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A small subset of carcinomas of various origins are associated with high numbers of tumor-infiltrating neutrophils (TINs). Here, we examined the characteristics of non-small-cell pulmonary carcinomas with high numbers of TINs, and their relationship with lymph node (LN) metastasis. The study included 100 patients diagnosed and treated for primary pulmonary carcinoma at Showa University Northern Yokohama Hospital from 2011 to 2012. We histopathologically de ned tumors with > 10 neutrophils per high-power eld as neutrophilrich. Among the 100 patients, 40 were classed as having neutrophilrich pulmonary cancer (NRPC), and tissue samples from these patients were prepared for further examination. Comparison of the clinicopathological factors (age, gender, tumor size, histological type, and grade) in NRPC cases with or without LN metastasis showed that none of the above factors was signi cantly correlated with LN metastasis. Immunohistochemical analysis of two cytokines that play a major role in granulopoiesis, granulocyte-colony stimulating factor (G-CSF) and macrophage-CSF (M-CSF), revealed that the expression of M-CSF, but not G-CSF, was signi cantly correlated with LN metastasis. Furthermore, coexpression of M-CSF and the M-CSF receptor was signi cantly correlated with LN metastasis, but coexpression of G-CSF and the G-CSF receptor did not show such a correlation. These ndings indicate that M-CSF-producing NRPCs show a signi cantly high lymph node metastasis potential.

Neutrophil-rich Pulmonary Carcinoma: Clinicopathological Characteristics and Cytokine Expression and Their Relationship with Lymph Node Metastasis