Original Paper

Medical Molecular Morphology

, Volume 42, Issue 3, pp 162-166

First online:

Morphometric analysis of regional lymph nodes in surgically resected non-small cell lung cancer

  • Hajimu GotohAffiliated withSurgical Pathology Division, Kobe University HospitalDepartment of Radiology, Kobe University Graduate School of Medicine
  • , Naoki KanomataAffiliated withSurgical Pathology Division, Kobe University HospitalDepartment of Pathology, Kawasaki Medical School Email author 
  • , Masahiro YoshimuraAffiliated withDepartment of Cardiovascular, Thoracic and Pediatric Surgery, Kobe University Graduate School of Medicine
  • , Yoshiharu OhnoAffiliated withDepartment of Radiology, Kobe University Graduate School of Medicine
  • , Takuya MoriyaAffiliated withDepartment of Pathology, Kawasaki Medical School
  • , Chiho OhbayashiAffiliated withSurgical Pathology Division, Kobe University Hospital

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Abstract

Nodal staging is a crucial factor in choosing the treatment option for non-small cell lung cancer (NSCLC). However, so far as we know, a computer-based histomorphometric analysis of lymph nodes in NSCLC has never been developed. We studied 299 surgically resected lymph nodes from 108 patients with NSCLC. Microscopic digital images were analyzed with Scion Image software. Seventy lymph nodes had at least one metastatic focus. The metastasis occupancy area per node ranged from 0.01 to 209.58 mm2 (mean, 29.58 ± 5.87 mm2). The metastasis occupancy ratio ranged from 0.01% to 100% (mean, 48.70% ± 42.10%). The short-axis diameter of malignant lymph nodes was significantly longer than that of benign lymph nodes (P = 0.0002). The average metastasis occupancy area in the regional lymph nodes of NSCLC is quite small. Various inflammatory conditions can result in a false-positive diagnosis when these techniques are used. Studies that combine analysis of primary tumor size and serum carcinoembryonic antigen (CEA) levels with imaging methods should be considered. Finally, the use of mediastinoscopy or video-assisted thoracoscopic surgery is encouraged in determining the exact nodal status in NSCLC.

Key words

Morphometry Histomorphometry Non-small cell lung cancer Lymph node Staging NIH image Scion image Tumor occupancy area