title: Significance of tumour vessel invasion in determining the morphology of isolated tumour cells in the pulmonary vein in non-small-cell lung cancer.
abstract: OBJECTIVE
  The existence of clustered isolated tumour cells (ITCs) in the pulmonary vein (PV) of the lungs of patients with lung cancer has been reported to be a prognostic factor. However, the clinical-pathological characteristics related to their presence in the PV remain unclear.
  
  
  METHODS
  We analysed the surgical results and clinical-pathological findings of 130 patients who underwent surgery for non-small-cell lung cancer in regard to blood vessel invasion (BVI), serum carcinoembryonic antigen (CEA) level, maximum standardized uptake value (SUV-max), size of the solid region in computed tomography findings and pathological stage according to an ITC type, i.e. no tumour (N), singular tumour cells (S) and clustered tumour cells (C).
  
  
  RESULTS
  ITCs were detected in 96 (74%) of the patients, with C observed in 43, S in 53 and N in 34. Recurrence was seen in 33 (26%) cases, 21 of which were classified as C, 9 as S and 3 as N. The disease-free survival rate was significantly worse in C cases when compared with the others (P < 0.01). The rate of C was high in cases with high serum CEA, advanced p-staging and positive BVI ratio. Furthermore, BVI positive and ITC morphology were strongly related (BVI positive; 79 in C, 40 in S, 9% in N; P < 0.01).
  
  
  CONCLUSIONS
  Clustered ITCs were shown to be a prognostic indicator and strongly related to BVI. Our results suggest that determination of BVI has prognostic value, as clustered ITCs with metastatic potential are disseminated from the invaded vein.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. soo1@hotmail.co.jp
authors.forename: Soichiro
authors.initials: S
authors.lastname: Funaki
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Abulimiti
authors.initials: A
authors.lastname: Abulaiti
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakagiri
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Minami
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000097:blood / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000473:pathology; D011667:Pulmonary Veins / Q000473:pathology*
keywords: Blood vessel invasion; Isolated tumour cells; Non-small-cell lung cancer; Recurrence; Surgery