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P1.02 - Biology/Pathology (ID 614)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
P1.02-017 - Freely Floating Cancer Cells in Lymph Node Sinuses of Hilar Lymph Node Positive Lung Cancer Patients (ID 7475)
09:30 - 16:00 | Author(s): S. Hiraiwa
Previous studies demonstrated that freely floating cancer cells (FFCCs) in the lymph node sinuses were of prognostic significance for colorectal and gastric cancers. The goal of the study is to assess the clinical significance of detecting FFCCs using Fast Red staining for cytokeratin in both stage I/II lung cancer patients and hilar lymph node positive lung cancer patients who underwent curative resection.
Between 2002 and 2011, a total of 167 patients ( including 23 hilar lymph node positive patients) were enrolled. Resected lymph nodes were stained for cytokeratin in order to achieve a clear distinction from coal dust. An anti-cytokeratin antibody was labeled with a secondary antibody conjugated with alkaline phosphatase, which was detected by a reaction with Fast Red/naphthol that produced a red color. Patients were considered to be positive for FFCCs (FFCC+) if more than one freely floating cytokeratin-positive cell was detected in the lymph node sinuses.
Among all 167 patients, a significant difference was observed in Five-year relapse-free survival rates (5Y-RFS), with 75.9% and 31.6% being achieved by FFCC- and FFCC+ patients, respectively (P<0.001). Similarly, the 5-year overall survival rate (5Y-OS) was significantly lower in FFCC+ patients, with 85.4% being achieved by FFCC- and 62.3% by FFCC+ patients, respectively (P=0.007). Among 23 hilar lymph node positive patients, a significant difference was also observed in 5Y-RFS, with 50.0% and 0.0% being achieved by FFCC- and FFCC+ patients, respectively (P=0.013). The 5Y-OS tended to be lower in FFCC+ patients, with 64.3% being achieved by FFCC- and 53.3% by FFCC+ patients, respectively (P=0.595).
The presence of FFCCs in stage I/II lung cancer patients was associated with a poor prognosis. In addition, FFCCs in hilar lymph node positive patients also have potential as a useful marker foreseeing the recurrence.