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Review paper

Preoperative tumour size as a predictor of the presence of lymphovascular invasion in lung adenocarcinoma

By
Kemal Grbić Orcid logo ,
Kemal Grbić
Contact Kemal Grbić

Clinic of Thoracic Surgery, Clinical Centre University of Sarajevo , Sarajevo, Bosnia and Herzegovina

Bakir Mehić ,
Bakir Mehić

Clinic for Lung Disease, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina

Dalma Udovičić-Gagula ,
Dalma Udovičić-Gagula

Department of Pathology, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina

Amina Valjevac ,
Amina Valjevac

Department of Human Physiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Adem Ćemerlić ,
Adem Ćemerlić

School of medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Ferid Krupić
Ferid Krupić

Department of Anaesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

Abstract

Aim
To examine whether preoperative tumour size may serve as a biomarker for the occurrence of lymphovascular invasion (LVI) in centrally and peripherally located lung adenocarcinoma.
Method
The study included 261 patients surgically treated for diagnosed lung adenocarcinoma. A ROC curve was used to determine the biomarker potential of tumour size relative to the occurrence of LVI. Binary logistic regression was used to show changes of tumour size impact on the status of LVI.
Result
Tumour prevalence according to localization had no statistical significance (p=0.464), while the presence of LVI in central, as well as peripheral positions, was statistically significantly different (p<0.001). The area under the curve of 0.978 highlights the fact that tumour size is an excellent marker of the presence of LVI in centrally located adenocarcinomas of the lung. A similar finding was confirmed in peripherally located lung adenocarcinomas with an area below the curve of 0.943. Binary logistical regression showed that in centrally localized adenocarcinomas of the lung, each additional centimetre of tumour growth represents an increase in the likelihood of LVI+ by 17.14 times. In peripherally located adenocarcinomas of the lung, this increase in likelihood of LVI for each centimetre of growth was 5.46 times.
Conclusion
With a high degree of sensitivity and specificity, preoperative tumour size may serve as an important biomarker and positive predictor of the presence of LVI in lung adenocarcinoma of any location.

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