RESUMO
Objective: The aim of this study was to elucidate the impact of pleural lavage cytology positivity on early recurrence in patients operated on non-small cell lung cancer (NSCLC). Methods: This is a multicentre prospective cohort study of 684 patients undergoing an anatomical lung resection for NSCLC between October 2015 and October 2017 at 12 national centres. A pleural lavage was performed before and after lung resection. The association between the different predictors of early recurrence and PLC positivity was performed using univariate and multivariate logistic regression models. A propensity score analysis was performed by inverse probability weighting (IPSW) using average treatment effect (ATE) estimation to analyse the impact of PLC positivity on early recurrence. Results: Overall PLC positivity was observed in 15 patients (2.2%). After two years, 193 patients (28.2%) relapsed, 182 (27.2%) with a negative PLC and 11 (73.3%) with a positive PLC (p<0.001). Factors associated to early recurrence were adenocarcinoma histology (OR=1.59, 95%CI 1.062.38, p=0.025), visceral pleural invasion (OR=1.59, 95%CI 1.042.4, p=0.03), lymph node involvement (OR=1.84, 95%CI 1.142.96, p=0.013), advanced pathological stage (OR=2.12, 95%CI 1.273.54, p=0.004) and PLC positivity (OR=4.14, 95%CI 1.2516.36, p=0.028). After IPSW, PLC positivity was associated with an increased risk of early recurrence (OR=3.46, 95%CI 2.255.36, p<0.001). Conclusions: Positive pleural lavage cytology was found to be the strongest predictor of early recurrence.(AU)
Assuntos
Humanos , Masculino , Feminino , Pulmão/cirurgia , Estadiamento de Neoplasias , Prognóstico , Cirurgia Torácica , Biologia Celular , Carcinoma Pulmonar de Células não Pequenas , Estudos Prospectivos , Estudos de Coortes , Doenças Respiratórias , Pneumopatias , Recidiva , Neoplasias Pulmonares/cirurgiaRESUMO
OBJECTIVE: The aim of this study was to elucidate the impact of pleural lavage cytology positivity on early recurrence in patients operated on non-small cell lung cancer (NSCLC). METHODS: This is a multicentre prospective cohort study of 684 patients undergoing an anatomical lung resection for NSCLC between October 2015 and October 2017 at 12 national centres. A pleural lavage was performed before and after lung resection. The association between the different predictors of early recurrence and PLC positivity was performed using univariate and multivariate logistic regression models. A propensity score analysis was performed by inverse probability weighting (IPSW) using average treatment effect (ATE) estimation to analyse the impact of PLC positivity on early recurrence. RESULTS: Overall PLC positivity was observed in 15 patients (2.2%). After two years, 193 patients (28.2%) relapsed, 182 (27.2%) with a negative PLC and 11 (73.3%) with a positive PLC (p<0.001). Factors associated to early recurrence were adenocarcinoma histology (OR=1.59, 95%CI 1.06-2.38, p=0.025), visceral pleural invasion (OR=1.59, 95%CI 1.04-2.4, p=0.03), lymph node involvement (OR=1.84, 95%CI 1.14-2.96, p=0.013), advanced pathological stage (OR=2.12, 95%CI 1.27-3.54, p=0.004) and PLC positivity (OR=4.14, 95%CI 1.25-16.36, p=0.028). After IPSW, PLC positivity was associated with an increased risk of early recurrence (OR=3.46, 95%CI 2.25-5.36, p<0.001). CONCLUSIONS: Positive pleural lavage cytology was found to be the strongest predictor of early recurrence.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/patologia , Estudos Prospectivos , Irrigação Terapêutica , Citologia , Estadiamento de Neoplasias , Doença Crônica , Recidiva Local de Neoplasia/epidemiologia , PrognósticoRESUMO
Presentamos el caso de una mujer con un síndrome de Sjögren diagnosticada, por estudio de sangre periférica y de la médula ósea, de «Linfoma de zona marginal, compatible con linfoma esplénico de linfocitos vellosos» a la que se practicó esplenectomía. El estudio posterior anatomopatológico del bazo confirmó la presencia de un linfoma esplénico de zona marginal de bajo grado, pero además existía otro linfoma difuso de células grandes, de fenotipo B, de alto grado de malignidad, sincrónico con el anterior y que los estudios previos hematológicos no habían detectado. Esta asociación es muy poco frecuente. Este caso demuestra la necesidad de la integración de los datos clínicos, patológicos y moleculares para llegar al diagnóstico correcto
We report a case of a marginal zone lymphoma consistent with an splenic lymphoma of hairy lymphocytes diagnosed in peripheral blood and bone marrow in a 69-years old female with a Sjögren syndrome. Splenectomy was indicated.. A later microscopic examination of spleen confirmed the presence of a low grade splenic lymphoma. However, another large cell diffuse lymphoma of phenotype B of high grade of malignancy, synchronic with the former was found. Previous hematologic studies had not detected it. This case shows the necessity of integrate clinical, pathologic and molecular biology information to get a correct diagnosis
Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Esplenectomia/métodos , Biomarcadores , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/patologia , Estadiamento de Neoplasias/métodos , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Tomografia Computadorizada de Emissão/métodos , Diagnóstico Diferencial , Técnicas de Diagnóstico do Sistema Digestório/tendências , Técnicas de Laboratório Clínico/tendências , Técnicas de Laboratório Clínico , Baço/patologia , Baço/cirurgia , BaçoRESUMO
Presentamos el caso de una mujer con un síndrome de Sjögren diagnosticada, por estudiode sangre periférica y de la médula ósea, de «Linfoma de zona marginal, compatible con linfomaesplénico de linfocitos vellosos» a la que se practicó esplenectomía.El estudio posterior anatomopatológico del bazo confirmó la presencia de un linfoma esplénicode zona marginal de bajo grado, pero además existía otro linfoma difuso de células grandes,de fenotipo B, de alto grado de malignidad, sincrónico con el anterior y que los estudios previoshematológicos no habían detectado. Esta asociación es muy poco frecuente.Este caso demuestra la necesidad de la integración de los datos clínicos, patológicos y molecularespara llegar al diagnóstico correcto
We report a case of a marginal zone lymphoma consistent with an splenic lymphoma of hairylymphocytes diagnosed in peripheral blood and bone marrow in a 69-years old female with a Sjögrensyndrome. Splenectomy was indicated..A later microscopic examination of spleen confirmed the presence of a low grade spleniclymphoma. However, another large cell diffuse lymphoma of phenotype B of high grade of malignancy,synchronic with the former was found. Previous hematologic studies had not detected it.This case shows the necessity of integrate clinical, pathologic and molecular biology informationto get a correct diagnosis
Assuntos
Feminino , Idoso , Humanos , Neoplasias Esplênicas/patologia , Neoplasias Primárias Múltiplas/patologia , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/patologiaRESUMO
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