title: Haemoptysis as a prognostic factor in lung adenocarcinoma after curative resection.
abstract: BACKGROUND
  Haemoptysis is a common symptom of lung cancer. Its prognostic role and mechanisms are still poorly understood.
  
  
  METHODS
  We retrospectively reviewed 666 consecutive patients with primary lung adenocarcinoma who underwent complete resection. The prognostic value of haemoptysis with respect to overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS) was analysed. To further explore the possible mechanisms of haemoptysis, we evaluated vascular endothelial growth factor (VEGF) expression, tumour necrosis, vascular invasion and extratumoural microvessel density (MVD) in 112 randomly selected patients.
  
  
  RESULTS
  Haemoptysis predicted poor OS, DSS and DFS in operable lung adenocarcinoma (all P<0.001). In addition, haemoptysis was associated with high white blood cell (WBC) count (P=0.032), high fibrinogen (Fib; P<0.001), high tumour greatest dimension (P<0.001), severe vascular invasion (P=0.002) and central tumour location (P<0.001). We obtained no statistically significant differences of VEGF expression, tumour necrosis and extratumoural MVD in haemoptysis and non-haemoptysis groups.
  
  
  CONCLUSIONS
  Our study demonstrates that haemoptysis predicts poor OS, DSS and DFS in lung adenocarcinoma after curative resection. Vascular invasion rather than angiogenesis or tumour necrosis could be the most important mechanism of haemoptysis in lung adenocarcinoma.
authors: Institute of Oncology, Provincial Hospital Affiliated to Shandong University, Shandong University, 324 Jingwu Road, Jinan 250021, People's Republic of China.
authors: P
authors: P
authors: Hu
authors: G
authors: G
authors: Wang
authors: H
authors: H
authors: Cao
authors: H
authors: H
authors: Ma
authors: P
authors: P
authors: Sui
authors: J
authors: J
authors: Du
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006469:Hemoptysis / Q000175:diagnosis*; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
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