title: Increase in preoperative serum reactive oxygen metabolite levels indicates nodal extension in patients with clinical stage I lung adenocarcinoma.
abstract: OBJECTIVE
  Reactive oxygen species contribute to various features of malignant tumors, including carcinogenesis, aberrant growth, metastasis, and angiogenesis. Investigation of serum oxidative stress levels may predict the tumor's condition, including malignant and metastatic potential.
  
  
  METHODS
  We recruited 46 patients (27 men, 19 women; median age 70 years) with clinical stage I lung adenocarcinoma who had undergone pulmonary resection with mediastinal lymph node dissection. Preoperative serum reactive oxygen metabolite (ROM) levels were measured as an indicator of oxidative stress.
  
  
  RESULTS
  The serum ROM level was significantly correlated with the increase in tumor size (P = 0.018) and pathological nodal extension (P = 0.005). Multivariate analysis revealed that pathological nodal extension was significantly correlated with the increase in serum ROM level (P = 0.027). The prognostic cutoff value was determined according to receiver operating characteristic curve analysis for patients with and those without nodal extension; the cutoff value was determined to be 318 Carratelli units (U.CARR).
  
  
  CONCLUSIONS
  The findings of our study revealed that patients with clinical stage I lung adenocarcinoma and a serum ROM level above 318 U.CARR were likely to develop nodal extension. The finding of a significant correlation between serum ROM level and nodal extension may help in the development of new treatment strategies.
authors.affiliation: Department of Thoracic Surgery, Osaka City University Medical School Hospital, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. t-tsukioka@med.osaka-cu.ac.jp
authors.forename: Takuma
authors.initials: T
authors.lastname: Tsukioka
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Nishiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Koshi
authors.initials: K
authors.lastname: Nagano
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Mizuguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Tei
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Suehiro
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000556:secondary / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D018384:Oxidative Stress; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012372:ROC Curve; D017382:Reactive Oxygen Species / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D017382:Reactive Oxygen Species