title: Lung excision of non-small-cell lung cancer leaves cancer cells in residual lobe: cytological detection using pulmonary vein blood.
abstract: OBJECTIVE
  Lung excision to treat non-small-cell lung cancer (NSCLC) is associated with a worse prognosis when compared with a lobectomy. Cancer relapse may be caused by tumour cells remaining in the residual lobe, the possibility of dislodged cancer cells in the residual lobe is assessed using pulmonary vein blood (PVB) from the resected lung.
  
  
  METHODS
  Twenty-eight patients with pathological stage I NSCLC who underwent lung excision followed by a lobectomy were evaluated according to the status of isolated tumour cells (ITCs) (origin of circulating tumour cells) in PVB from the resected lobe. Survival was also assessed according to the status of ITCs.
  
  
  RESULTS
  The rate of ITC presence was 60.7% and depended on margin distance/tumour size (M/T) with a threshold of 1.0-30.8% (4/13) in M/T greater than or equal to 1.0 and 86.7% (13/15) in M/T smaller than 1.0 (P = 0.001). PVB-ITC status was no ITCs (N) in 11 (39.3%), only singular cells (S) in 13 (50.0%) and clustered cells (C) in 4 (14.3%). In addition, the survival status of patients with clustered cells was exclusively wrong.
  
  
  CONCLUSIONS
  After pulmonary excision for lung cancer, tumour cells remain in the residual lobe and the morphology of which may indicate recurrence.
authors.affiliation: Japan Community Healthcare Organization, Hoshigaoka Medical Center, Hirakata, Japan Division of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan nsawabata@hotmail.com nsawabata@hoshigaoka-hp.com.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.affiliation: Division of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Funaki
authors.affiliation: Division of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.affiliation: Division of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Meinosin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D008297:Male; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011013:Pneumonectomy / Q000009:adverse effects*; D011667:Pulmonary Veins / Q000473:pathology*
keywords: Circulating tumour cell; Lung excision; Non-small-cell lung cancer; Pulmonary vein blood