0051, Japan. ishiwa@mtg.biglobe.ne.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiwa
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ogawa
authors.forename: Akira
authors.initials: A
authors.lastname: Shoji
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Maehara
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takanashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Yazawa
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology* / Q000601:surgery; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000145:classification / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000473:pathology; D002455:Cell Division; D005260:Female; D005347:Fibroblasts; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate