RESUMO
Purpose. The objective of this study is to describe the anatomic location of the sentinel lymph node (SLN) of patients with lung carcinoma and to analyze its relationship with the characteristics of the tumor. Patients and methods. 98 Stage I lung cancer patients were included in the study. SLN was marked just after performing the thoracotomy by injecting peritumorally 0.25 mCi of nanocolloid of albumin (Nanocol1) labeled with Tc-99 m in 0.3 ml, and later, it was resected. For SLN micrometastasis analysis, CEACAM5, BPIFA1, and CK7 gene expression at mRNA level was studied. Possible relation between tumor characteristics and SLN location was analyzed. Results. While most of the SLN were located in hilar area, we find a significantly higher number of SLN located in mediastinal stations when the lesion is in the left upper lobe (LUL). This difference disappears in the group of SLN with a positive result in the micrometastasis study. Regarding tumor size, squamous tumors and tumors located in the left lower lobe (LLL) were found significantly larger. Conclusion. The location of the SLN in patients with stage I lung cancer is predominantly hilar, being less consistent in the left hemithorax. The tumor size or histological type is not variables that affect this distribution. The distribution of SLNs with a positive result in the analysis of micrometastasis suggests further spread to the hilar areas when the lesion is in the LUL and to the mediastinal zones when it is in the LLL (AU)
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Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares , Biópsia de Linfonodo Sentinela/tendências , Toracotomia/métodos , Topografia Médica/métodos , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Micrometástase de Neoplasia/diagnósticoRESUMO
La existencia de metástasis endotraqueales (ME) de carcinomas de origen no pulmonar es rara. Las manifestaciones clínicas más comunes son hemoptisis, tos y disnea, aunque no es raro encontrarlas como hallazgo casual en el curso de una broncoscopia. Las neoplasias que con mayor frecuencia se asocian a estas lesiones metastásicas son las derivadas de mama, colon y riñón. Su hallazgo supone un estado avanzado de la enfermedad, aunque la supervivencia está en función del tipo de tumor primario, la existencia de lesiones concomitantes y las características del paciente. Por lo tanto el tratamiento debe individualizarse. En el caso de las ME de carcinoma colorrectal (CCR) recomendamos la realización de una broncoscopia preopcratoria pues es posible encontrar lesiones en el árbol traqueobronquial que influyan en el pronóstico y tratamiento de la enfermedad (AU)
Existence of endotracheal metastases (EM) of non-pulmonary origin cancer is rare. The most common clinical manifestations are hemoptysis, cough and dyspnea, although it is not rare to find it as a casual finding during a bronchoscope examination. The neoplasms that are most frequently associated to these lesions are those derived from the breast, colon and kidney. When they are found, it means that there is an advanced stage of the disease, although survival is based on the type of primary tumor, existence of common commitment lesions and the characteristics of the patient. Thus, the treatment should be individualized. In the case of colorectal carcinoma (CRC) EM, we recommend performing a pre-operative bronchoscopy since lesions that influence the prognoses and treatment of the disease may be found in the trachea and bronchial tree (AU)
