Correlation between CXCR4, CXCR5 and CCR7 expression and survival outcomes in patients with clinical T1N0M0 non-small cell lung cancer

BACKGROUND

Lung cancer is the leading cause of cancer-related death. Even if early detection and treatment have proven to be effective, the survival outcomes are still poor.

METHODS

Tissue samples and clinicopathological data of 244 patients with clinical T1N0M0 NSCLC were collected. We investigated CXCR4, CXCR5 and CCR7 expression levels using the immunohistochemical method and analyzed their correlations with clinicopathological characteristics and survival outcomes.

RESULTS

Elevated expression levels of CXCR4, CXCR5 and CCR7 were found in tumor tissues (P < 0.001). The expression levels were remarkably different in histological type (CXCR4, P = 0.032; CXCR5, P < 0.001; CCR7, P < 0.001) and LVI (CXCR4, P = 0.017; CXCR5, P = 0.030; CCR7, P < 0.001). In addition, CXCR4 and CXCR5 expression were significantly different in tumor differentiation (CXCR4, P < 0.001; CXCR5, P < 0.001). Survival analysis showed that patients with positive CXCR4 expression had a significantly lower five-year DFS (P = 0.007) and a lower five-year OS (P = 0.010). Patients in the CXCR5 positive group had a significantly lower five-year DFS (P = 0.038) and a lower five-year OS (P = 0.220), which were statistically insignificant. However, five-year DFS and five-year OS of patients with positive CCR7 expression were significantly higher (DFS: P < 0.001; OS: P < 0.001). CXCR5 and CCR7 expression were found to be independent prognostic factors through multivariate analysis.

CONCLUSIONS

Expression levels of CXCR4, CXCR5 and CCR7 were significantly higher in tumor tissues, and expression of CXCR5 and CCR7 were independent prognostic factors for survival. Moreover, all three chemokines were correlated to the survival outcomes of patients with clinical T1N0M0 NSCLC, providing potential prognosticators and therapy targets for lung cancer treatment.

[Correlation factors of lymph node metastasis in patients with clinical stage T1a non-small cell lung cancer]

OBJECTIVE

To explore the relationship between the lymph node metastasis and clinicopathological features in patients with clinical stage T1a non-small cell lung cancer (NSCLC).

METHODS

Clinicopathological data of a total of 418 patients who underwent lobectomy and systematic lymph node dissection were retrospectively analyzed. Logistic regression was used to analyze the relationship between lymph node metastasis and clinicopathological features.

RESULTS

Lymph node metastasis was observed in 25 patients. There were 122 patients who were diagnosed as ground glass opacity with no lymph node metastasis. 399 patients had subcarinal dissection, among them 7 patients were found to have lymph node metastasis. Univariate analysis showed that gender, smoking history, diameter of lymph node, ground glass opacity (GGO), differentiation of the tumor and tumor site were the factors affecting lymph node metastasis (all P < 0.05). Logistic regression analysis showed that diameter of lymph node, differentiation of the tumor and the site of lesion were independent risk factors for lymph node metastasis of NSCLC.

CONCLUSIONS

Tumor in the left lung, poor differentiation, and diameter of lymph nodes ≥ 1 cm on the preoperative CT image are independent risk factors for lymph node metastasis of NSCLC, hence we should pay attention before surgery and systematic lymph node dissection should be done. For patients with poor differentiation and lymph nodes ≥ 1 cm, subcarinal lymph nodes dissection is recommended for the sake of higher possibility of lymph node metastasis. For patients with ground glass opacity ≤ 2 cm, the lymph node metastasis is extremely rare, therefore, selective lymph node dissection is reconmmended.