{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:56:57Z","timestamp":1774342617545,"version":"3.50.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Mol. Biosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>It remains controversial regarding the prognostic impact and therapeutic implications for immunotherapy of lymph node yield (LNY) during sublobar resection (SR) on stage I lung adenocarcinoma (LUAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed a retrospective cohort of 400 patients with stage I LUAD who underwent SR, with peripheral blood samples prospectively collected for detecting inflammatory cytokines (IFCs). The effect of different LNY (\u22654 vs. &amp;lt;4 nodes) on survival and IFC change was evaluated. Consensus clustering analyses were performed using data from The Cancer Genome Atlas (TCGA) and our validation cohort to explore associations between IFCs and immune\/cell death profiles. A Bayesian meta-analysis was further conducted to assess the impact of LNY in LUAD undergoing SR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The survival analysis of our cohort demonstrated that increased LNY during SR did not prolong RFS (\u22654 vs. &amp;lt;4 nodes: HR = 1.15; 95%CI: 0.76\u20131.74). A lower LNY during SR was associated with significantly better RFS in stage I LUAD receiving adjuvant immunochemotherapy (\u22654 vs. &amp;lt;4 nodes: HR = 0.41; 95%CI: 0.17\u20130.94). In terms of IFCs, extensive lymph node dissection led to significantly increased levels of IL-6, IL-4, IL-10 and TNF-\u03b1 after SR (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05). Consensus clustering based on the IFCs identified two subgroups (Cluster 1 and 2) in TCGA cohort with distinct immune and cell death profiles, including differences in immunogenic cell death and damage-associated molecular patterns. Cluster 2 exhibited a higher Tumor Immune Dysfunction and Exclusion (TIDE) and tumor mutation burden scores. Similar findings were observed in our validation cohort, where Cluster 2 displayed higher number of neoantigens. The Bayesian meta-analysis also corroborated that increased LNY did not improve RFS (HR = 0.98; 95%CI: 0.20\u20132.94) in pathological stage I LUAD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Increased LNY during SR might confer no additional benefits to RFS for p-stage I LUAD. Excessive removal of LNs might exert adverse impact on physical sensitivity to immunochemotherapy. Personalized lymph node management should be adopted for selected node-negative disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmolb.2026.1727569","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:24:39Z","timestamp":1774329879000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic impact of the lymph node yield on survival in patients with stage I lung adenocarcinoma receiving sublobar resection"],"prefix":"10.3389","volume":"13","author":[{"given":"Yongzhong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuejun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qifeng","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongbing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiming","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.jtcvs.2018.02.095","article-title":"Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer","volume":"156","author":"Ajmani","year":"2018","journal-title":"J. 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